bcl-2与乳腺癌耐药蛋白基因在弥漫大B细胞淋巴瘤中表达的意义

目的 研究bcl-2和乳腺癌耐药蛋白(BCRP)基因在非霍奇金淋巴瘤(NHL)中的表达及其相关性.方法 对初治弥漫大B细胞淋巴瘤(DLBCL)患者(40例)淋巴结组织液,采用流式细胞术(FCM)及反转录聚合酶链反应(RT-PCR)技术定量检测其BCRP mRNA的表达,同时将患者标本常规石蜡包埋、HE染色和链霉菌素牛物素技术(LSAB)免疫组织化学法标记bcl-2蛋白表达.结果 40例DLBLC患者的bcl-2与BCRP的阳性表达率分别为60.0%(24/40),37.5%(15/40),不同临床分期的DLBCL患者,BCRP阳性表达率差异有统计学意义(x2=6.0606,P<0.05).bcl-2、BCRP表达阳性组有效率低于表达阴性组,差异有统计学意义(x2=5.7618,P<0.05;x2=6.5541,P<0.05);bcl-2和BCRP表达均阳性与均阴性患者的疗效比较,差异无统计学意义(x2=2.0263,P>0.05).结论 BCRP可能在DLBCL的原发多药耐药中发挥重要作用,并有助于化疗疗效的评估及提示疾病转归;bcl-2在DLBCL中的表达对肿瘤恶性程度及预后的判断均有一定意义;联合检测bcl-2和BCRP基因对评价DLBCL预后有较大意义.     

Choi和Hans分型在弥漫大B细胞淋巴瘤预后评价中的意义

目的 探讨Choi和Hans分型在弥漫大B细胞淋巴瘤(DLBCL)预后评价中的意义.方法 收集山西省肿瘤医院病理科有详细随访资料的DLBCL 99例,用免疫组织化学EnVision法检测bcl-2、bel-6、CD10、FOXP1、GCET1、MUM-1的表达情况.根据Choi和Hans两种分类法分别将所有病例分型.其中35例应用荧光原位杂交技术检测bcl-6基因重排情况.结果 按Hans分类法生发中心B细胞(GCB)型21例,非GCB(nonGCB)型78例;按Choi分类法GCB型23例,nonGCB型76例.GCB型生存率明显优于nonGCB型,差异有统计学意义(P=0.000).FOXP1蛋白阳性表达与预后呈负相关(P=0.011),GCET1阳性表达则与预后呈正相关(P=0.027).在35例DLBCL患者中.bcl-6基因重排阳性高发于nonGCB型患者,bcl-6基因重排与bcl-6蛋白的表达没有明显相关性.结论 Choi和Hans两种分类法免疫分型GCB型预后都优于nonGCB型.bcl-6、FOXP1、GCET1的表达与预后有相关性.Choi及Hans分类法对DLBCL的免疫分型、临床预后估计均有应用价值.     

