Normal colon tissue and colon carcinoma show no difference in heparanase promoter methylation D. Hershkovitz * , Y. Peerless, E. Simon, E. Sabo, O. Ben-Izhak * Rambam Health Care Campus, Dept. of Pathology, Haifa, Israel Objective: Heparanase, the sole heparan sulfate degrading enzyme, has a role in cellular invasion. Accordingly, a large number of studies have demonstrated an association between heparanse expression and tumor stage and patients' prognosis. In colon carcinoma, heparanase shows increased expression in tumor compared to normal tissue and its expression correlates with the presence of metastasis. One of the regulatory mechanisms of heparanase expression is methylation on its promoter. In the present study we evaluated the role of heparanse promoter methylation in colon carcinoma. Method: Analysis of heparanse promoter methylation was done on 32 samples of colon carcinoma as well as 30 sample of normal colonic mucosa. DNA was extracted from FFPE tissue and subjected to bisulfite conversion. The relative fraction of methylated and unmethylated DNA was evaluated with real-time PCR. Results: The fraction of methylated DNA was 1 %±0.6 in the colon carcinoma group, and 2.4 %±0.6 in the normal colon group (P=0.11). Only one case in the normal group and one case in the tumor group showed more than 10 % methylation in the heparanase promoter. Conclusion: We did not find any difference in heparanase promoter methylation between colon carcinoma and normal colonic mucosa, suggesting that heparanase overexpression in colon carcinoma is mediated by other mechanisms. Objective: Among B-cell non-Hodgkin's lymphomas, neural cell adhesion molecule/CD56 expression is exceptional. The aim of this study is to report unusual CD56 (neural cell adhesion molecule, NCAM) expression on diffuse large B cell lymphoma (DLBCL). Method: The panel of antibodies included CD3, CD20, CD10, bcl-2, bcl-6, MUM-1 and CD56. Results: A total of 50 cases of DLBCL were identified and one case was also detected positive for CD56. The subject was female, 48 years old. The patient had presented generalized lymphadenopathy. She had not documented involvement of extranodal sites. The case is alive with disease 1 year after diagnosis and chemotherapy treatment. Objective: A case of mediastinal T-cell lymphoblastic lymphoma with indolent clinical course in a 52-yearold man was studied by immunohistology and molecular biology. Method: Formalin-fixed sample. Histology with Ematox-ilin&Eosin and Giemsa; immunohistochemistry by APAAP method. T-cell receptor gamma rearrangement by BIOMED2 protocols. Results: After one fainting episode the patient was found to have pericarditis caused by a XX-cm-diameter mediastinal mass. The 2 first biopsies were unsuccessful and the third diagnostic one was done 6 months later. In this time-period the patient was well without symptoms and the mass stable. After two mediastinal biopsies with unspecific features (Castleman disease?), the diagnostic one showed fibrosis, abundant small reactive lymphocytes (CD20+/CD3+) and areas with diffuse small-medium size lymphocytes positive for CD3, TdT, CD34, CD7, LMO2 and high Ki67. T-cell receptor gamma genes were monoclonally rearranged. Conclusion: Indolent T-LBL is exceedingly rare: for this reason in our case LMO2 was a key marker for the diagnosis which was delayed for the presence of fibrosis and reactive B cells. Objective: Granulocytic sarcoma (GS), also termed myeloid sarcoma or chloroma, is a rare malignant solid tumor resulting from the extramedullary proliferation of myeloblasts or immature myeloid cells. GS most frequently occurs in patients with acute myeloid leukemia, myeloproliferative neoplasms or myelodysplasia. GS rarely presents in the absence of systemic myeloid disease. GS most commonly occurs in the soft tissues of the head and neck, bone, skin and less often in the central nervous system and spinal cord. Results: A 40 year old woman presented with 1 month history of weakness of both legs. MRI of the thoracal spine showed 4 cm diameter epidural mass compressing the dural sac in the spinal canal at the T9-10 levels. Decompressive laminectomy and tumor removal were performed resulting in neurological improvement. Histologically neoplastic cells have round nuclei with finely dispersed chromatin and scant cytoplasm proliferating in a diffuse pattern. Immunohistochemically, tumor cells were positive for MPO, CD117, CD45, CD99. Diagnosis was GS without bone marrow involvement. Conclusion: We report the case of GS due to unusual localization and nonleukemic presentation. Results: There were 5 males and 1 female with a median age of 40 years (22-79 years). Physical examination shows splenomegaly in all cases and hepatomegaly in 2 cases, hematological parameters shows lymphocytosis with peripheral hairy cells in all cases. Flow cytometric immunophenotyping was done in 2 cases, and confirmed the diagnosis of HCL with CD11c, CD25+, CD103+, CD123 +, and CD5-, CD10-, and CD23-. Bone marrow biopsy was done in all cases, showing massive infiltration with villous cytoplasmic projection cells that were CD20 positive. The treatment consists of blood transfusion in all cases, associated with splenectomy in 3 cases, only 1 patient was treated with (2 CDA: cladribine) with a complete remission after a follow up of 24 months. Conclusion: HCL has consistent cytologic histologic and immunologic features that make classification reliable and reproducible; it remains problematic because of the variety of the disorders and the differential diagnosis of splenic lymphoma of the marginal zone. Objective: Primary CNS lymphomas (PCNSL) are uncommon tumors in immunocompetent patients, they represent up to 1 % of non Hodgkin lymphomas (NHL) and 3-5 % of all brain tumors. The majority of PCNSL are diffuse large B cell lymphomas, 2-5 % are T cell lymphomas, in rare instances low grade B cell lymphomas. We determine clinical characteristics, histological findings and treatment outcome of PCNSL. Method: Five cases of PCNSL occurring between 1993 and 2007 were retrospectively reviewed. Results: They were 4 males, 1 female, median age 50 years, range (23-74). Most common symptom was neurological deficits (4cases). MRI of the brain revealed an expansive tumor affecting the parietal bone in 3 cases, the temporal bone in 1 cases and the frontal bone in 1 case. Immunohistological finding showed large B-cell NHL in 2 cases, anaplastic lymphoma in 2 cases, and large-cell immunoblastic lymphoma in 1 case. Treatment consists on exclusive tumoral resection in 3 cases, surgery and chemotherapy (1 case), complicated by death in all these cases. Surgery followed by high dose chemotherapy and radiotherapy (1 case) with complete remission after a follow-up of 7 years. Conclusion: Chemotherapy followed by involved field irradiation appears to be an adapted therapy. Objective: Primary cutaneous non-Hodgkin's lymphoma (PCNHL) is defined as lymphoma limited to skin without extra-cutaneous involvement at presentation. We describe here epidemiological and histo-pathological aspects of PCNHL.