ObjectiveTo highlight the characteristics of pulmonary MALT lymphoma with diffuse lung disease. MethodsThe clinical,radiological and pathological data of two patients with pulmonary MALT lymphoma were analyzed,and relevant literature was reviewed. ResultsOne patient was a 59-year-old male with cough for five years while antibiotic treatment was ineffective. The chest CT scan demonstrated diffuse lung disease,bilateral multiple consolidation and ground-glass opacities,small nodules and bronchiectasis. Thoracoscopy biopsy was performed and the pathology study confirmed the diagnosis of MALT lymphoma. Another case was a 50-year-old female,who suffered from fever,cough and dyspnea. The chest CT scan revealed bilateral multiple patchy consolidation,with air bronchogram. The eosinophils count in blood was high. Diagnosed initially as eosinophilic pneumonia,she was treated with corticosteroids. The clinical symptoms were improved,but the CT scan revealed no change. After the computed tomography guided percutaneous lung biopsy,pathological examination confirmed the diagnosis of MALT lymphoma. ConclusionMALT lymphoma with diffuse lung disease is rare and easy to be misdiagnosed. The positive rate of bronchoscopy is low and percutaneous lung biopsy or thoracoscopy biopsy is more useful for diagnosis.
ObjectiveTo detect the frequency of anaplastic lymphoma kinase (ALK), ROS1 and RET fusion genes in non-small cell lung cancer (NSCLC) patients in Sichuan, and analyze their correlation with clinical features of NSCLC. MethodsReverse transcription-polymerase chain reaction (RT-PCR) was performed to examine gene rearrangement of ALK, ROS1 and RET fusion genes in 310 NSCLC patients who were admitted in Department of Pulmonary Neoplasm of Sichuan Cancer Hospital from March 2009 to March 2012. There were 234 male and 76 female patients with their median age of 60 years (range, 29 to 77 years). There were 164 patients with a smoking history. Histological types included adeno-carcinoma (AC) in 142 patients, squamous cell carcinoma (SCC) in 138 patients, adenosquamous carcinoma in 10 patients, and other types in 20 patients. Patients, gender, age, smoking history, histological types and TNM staging were also collected. Correlations between fusion genes and clinical features were analyzed. ResultsAmong the 310 patient:15 patients with ALK fusion genes were identified (EML4-ALK) with a positive rate of 4.84%, including 14 patients with AC and 1 patient with SCC. ALK fusion genes were more common in patients under 60 years, without a smoking history, and with AC (P < 0.05). ALK fusion genes were not significantly correlated with gender or histodifferentiation. One patient with ROS1 fusion genes (CD74-ROS1) was identified with a positive rate of 0.32%, who was AC patients. Two patients with RET fusion genes (KIF5B-RET) were identified with a positive rate of 0.64%, both of whom were AC patients. ConclusionsGene rearran-gement rates of ALK, ROS1 and RET in NSCLC patients in Sichuan are 4.84%, 0.32% and 0.64% respectively. Patients with negative gene mutation of epithelial growth factor receptor (EGFR), AC, younger age, without a smoking history or with a light smoking history are more common to have ALK gene rearrangement. Gene rearrangement rates of ROS1 and RET are low, and their clinical significance needs more research.
ObjectiveTo study the clinicopathological features of mediastinum nodular sclerosis Hodgkin lymphoma (NSHL) in order to improve the recognition of it. MethodsThe clinical data of 3 cases of mediastinum NSHL between 2003 and 2012 were collected. Then we analyzed the carcinoma pathologic samples by pathomorphology, immunophenotypic phenotype, related gene rearrangement and situ hybridization with EBER. ResultsThe pathomorphologic results showed that broad fibrotic bands subdivided the lymphoid parenchyma into large nodules, the tumoral cells had distinct boundary with empty cytoplasm and small-to-medium-sized nucleoli, and the nodules contained inflammatory cell components. The immunophenotypic phenotype of the tumoral cells were CD15, CD30, PAX-5 and CD20 partly, but anaplastic lymphoma kinase, CD45, cytokeratin, CD79α and S-100 were not expressed. T cell receptor γ and IgH gene were no rearranged, and EBER in situ hybridization was not detected. ConclusionVarious lymphomas occur in the mediastinum and mediastinum NSHL is just one of them. Mastering its distinctive pathomorphology and immunophenotypic phenotype is highly significant for diagnosis, differential diagnosis and treatment of the disease.