儿童侵袭性成熟B细胞淋巴瘤的临床病理学及分子遗传学特点

目的 分析总结中国儿童各类型侵袭性成熟B细胞淋巴瘤的临床病理学及分子遗传学特点,为其诊断的标准化提供依据.方法 收集97例儿童侵袭性成熟B细胞淋巴瘤石蜡包埋组织标本,包括伯基特淋巴瘤(BL)81例、弥漫大B细胞淋巴瘤(DLBCL)8例、介于BL和DLBCL间的不能分类的B细胞淋巴瘤(BL/DLBCL)8例,利用免疫组织化学技术和间期荧光原位杂交(FISH)技术检测其免疫表型和分子遗传学特征.结果 BL的bcl-2和MUM1的阳性率分别为3%(2/66)和17%(12/71),DLBCL分别为50%(4/8)和63%(5/8),BL/DLBCL分别为50%(4/8)和63%(5/8).BL、DLBCL和BL/DLBCL的Ki-67平均值分别为(93±4.4)%、(83±14.3)%和(80±11.5)%.BL、DLBCL和BL/DLBCL的c-myc基因易位的比例分别为98%(79/81)、38%(3/8)和50%(4/8).38%(3/8)的DLBCL和25%(2/8)的BL/DLBCL存在bcl-6基因的多拷贝,BL与DLBCL之间、BL与BL/DLBCL之间bcl-2、MUM1和Ki-67平均值的差异及c-myc基因易位和bcl-6基因多拷贝的差异均有统计学意义(均P＜0.05).结论 儿童侵袭性成熟B细胞淋巴瘤的诊断和分型需要综合分析形态学、免疫表型和分子遗传学特征.儿童BL/DLBCL可能是DLBCL的一个亚型.CD10+、bcl-6+、bcl-2-、Ki-67＞90%、伴有IGH/c-myc重排、不伴有bcl-2和bcl-6重排时,支持BL的诊断;bcl-2+、Ki-67为50%～90%,同时伴有bcl-6基因的多拷贝时,支持DLBCL或BL/DLBCL的诊断.     

葛根总黄酮诱导白血病细胞株凋亡及其分子机制的研究

目的 探讨葛根总黄酮(PR)对慢性粒细胞白血病(CML)细胞株K562和急性早幼粒细胞白血病(APL)细胞株NB4细胞增殖及凋亡的影响.方法 采用MTT法检测PR对K562细胞、NB4细胞的增殖抑制率;光学显微镜及荧光显微镜观察细胞形态改变;Hoechest33258荧光染色AnnexinV/PI双染法检测细胞凋亡率;DNA PI染色法分析细胞周期及亚二倍体峰.Western blot分别检测NB4细胞JNK、PARP、bcl-2、Caspase3,K562细胞bcr-abl、p53、bcl-2、Fas/FasL蛋白表达的变化.结果 12.5～200 μg/ml PR均能抑制K562、NB4细胞增殖.光学显微镜及荧光显微镜下观察到核固缩、凋亡小体等典型的细胞凋亡改变;Annexin V+/PI-细胞呈时间-剂量依赖性增加;DNA PI染色法发现细胞亚二倍体比例增加,G1期比例下降、S期比例增加.PR呈时间-剂量依赖性抑制K562细胞、NB4细胞增殖,诱导细胞凋亡.不同浓度PR干预后K562细胞bcr-abl蛋白水平呈浓度依赖性下调(F=18.74,P<0.05),而bcl-2则无明显变化;p53表达呈浓度依赖性上调;Fas/FasL表达无明显变化.NB4细胞JNK、PARP及Caspase 3蛋白表达与PR浓度呈正相关,与凋亡抑制蛋白bcl-2则呈负相关(F=42.32,P<0.05).结论 PR能有效抑制K562、NB4细胞增殖,阻滞细胞周期进程,诱导细胞凋亡,但分子机制不同.提示一定浓度PR具有较广谱的抗白血病效应.     

MTAP、CDKN2A和CDKN2B在弥漫大B细胞淋巴瘤中的表达及其临床意义

目的 研究弥漫大B细胞淋巴瘤(DLBCL)MTAP、CDKN2A和CDKN2B基因的表达及其临床意义.方法 以实时定量聚合酶链反应(PCR)方法检测40例DLBCL及19例淋巴结反应性增生组织中MTAP、CDKN2A和CDKN2B基因的表达情况,结合临床特征进行分析,并进行随访.结果 DLBCL组MTAP、CDKN2A和CDKN2B基因表达水平较淋巴结反应性增生组降低,差异有统计学意义(P值分别为0.024、0.044和0.047);三者表达均与Ann Arbor临床分期相关(P值分别为0.004、0.001和0.027);与患者的性别、年龄、淋巴结外病变累及、ECOG体力评分、骨髓累及、血清乳酸脱氢酶水平均无明显相关(均P＞0.05).其中MTAP与CDKN2A基因表达情况还与B症状(P值分别为0.003和0.028)和国际预后指数(IPI)相关(P值分别为0.001和0.011).此外,生存分析结果显示,MTAP、CDKN2A和CDKN2B基因表达水平与患者总生存期相关(P值分别为0.022、0.019和0.042).结论 MTAP、CDKN2A和CDKN2B基因在DLBCL中呈低水平表达,与疾病进展和患者预后有关,可作为反映其生物学行为和评估患者临床疗效的分子标志物.     

