bluuebunny/crossref_metadata_2025_split huggingface dataset:
A t(14;18) Negative Nodal Diffuse Follicular Lymphoma with 1p36/TNFRSF14 LOH Detected by Cytogenomic Microarray Analysis
Authors: Lazim A , Mackrides N , Nasibli J , Pei J , Nejati R , Mansoor N 
Published: November 2023

Abstract

Introduction/Objective
Among the already described variants of nodal follicular lymphoma (FL), there is a variant with diffuse growth pattern with a predilection to involve the inguinal lymph nodes and peculiar immunohistochemical and molecular characteristics. The diffuse growth pattern is manifested by the complete absence of follicles without a follicular/dendritic meshwork (negative CD21 and CD23). This variant was first described by Katzenberger in 2009. It is distinguished from other variants by CD23 expression, lack of t(14;18)/ IGH::BCL2 rearrangement, and chromosome segment 1p36 deletion or TNFRSF14 mutations.

Methods/Case Report
A 43-year-old Caucasian male presented with a lump in his left groin, noted by him after exercising and sought surgical opinion to rule out inguinal hernia. CT- scan of abdomen and pelvis showed a well circumscribed 4.3 cm lymph node in the left groin region. Histological analysis of the lesion depicted a lymph node with a predominantly diffuse and focally vaguely nodular proliferation effacing the architecture. Numerous centrocytes admixed with occasional centroblasts averaging &lt;15/HPF. The neoplastic cells are positive for CD20, PAX5, CD10, BCL6, CD23 and BCL2, and are negative for CD5 and cyclin D1. The CD21 highlights few residual germinal centers at the periphery of the lymph node. The proliferative (Ki67+) index is approximately 30-40%. Flow cytometry demonstrates CD10 positive, kappa monoclonal B cell population (20% of total). FISH analysis was negative for both IgH/BCL2 t(14;18) rearrangement and TNFRSF14 (1p36) Deletion. However, cytogenomic microarray analysis (CMA) revealed genomic imbalances and copy neutral Loss of Heterozygosity over 1p36 in a mosaic state representing about 40% of the cells, which notably encompasses PRKC2, SKI, TNFRSF14, PRDM16, TP73 and PRL22 genes.
The findings are consistent with a final diagnosis of diffuse follicular lymphoma variant, WHO grade 1-2 of 3.

Results (if a Case Study enter NA)
N/A

Conclusion
The copy neutral Loss of Heterozygosity of 1p36 region which contains TNFRSF14 gene was detected by CMA only. Undoubtedly, CMA results can play a pivotal role in identifying copy neutral Loss of Heterozygosity or small regions deletions or gains that can be missed by conventional cytogenetics and FISH studies and subsequently establishing diagnosis and prognostic stratification of hematologic neoplasms.
Hodgkin lymphoma involving the Brain; A Rare Case report
Authors: Tahir M , Polski J , Elkadi O 
Published: November 2023

Abstract

Introduction/Objective
Hodgkin lymphoma (HL) is a systemic disease that usually affects the cervical, mediastinal, and supraclavicular lymph nodes. Involvement of the central nervous system (CNS) by primary or systemic HL is extremely rare, and it is usually associated with severe systemic relapse disease.

Methods/Case Report
A 31-year-old male presented with severe hypercalcemia and months of dry cough and B symptoms including night sweats and weight loss. The CT of the chest and abdomen was significant for splenomegaly and perihilar/subcarinal mass. The patient was diagnosed with classic HL stage IVB and was started on Adriamycin, Vinblastine Sulfate, Dacarbazine (AVD), and Brentuximab regimen. A month later the patient exhibits neurological symptoms, and an MRI of the brain showed 1 x 1 x 1.1 cm a spherical lesion near the gray-white matter differentiation of the right anterior temporal pole.
Histologically, the resection specimen consists of sheets of atypical pleomorphic cells. Some with bilobated to multilobated nuclei, a prominent eosinophilic nucleolus, and ample amphophilic cytoplasm consistent with Reed- Sternberg cells (RSC), diagnostic of classic HL.
Immunohistochemically, the RSC and variants were positive for CD15, CD30 (weak), CD79 a, and PAX5. The weak expression of CD30 was secondary to treatment with anti-CD30 antibodies. The malignant cells were negative for CD3, CD10, CD45, Bcl-2, ALK1, MUM-1, and SV40.

Results (if a Case Study enter NA)
NA

Conclusion
CNS involvement in HL is rare, but it must be considered in patients with previous history of HL who present with intracranial lesion. A multidisciplinary approach is needed for these cases because there is no consensus on the best treatment, and surgery followed by targeted radiotherapy and systemic chemotherapy should be considered on individual basis and according to the complexity of each case. At present, the prognosis of this rare complication is poor and needs to be improved.
Acute myeloid leukemia with t(16;21)(q24;q22), CBFA2T3::RUNX1, in post-treatment setting, a case report
Authors: Yang T , Khan A I , Hanan A , Kataria N , Khan A 
Published: November 2023

Abstract

Introduction/Objective
Acute myeloid leukemia (AML) with t(16;21)(q24;q22), CBFA2T3::RUNX1 is an uncommon entity that has been reported in both pediatric and adult patients as de novo AML or secondary to prior chemo/radiation therapy. CBFA2T3::RUNX1 AMLs share similar clinico-pathological features and gene expression profile with RUNX1::RUNX1T1 AML.

