uso racional de la...
TRANSCRIPT
G. MassarelliUniversidad de Sassari
Italia
Uso racional de la
InmunohistoquímicaPatología linfáticaAplicación práctica
XV Congreso de la Sociedad Cubana de
Anatomía Patológica (SCAP) &
V Congreso de la División Cubana de la
International Academy of Pathology (IAP)
Curso Post-Congreso
15 de noviembre de 2019
INOR - La Habana CUBA
Case 1 (S-18-610)
Female patient, 45 yrs
Bilateral cervical, mediastinal and abdominal lymph node
enlargement
Surgical biopsy: Right supraclavicular lymph node
Lymph node (1 cm in diameter) with soft consistency,
grayish-brown in color. Small fragments, the longest of them
of about 0.8 mm in length
Clinical presentation
Case 1(S-18-610)
Differential diagnoses
DLBCL (polymorphic)
BL
ALCL
CHL anaplastic
T/HRLBCL
CD 20
CD 3
CD 30
1st line antibodies
CD 20
CD 3
CD 30
Case 1(S-18-610)
CD 20 all cells are positive
CD 3 only a few mature T cells
CD 30 negative on polymorphic cells
Results Exclusion
T/HRLBCL
ALCL
CHL
Remain
DLBCL
BL
CD 10, BCL 6, MUM 1
MYC, BCL 2, EBV, Ki 67, CD 138
2nd line antibodies
CD 10
BCL 6
MUM 1
Ki 67
MYC
CD 138 LMP1
BCL 2
Case 1(S-18-610)
Results Interpretation
CD 10 all cells are negative
BCL 6 scarce positivity
MUM 1 good positivity
BCL 2 > 60% positivity
EBV negativeNo Burkitt lymphoma
Non-GCB lymphoma
MYC > 70% positivity
Ki 67 > 75% positivity
Final diagnosis
Case 1(S-18-610)
High grade B-cell lymphoma,
MYC & BCL 2 double expressor
Case 2(S-18-2091)
Clinical presentation
Female patient, 52 yrs
Paravertebral (lumbar region) mass
Retroperitoneal lymphadenopathy
Core biopsy TC-guided:
Three filaments, the longest of them was
about 1.4 cm.
Case 2(S-18-2091)
Differential diagnoses
DLBCL (polymorphic)
BL
T/HCRLBCL
1st line antibodies
CD 20
CD 3
CD 20
CD 20
CD 3
Case 2(S-18-2091)
CD 20 all cells are positive
CD 3 only a few mature T cells
Results Exclusion
T/HRLBCL
Remain
DLBCL
BL
CD 10, BCL 6, MUM 1
MYC, BCL 2, EBV, Ki 67, CD 138
2nd line antibodies
CD 10
BCL 6
MUM 1
Ki 67
MYC
LMP 1 BCL 2
Case 2(S-18-2091)
Results
Non-GCB lymphoma
Interpretation
No Burkitt lymphoma
CD 10 all cells are negative
BCL 6 negative
MUM 1 good positivity
BCL 2 > 75% positivity
EBV negative
MYC > 85% positivity
Ki 67 > 85% positivity
Final diagnosis
Case 2(S-18-2091)
High grade B-cell lymphoma,
MYC & BCL 2 double expressor