弥漫大B细胞淋巴瘤细胞耐药的研究进展

弥漫大B细胞淋巴瘤(DLBCL)化疗耐药的主要原因是细胞耐药.研究表明DLBCL细胞耐药与耐药基因及其耐药相关蛋白、细胞因子、黏附分子有关,并在造血微环境中通过信号转导介导细胞耐药.     

硼替佐米对白血病细胞株HEL抑制作用的初步探讨

目的 探讨硼替佐米单独或联合化疗药物对急性白血病细胞株HEL生长的影响及其机制.方法 MTT法检测药物对HEL的生长抑制效应,流式细胞术检测细胞周期变化及凋亡,Western blotting检测凋亡及细胞周期相关蛋白表达.结果 硼替佐米对HEL细胞的生长抑制作用呈浓度依赖关系,其半数抑制浓度(IC50)为7.15 nmol/L;硼替佐米联合化疗药物明显增强抑制HEL细胞生长;流式细胞术检测可见时间依赖性的G2/M周期阻滞;Western blotting检测显示bcl-2表达下降,bax、p27表达增高,联合用药时具有相加效应,但不管是单独或联合用药,p53蛋白的表达均无明显改变.结论 硼替佐米可能是一种有效治疗急性白血病的药物,与柔红霉素联合应用有更强的抑制肿瘤细胞生长和诱导其凋亡的作用,其机制可能与bcl-2,bax及p27蛋白的调节有关,是非p53依赖性的.     

P53突变蛋白表达对弥漫大B细胞淋巴瘤预后的预测作用

目的 探讨p53突变蛋白表达对弥漫大B细胞淋巴瘤(DLBCL)预后的预测作用,指导个体化治疗.方法 随机选择初治DLBCL患者62例,应用免疫组织化学方法检测p53突变蛋白和CD10、bcl_6、MUM1的表达,分析p53突变蛋白表达与患者临床特征、分子分型以及预后的关系.结果 48.4%(30/62)的患者表达p53突变蛋白.p53突变蛋白表达与初始治疗反应有关(x2=20.365,P=0.040),阳性组的完全缓解率为33.3%(10/30),阴性组为59.4%(19/21);与分子分型有关(x2=31.023,P=0.021),阳性组非生发中心型比例显著高于阴性组,分别为83.3%和56.2%;与其他临床特征无关.多因素生存分析显示p53突变蛋白表达是独立的预后预测因子,阳性组的无进展生存期和中位生存期均短于阴性组(x2=36.784,P=0.005和x2=35.276,P=0.006).结论 p53突变蛋白表达是DLBCL独立的不良预后因子,能够用来指导个体化治疗.     

