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Institut für Pathologie - European Society for Medical Oncology · PDF file 2017. 11. 24. · Institut für Pathologie Institut für Pathologie Prof. Dr.Med. Leticia Quintanilla-Fend

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Folie 1histology Cytology
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• Increases diagnostic accuracy
Cell lineage determination
Peripheral T-cell lymphomas from 41% to 86%
• Gives prognostic information
Rearrangement of BCL-2
Rearrangement of BCL-1
BRAF
Increases diagnostic accuracy
Peripheral T-cell lymphomas from 41% to 86%
• Gives prognostic information
Pan-B cell marker +
Precursor B-ALL/LBL
most MCL CLL
rare DLBCL & MZL
• LEF-1 is expressed normally in T-cells
• LEF-1 is expressed by B-cell precursors and CLL but not in mature B-cells
• LEF1 is a transcription factor involved in the Wnt signaling pathway
Lymphoid enhancer binding factor-1 (LEF-1)
• Most MCL are positive including the cases of cyclin D1 negative
– (CycD1-,CD5+, Sox11+)
• Some Burkitt lymphoma, lymphoblastic lymphomas and T-prolylmphocytic leukemias are postive
Sox 11 expression in Mantle cell lymphoma
Mozos A et al. Haematologica 2009;94:1555-1562
Sox 11
Kappa Lambda
• Immunophenotype
• PAX5 (90%)
Classical Hodgkin lymphoma T-cell rich large B-cell lymphoma
2
Pan-T cell marker +
Precursor T-ALL/LBL
Biomarkers of cell lineage/differentiation
found in activated reactive cells (ICOS,
PD1)
markers needed for TFH assessement
- interprete in the pathological/clinical
Biological Prognostic markers.
Other molecules
– PCR based techniques
• Quantitative (Real-time PCR)
• Qualitative (clonality analysis)
• Interphase FISH can be apply to paraffin-tissue
• Best method to detect
Fluorescence in situ hybridization (FISH)
Break-apart FISH Fusion FISH
tel
CCND1/
• Diagnostic ancillary methods
PCR based techniques
• Quantitative (Real-time PCR)
• Qualitative (clonality analysis)
t(2;12)
AS-PCR with melting curve for mutations with hot spots.
Wild type MYD88 L265P Mutation
MYD88 mutation analysis (LPL)
Wild type
Schmidt J et al, BJH 2015, 169:795-803 Bonzheim I et al Blood 2015
TNFRSF14 mutations in PFL
Coverage: 1336
Allele frequency:
PFL29 TNFRSF14 Reverse
• Immunoglobulin gene or T-cell receptor gene rearrangements – Malignant vs. bening
– Cell lineage B vs T
• Diagnosis of residual disease
• In disease – Unique molecular fingerprint
– Determination of clonal relationship
– Transformation vs. second malignancy
Monoclonal peak FR3 Faint polyclonal background
GeneScan
Automated fragment length analysis
• Predominance of T-cells, rimming of fat cells
35-year-old woman,
Subcutaneous nodules
neoplasia is found!
Discordant lymphomas
Bone marrow
Lymph node
60-year-old male, with history of CLL now with retroperitoneal lymphadeno- pathy, B-symptoms, lymphocytosis of PB
Richter´s transformation
Approach to the diagnosis of discordant lymphomas
Discordant lymphoma is not associated with an increase risk of CNS involvement
histology Cytology
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