Concurrent malignant melanoma and cutaneous involvement by classical hodgkin lymphoma (CHL) in a 63 year-old man

ABSTRACT: Classical Hodgkin lymphoma (CHL) is a lymphoproliferative disorder that has a bimodal age distribution, affecting young and elderly individuals, and is curable in more than 90% of patients. Here we report the coexistence of cutaneous CHL and malignant melanoma as the presentation of papules and a plaque, in an individual with remote history of systemic CHL. One of the biopsies showed a mononuclear cell infiltrate with Reed-Sternberg (RS) like cells that were positive for CD30 and CD15, but negative for CD45. A second concurrent biopsy showed an atypical melanocytic proliferation with significant pagetoid spreading and diffuse Melan-A staining. Based on morphology alone, it is almost impossible to distinguish CHL from other primary cutaneous lymphoproliferative disorders, such as CD30+ lymphoproliferative disorder (lymphomatoid papulosis (LyP) and primary cutaneous anaplastic large-cell lymphoma), or even tumor stage mycosis fungoides when the epidermotropism is minimal. Additionally, bizarre melanocytic cells can also appear similar to RS cells. Our case illustrates the first case report of malignant melanoma and CHL in a patient presenting simultaneously. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/897975734993722

FGFR1 amplifi cation and the progression of non-invasive to invasive breast cancer

The incidence of invasive breast cancer (IBC) can be dramatically reduced by improving our abilities to detect and treat ductal carcinoma in situ (DCIS). Progress will be based on a detailed understanding of molecular mechanisms responsible for tumor progression. An interesting study by Jang and colleagues evaluated and compared the frequency of amplification of four oncogenes (HER2, c-MYC, CCND1 and FGFR1) in large cohorts of pure DCIS, in the DCIS component of IBC, and in corresponding IBC. Of particular interest, they found a twofold increase in FGFR1 amplification in IBC versus pure DCIS, and significantly reduced disease-free survival in amplified versus unamplified IBC - leading the authors to conclude that FGFR1 plays an important role in the development and progression of IBC. These observations indeed provide hints that FGFR1 is important in this setting, although the issue is very complex and far from resolved

From individuals to aggregations: the interplay between behavior and physics

This paper analyses the processes by which organisms form groups and how social forces interact with environmental variability and transport. For aquatic organisms, the latter is especially important—will sheared or turbulent flows disrupt organism groups? To analyse such problems, we use individual-based models to study the environmental and social forces leading to grouping. The models are then embedded in turbulent flow fields to gain an understanding of the interplay between the forces acting on the individuals and the transport induced by the fluid motion. Instead of disruption of groups, we find that flows often enhance grouping by increasing the encounter rate among groups and thereby promoting merger into larger groups; the effect breaks down for strong flows. We discuss the transformation of individual-based models into continuum models for the density of organisms. A number of subtle difficulties arise in this process; however, we find that a direct comparison between the individual model and the continuum model is quite favorable. Finally, we examine the dynamics of group statistics and give an example of building an equation for the spatial and temporal variations of the group-size distribution from individual-based simulations. These studies lay the groundwork for incorporating the effects of grouping into models of the large scale distributions of organisms as well as for examining the evolutionary consequences of group formation. � 1999 Academic Press † Author to whom all correspondence should be addressed. 1

Treatment of pagetoid reticulosis with intensity modulated radiation therapy

Pagetoid reticulosis, also known as Woringer-Kolopp disease, is a rare variant of cutaneous T-cell lymphoma usually presenting as an isolated patch or plaque on the extremities.  Immunohistochemical staining of T-cell markers can be variable, but as the name implies the epidermotropic lymphocytes consistently display a “pagetoid” appearance.  The following case demonstrates clearance of this condition with intensity modulated radiation therapy, whereas most cases are managed with electron beam therapy if radiation therapy is implemented

Acute EBV infection masquerading as "In-situ Follicular Lymphoma": a pitfall in the differential diagnosis of this entity

We present the case of a 30 year-old man who was referred for evaluation of diffuse lymphadenopathy. Six weeks prior, he noticed darkening of his urine associated with pale stools, nausea and an eventual 30 lb weight loss within a month. The initial laboratory findings showed elevation of the liver enzymes. A CT scan showed mesenteric and periaortic lymphadenopathy with the largest lymph node measuring 2.8 cm. Other laboratory results were otherwise unremarkable (including a normal LDH) with the exception of positive serum antibodies against Epstein-Barr virus (EBV) associated antigens (IgM+ and IgG+). An excisional biopsy of 4 of the small neck lymph nodes showed a normal architecture with prominent follicles and an intact capsule. But, by immunohistochemistry two of the follicles showed aberrant coexpression of BCL-2, in addition to CD10 and BCL-6. In-situ hybridization for early Epstein-Barr virus mRNA (EBER) and immunohistochemistry for latent membrane protein-1 (LMP-1) stained both scattered positive cells, as well as BCL-2 positive B-cells. Although an original diagnosis of in-situ follicular lymphoma was favored at an outside facility, additional interphase fluorescence in situ hybridization (FISH) studies for t(14;18);(IGH-BCL2) rearrangement (performed on the BCL-2 + follicles microdissected from the tissue block; Abott probe dual colour fusion) and molecular studies (IGH gene rearrangement by PCR, also performed on the microdissected follicles) were negative. Serologic studies (positive EBV antibodies) and immunostains in conjunction with the molecular studies confirmed the reactive nature of the changes. Our case also shows direct immunopathogenic evidence of BCL-2 expression among the EBV-infected cells, which has to our knowledge not been previously documented in vivo. A diagnosis of EBV infection should, therefore, be considered when confronted with BCL-2 expression in germinal centers, particularly in younger individuals, as the diagnosis of FLIS may lead to extensive and invasive haematologic work-ups. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/132365631894006

Donor-free oligothiophene based dyes with di-anchor architecture for dye-sensitized solar cells

Traditionally, metal free DSSCs are fabricated from sensitizers designed using a donor-pi-acceptor (D-π-A) architecture. More recently, non-conventional dyes without strong donor units have emerged and have provided competitive power conversion efficiencies (PCEs) with respect to their (D-π-A)-based counterparts. Here, we report the synthesis and DSSC fabrication of oligothiophene molecules featuring two anchoring groups that do not possess strong donor moieties and are able to adopt V- and U-shape conformations. PCEs of 3.70% was obtained with the smaller 5-thiophene dyes (5T2A, 5T2A-E) possessing higher PCEs than their larger 8-thiophene counterparts containing diacetylene units (8T4A, 8T4A-E). Comparison to the DSSC properties of the analogous linear dye 5T, indicates that the architecture and structure of this series of dyes are likely responsible for their lower performance