NF-κB信号通路的阻断对皮肤鳞癌SCL-1细胞凋亡的影响

目的:利用siRNA技术抑制核因子-kappa B(nuclear factor-kappa B,NF-κB)亚单位p65基因的表达,研究其对p65表达的抑制作用,并探讨其对皮肤鳞癌SCL-1细胞凋亡的影响.方法:将终浓度为50 nmol/L的p65 siR-NA转染皮肤鳞癌SCL-1细胞,通过RT-PCR检测p65 mRNA的表达;利用Western blotting检测p65、bcl-2和bax蛋白表达,利用Caspase-Glo(R)-3/7,8和9检测试剂盒检测caspase-3/9的活性;最后通过流式细胞术检测细胞凋亡.结果:p65 siRNA转染SCL-1细胞后的48 h,p65 mRNA的表达水平最低,与0 h相比,差异有统计学意义(0.23±0.10vs.0.66±0.05,P＜0.05);转染48 h后,p65和bcl-2蛋白表达水平下调,而促凋亡蛋白bax的表达上升,进一步caspase-3/9的活性也显著升高.流式细胞术结果表明,p65 siRNA能明显诱导SCL-1细胞发生凋亡,其早期凋亡的比率为20.28%±1.87%,显著高于未处理组和对照siRNA组(凋亡率分别为9.13%±1.51%和9.37%±1.38%,F=47.532,P＜0.01).结论:p65 siRNA能够阻断皮肤鳞癌细胞中NF-κB信号通路,并下调抑凋亡蛋白bcl-2的表达,上调促凋亡蛋白bax的表达以及提高caspase的活性,提示NF-κB信号通路有望成为皮肤鳞癌基因治疗的分子靶点.     

非霍奇金淋巴瘤中枢神经系统累及的诊断和预防

非霍奇金淋巴瘤(NHL)患者中枢神经系统(CNS)累及预后不良,其中位生存期2～6个月.与NHLCNS累及相关参数是年轻、进展期、累及结外部位数、乳酸脱氢酶(LDH)增高和国际预后指标(IPI)积分.最有希望的治疗为自体造血于细胞移植,可延长中数生存期10～26个月.处于CNS侵袭高危状态的某些NHL亚型患者需要早期进行CNS预防,如伯基特淋巴瘤(BL)和淋巴母细胞淋巴瘤(LBL).弥漫性大B细胞淋巴瘤(DLBCL)初期治疗时是否需应用CNS预防久有争议,因为它属于CNS累及(≈5%)的低危群体.危险模式的确定有助于预示NHL的CNS复发.     

Molecular pathological analysis of testicular diffuse large cell lymphomas

The molecular pathology of 20 lymphomas, which presented as testicular masses in patients with no evidence of previous lymphoma, was analyzed. These lymphomas occurred in men with a median age of 69 years (range, 37 to 87 years). Nine of the 14 patients with follow-up died of lymphoma (median survival, 12 months). All cases were diffuse large B-cell lymphomas that were positive for CD20 and commonly showed plasmacytoid differentiation (10 of 20 cases). Three cases were Burkitt's-like large cell lymphomas. Infiltration by lymphoma in the seminiferous tubules was seen in most cases. All lymphomas were negative for human herpesvirus 8 and Epstein-Barr virus by 35 cycles of polymerase chain reaction (PCR), suggesting that these viruses are not involved in the pathogenesis of primary testicular diffuse large B-cell lymphomas (DLBCL). PCR-based studies for t(14;18) and t(11;14) translocations, commonly seen in follicular and mantle-cell lymphomas, were negative in all cases. Nucleotide sequences of the V-D- and J segments of the immunoglobulin heavy chain gene (IgH) rearrangements obtained in 12 cases after PCR amplification were analyzed and compared with known germlines. The frequency of VH-family use in testicular DLBCL was similar to that reported for normal peripheral blood lymphocytes and follicular lymphomas. This contrasts with the previously published findings of preferential use of the VH3- or VH4-family by nodal DLBCL. Comparison with the published germlines showed a low similarity index in most of the cases, suggesting the presence of extensive somatic mutations. Ongoing mutation, as indicated by intraclonal variation in IgH sequence, was observed in all sequenced cases, suggesting direct antigen stimulation, which represents another difference between primary testicular and nodal DLBCL. Our results suggest that testicular lymphomas represent a subset of DLBCL that differs from their nodal counterparts in several respects. Their histological and molecular features show some similarities to those seen in marginal zone (MALT) lymphomas.     

