Consolidation of P2Y12 Testing While Maintaining Quality and Turnaround Time

Objective: To consolidate the test performed at 2 different locations at 1, thereby improving cost effectiveness while maintaining quality and result turnaround time.https://jdc.jefferson.edu/patientsafetyposters/1059/thumbnail.jp

Primary CNS small mature B-cell lymphoma with plasmacytic differentiation presenting as an amyloidoma: a case report and review of literature

Primary central nervous system lymphomas (PCNSL) without systemic involvement are rare and account for only 2-3% of all brain tumors and \u3c1% of all non-Hodgkin’s lymphoma (NHL). Close to 40% of PCNSL are associated with immunosuppression, however, the incidence of primary central nervous system (CNS) lymphomas has shown an increasing trend in immunocompetent patients in recent decades due to better control of HIV and drug-induced immunosuppression [2]. Here, we describe a case of a primary CNS non-Hodgkin’s small mature B-cell lymphoma with plasmacytic differentiation in an immunocompetent individual. A previously healthy 87-year-old Caucasian woman presented to the neurology clinic with complaints of slowly progressing left sided weakness, predominantly in the left arm and leg over the last 6 months. Magnetic resonance imaging of the brain revealed a large, confluent white matter T2-hyperintensity in the right frontal lobe with multifocal nodular enhancement involving the left cerebral hemisphere, cerebellum, and leptomeninges, consistent morphologically with lymphoplasmacytic lymphoma. A bone marrow biopsy showed normal trilineage hematopoiesis with no evidence of lymphoma, myeloma or amyloidosis. Our patient was treated with Rituximab but developed an ischemic infarct of the left frontal white matter. She and her family decided to forego further treatment and switch to hospice care

Clinico-pathological features and PD-1/PD-L1 Expression in Primary Mediastinal Large B Cell Lymphoma

Primary Mediastinal Large B Cell Lymphoma (PMBCL) is a distinct subtype of Diffuse Large B Cell Lymphoma (DLBCL) that has been historically reported to have a worse prognosis than DLBCL. Occasional studies have reported PD-L1 expression in PMBCL, which can emerge as an important target for immune-check point therapy. This study aimed to evaluate clinico-pathological features and characterize the expression of PD-1 and PD-L1 in a single cohort of 15 patients with PMBCL. A total of 15 cases of PMBCL were retrieved from records of the department of Pathology; eleven of these had tissue available for additional immunohistochemistry, specifically, PD-L1 (clone SP142) and PD-1 (clone NAT105). A cut-off of ≥30% was used for PD-1 and PDL-1 expression in tumor cells, and ≥20% for tumor-infiltrating lymphocytes (TILs) and tumor-associated macrophages (TAMs). The median age was 42 years (23-83 years), and 9 of 15 (60%) patients were females. Of the 8 patients with clinical data, three (38%) received aggressive R-EPOCH therapy and responded. Tumor cells showed positive PD-L1 expression in only 1 case (9%), and TAMs showed positive PDL-1 expression in seven cases (64%). None of the cases analyzed showed positive PD-1 expression in TCs, while four cases (36%) showed positive PD-1 expression in TILs