Primary cutaneous large B-cell lymphomas of the legs. A distinct type of cutaneous B-cell lymphoma with an intermediate prognosis. Dutch Cutaneous Lymphoma Working Group

BACKGROUND AND DESIGN: Primary cutaneous follicular center cell lymphomas represent a distinct type of cutaneous B-cell lymphoma, clinically characterized by localized skin lesions on the head or trunk and an excellent prognosis. Histologically similar lymphomas may occur on the legs. The clinical behavior of this group is still undefined, and controversy exists whether these lymphomas should be classified as follicular center cell lymphoma or B-immunoblastic lymphoma. We reviewed the clinical, histologic, and follow-up data of 18 patients with primary cutaneous large B-cell lymphoma of the legs. RESULTS: Primary cutaneous large B-cell lymphoma of the legs generally occurred in elderly patients (median age at diagnosis, 76 years), in particular women (male-female ratio, 7:2), and preferentially affected the lower legs (14 of 18 patients). Radiotherapy and/or systemic polychemotherapy resulted in complete remissions in 16 of 17 patients. Follow-up data demonstrated estimated 2- and 5-year survival rates of 77% and 58%, respectively. Histologic evaluation showed diffuse dermal infiltrates with variable proportions of centroblasts (large noncleaved cells), large centrocytes (large cleaved cells), and B immunoblasts. Seventeen of 18 patients were diagnosed as having primary cutaneous follicular center cell lymphoma; only 1 patient, whose histologic examination showed more than 30% immunoblasts, was diagnosed as having B-immunoblastic lymphoma. CONCLUSIONS: Primary cutaneous large B-cell lymphoma of the legs is a distinct clinicopathologic entity that mainly affects elderly patients and has an intermediate prognosis. Although most cases have a follicular center cell origin, primary cutaneous large B-cell lymphoma is proposed as the most appropriate term for this type of cutaneous lymphoma.     

Ocular adnexal lymphoma. A clinicopathologic study with identification of lymphomas of mucosa-associated lymphoid tissue type

PURPOSE: Extranodal marginal zone B-cell lymphoma (low-grade B-cell lymphoma of mucosa-associated lymphoid tissue [MALT] type) is a distinctive type of lymphoma that usually arises in association with mucosa or other epithelial structures and has an indolent clinical course. The frequency and clinical features of MALT lymphomas in the ocular adnexa have not been well studied. METHODS: The authors examined the clinicopathologic features of ocular adnexal lymphoma, identified a subset of cases with MALT characteristics, and determined patient outcome. RESULTS: The 42 patients, 16 men and 26 women age 35-89 years (mean, 64) were followed an average of 4.8 years. Thirty-two patients had ocular adnexal involvement at presentation (primary ocular adnexal lymphoma) and 10 had a history of lymphoma that relapsed in the orbit (secondary ocular adnexal lymphoma). In the primary group, 23 patients had lymphoma confined to the ocular adnexa, 3 had a single lesion that invaded adjacent structures, and 6 had distant spread at the time of presentation. Twenty-five patients achieved a complete remission. Nine patients, including 6 patients whose disease was localized initially, had progression or relapse of disease in distant sites. At last follow-up, 21 patients were free of disease, 9 were alive with disease and 2 had died of lymphoma. In the secondary group, at last follow-up, 1 patient had died of other causes, free of lymphoma, 3 patients were alive with disease and 5 had died of lymphoma (outcome not known in 1 case). Using the recently described revised European-American lymphoma classification, we found 16 MALT lymphomas, 8 diffuse large B cell, 12 follicular center, 3 mantle cell, 1 B-small lymphocytic lymphoma, and 2 unclassifiable low-grade lymphomas. The most common type of primary lymphoma was MALT type (15 of 30 classifiable cases), and the most common secondary lymphoma was follicular center (6 of 10). No increased frequency of conjunctival or lacrimal gland involvement by MALT lymphomas was found. All 33 lymphomas with immunophenotyping were of B lineage. CONCLUSIONS: Ocular adnexal lymphomas are B-cell tumors that develop in older adults, predominantly among women. Primary orbital lymphomas have a favorable prognosis; a high proportion of them have MALT characteristics.     

Gastrointestinal lymphomas: an overview with emphasis on new findings and diagnostic problems

The first section of this article summarizes the salient clinicopathologic features of the more common types of primary gastrointestinal lymphomas, the recent explosion of information on the low grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), and new findings on multiple lymphomatous polyposis and ulcerative jejunitis. The second section discusses the practical problems that may be encountered in the diagnosis of gastrointestinal lymphomas, including diagnosis of large cell malignancies, distinction between lymphoma and reactive lymphoid hyperplasia, classification of diffuse small B-cell lymphomas (including the potential pitfall of mistaking Burkitt's lymphoma for small B-cell lymphoma), recognition of large cell transformation in low-grade B-cell MALT lymphoma, assessment of gastric biopsies from MALT lymphoma patients after anti-Helicobacter therapy, and assessment of nodal or splenic involvement in low-grade MALT lymphoma.     

The B7/BB1 antigen is expressed by Reed-Sternberg cells of Hodgkin's disease and contributes to the stimulating capacity of Hodgkin's disease-derived cell lines

The B7/BB1 molecule has recently been found to be expressed on professional antigen-presenting cells and to be the natural ligand for CD28 and CTLA-4 on T cells. On binding of B7/BB1, CD28 transduces a signal that synergizes with triggering of the T-cell antigen receptor, resulting in enhanced cytokine secretion. In view of the data supporting an antigen-presenting function of Reed-Sternberg cells, we evaluated the expression of B7/BB1 in lymph nodes affected by Hodgkin's disease. B7/BB1 was found to be strongly expressed by the Reed-Sternberg cells in all 47 cases of Hodgkin's disease studied. Moreover, Reed-Sternberg cells were frequently surrounded by CD28-expressing T cells. Evidence for a functional role of B7/BB1 on Reed-Sternberg cells was obtained by our findings that T-cell proliferation and interleukin-2 (IL-2) production in the primary allogenic mixed lymphocyte reaction (MLR), using the B7/BB1-expressing Hodgkin's disease-derived cell lines L428 and KM-H2 as stimulators, could be partially blocked by adding anti-B7 monoclonal antibody. B7/BB1 expression was also evaluated in a group of non-Hodgkin's lymphomas (n = 46). Whereas B7/BB1 was not expressed by the neoplastic cells of most non-Hodgkin's lymphomas, including T-cell-rich B-cell lymphoma (n = 11), it was present on the neoplastic cells of anaplastic large-cell lymphoma (Ki-1 lymphoma) (n = 5) and follicular lymphoma (n = 4). Our data provide further evidence for an accessory cell function of Reed-Sternberg cells. The accessory cell function of Reed-Sternberg cells might lead to pronounced T-cell activation in vivo, which might contribute to the Hodgkin's syndrome. In addition, our study indicates that B7/BB1 may be a useful marker for differentiating Hodgkin's disease from morphologically similar conditions such as T-cell-rich B-cell lymphoma.     

VH gene analysis of primary cutaneous B-cell lymphomas: evidence for ongoing somatic hypermutation and isotype switching

Primary cutaneous B-cell lymphomas are B-cell non-Hodgkin's lymphomas that arise in the skin. The major subtypes discerned are follicle center cell lymphomas, immunocytomas (marginal zone B-cell lymphomas), and large B-cell lymphomas of the leg. In this study, we analyzed the variable heavy chain (VH) genes of 7 of these lymphomas, ie, 4 follicle center cell lymphomas (diffuse large-cell lymphomas) and 3 immunocytomas. We show that all these lymphomas carry heavily mutated VH genes, with no obvious bias in VH gene usage. The low ratios of replacement versus silent mutations observed in the framework regions of 5 of the 7 lymphomas suggest that the structure of the B-cell antigen receptor was preserved, as in normal B cells that are selected for antibody expression. Moreover, evidence for ongoing mutation was obtained in 3 immunocytomas and in one lymphoma of large-cell type. In addition, in 1 immunocytoma, both IgG- and IgA-expressing clones were found, indicative of isotype switching. Our data provide insight into the biology of primary cutaneous B-cell lymphomas and may be of significance for their classification.     

Effects of maternal exercise on fetal activity in late gestation

Sixty malignant non-Hodgkin's lymphomas originating in the upper aerodigestive tract have been analyzed for their cytologic type, immunophenotype and association with the Epstein-Barr virus (EBV). The majority of these tumors were B-cell lymphomas of blastic cytology (78%) with the exception of lymphomas in the parotid gland. Large B-cell lymphomas were the most frequent encountered in the sinonasal region and Waldeyer's ring. Twelve lymphomas were of T- or T/NK (natural killer)-cell lineage. They were in the nasal cavity and the paranasal sinuses (4), the tonsil (5), and the oral cavity (3). Epstein-Barr sequences were detected in five angiocentric T/NK-lymphomas, one peripheral T-cell lymphoma, one lymphoma of lymphomatoid granulomatosis type, one large B-cell lymphoma, and in a lymphoroliferative disorder in an HIV-positive patient. These results suggest that EBV is not involved in lymphomagenesis of B-cell tumors, but is associated with angiocentric T/NK-cell lymphoma in the upper aerodigestive tract.     

Peculiarity of soleus motor potentials evoked by transcranial magnetic stimulation and electrical stimulation of tibial nerve

Fas (Apo-1/CD95) ligand (FasL) is a cytotoxic molecule used by T lymphocytes and natural killer cells for target-cell killing and by nonmalignant and malignant cells in the suppression of immune responses. In this study, FasL expression in B- and T-cell non-Hodgkin's lymphomas was investigated by paraffin immunohistochemical analysis. FasL expression was found to be weak in nonaggressive lymphomas (chronic lymphocytic leukemia/small lymphocytic lymphoma, lymphoplasmacytoid lymphoma, Grade 1 follicular center cell lymphoma) and mantle cell lymphoma but strong in aggressive B-cell lymphomas (diffuse large B-cell lymphoma, Burkitt's-lymphoma). Precursor B-lymphoblastic lymphomas were more heterogeneous, with expression varying from weak to strong. In T-cell lymphomas (anaplastic large-cell lymphoma; peripheral T-cell lymphoma, unspecified), strong FasL expression was observed. Apparently, FasL expression is not limited to neoplasms derived from T cells or natural killer cells, and it might play a supporting role in the progression of non-Hodgkin's lymphomas.     

Nurses achieve quality with pre-assessment clinics

Twelve patients with diagnosis of B-cell non-Hodgkin's lymphoma/leukemia and del[7q] were studied for their clinical, cytogenetic, and molecular characteristics. Eleven patients were classified as small cell lymphoma whereas one had a diffuse large cell lymphoma. Lymphoplasmacytic features were observed in six out of eleven small cell lymphomas. Morphologically and immunologically these small cell lymphomas could be classified as chronic lymphocytic leukemia (typical or atypical; 4 cases), marginal zone lymphoma (splenic lymphoma with villous lymphocytes; 1 case), mantle cell lymphoma (2 cases), or nonspecified, non-Hodgkin's lymphoma (4 cases). Eleven of twelve patients presented with peripheral blood and bone marrow involvement. Two of twelve cases showed del[7q] as the sole anomaly. Two different types of deletions were present: ten cases had del(7)(q21q31) and two cases had del(7)(q31q34). Cases that could be molecularly investigated did not show any involvement of BCL2, BCL3, or BCL6, and only one case had BCL1 rearrangement. The data indicate that del(7q) is associated with a subset of mature small B-cell lymphoproliferative disorders of which some but not all show lymphoplasmatic features.