Methods/Case Report
We report a case of AML with CBFA2T3::RUNX1 in a 52 year old female who had history of small cell cervical cancer treated with chemotherapy (4 cycles of cisplatin and etoposide) and pelvic radiation therapy. About 17 months after completion of therapy, she presented with anemia and thrombocytopenia, normal WBC/neutrophil count, eosinophilia and increased blasts (up to 10%) in blood. Bone marrow biopsy shows AML with maturation (FAB-M2), erythropoiesis is present, whereas megakaryocytes are decreased. Flow cytometry analysis shows myeloblasts with aberrant CD19 and CD56 expression; in addition, increased CD117/tryptase positive cells are noted, mostly interstitial and more concentrated around bone trabeculae. By immunohistochemical stains, these cells are at least partially positive for CD25, negative CD2, CD30. Karyotype studies demonstrate t(16;21)(q24;q22) and trisomy 8 in all metaphases. FoundationOne heme NGS studies confirmed CBFA2T3::RUNX1 fusion, and no additional mutations were identified. Patient received induction chemotherapy with Idarubicin/Cytarabine plus GO (Gemtuzumab ozogamicin); day 14 bone marrow showed chemotherapeutic effect and she is now in morphologic remission 5 months after diagnosis.

Results (if a Case Study enter NA)
NA

Conclusion
Our case adds to the limited knowledge of CBFA2T3::RUNX1 AMLs. Our case shows morphological and immunophenotypic features similar to AML with RUNX1::RUNX1T1, with unusual presentation of peripheral eosinophilia, and increased CD117/tryptase positive cells in bone marrow, the latter has been reported occasionally in core binding factor AMLs. We emphasize the importance of comprehensive genetic studies in AML patients, lack of adverse genetic abnormalities in our patient indicates favorable risk category regardless of the post-treatment clinical setting.
Primary Central Nervous System ALK-Negative Anaplastic T-Cell Lymphoma is a Challenging and Uncommon Diagnosis
Authors: Mohamed R , Howell D , Peng Cheng H 
Published: November 2023

Abstract

Introduction/Objective
Primary central nervous system lymphoma (PCNSL) accounts for only 1% of all lymphomas and 6% of all tumors in the central nervous system. Most of these lymphomas are B-cell types, while T-cell types are less common. Anaplastic T-cell lymphoma with ALK-negative is the least common form of anaplastic T-cell lymphoma. It has a similar morphology but is more aggressive than ALK-positive variant. Smaller numbers of ALK-negative PCNSL have been reported. Herein, we report a case of cerebellar ALK-negative anaplastic T-cell lymphoma (ATCL) not only because of the unique location but also to highlight this entity to be considered in future diagnosis to avoid delay or misdiagnosis.

Methods/Case Report
A 58-year-old woman with no significant past medical history presented with headaches, aphasia, confusion, short memory loss, and loss of control over her body. She had had similar episodes more than three months before. MRI demonstrated extensive enhancement of the leptomeningeal, pial, and pachymeningeal surfaces. Moreover, there are nodular mass-like areas along the cerebellar folia. Left suboccipital craniotomy with biopsy of left cerebellar lesion was performed. Histopathological examination revealed numerous large, atypical lymphocytes characterized by large-size, ovoid to irregular to lobated nuclei, vesicular chromatin, and vacuolated cytoplasm. These cells react positive to CD3, CD30, CD43, CD2, CD7CD56, and negative to ALK1, CD8, CD20, PAX5, CD5, CD10, CD15, CD34, CD138, EMA, p63, TdT, GFAP, CAM5.3, synaptophysin, SOX10, and EBER in situ
hybridization. No ALK separation is observed by FISH; however, three copies of the ALK gene are found on chromosome 2p23. ALK-negative ATCL was diagnosed based on all these findings.

Results (if a Case Study enter NA)
N/A

Conclusion
Primary central nervous system lymphoma (PCNSL) is extremely rare, and most lymphomas are B-cell types. Anaplastic T-cell lymphomas, ALK-negative lymphoma is a rare and most aggressive variant of T-cell lymphoma. Reporting this tumor is crucial to avoid delay or misdiagnosis.
The value of cytology in diagnosis of body fluids with lymphoma involvement: a report of 29 cases
Authors: Ak S , Wang X , Zhang S 
Published: November 2023

Abstract

Introduction/Objective
Lymphoma involving body fluids (pleural, abdominal or pericardial) can be secondary or primary (such as primary effusion lymphoma). The incident rate is variable depending on the hospital setting (general or specialty hospitals), and it is generally low. Due to the large specimen volume, relatively easy collecting sample and stable cellular preservation, body fluids are good sources for diagnosis and classification of lymphoproliferative diseases.

Methods/Case Report
A retrospective case search from a tertiary academic medical center during 2015 to 2023 were performed for body fluid cytology with diagnosis of lymphoma. The results of cytology, ancillary cellblock, immunohistochemistry and flow cytometry were collected, and the synchronous or follow-up surgical biopsies/resections were cross examined.

Results (if a Case Study enter NA)
Total 29 cases of body fluids with lymphoma involvement were identified in the study period. There were 22 patients including 9 males and 13 females and age ranged from 16 to 88 years (mean
64.5 years). Only 4 patients (4/22, 18.2%) had history of lymphoma when they presented with body fluids, and the remaining 18 patients (18/22, 81.8%) presented body fluids as the initial or synchronous sign of lymphoma. 26/29 cases had cellblock or flow cytometry done and 13/29 cases had both. All 22 cases had adequate lymphoma diagnosis and classification by combined cytology and ancillary tests and included 5 high grade B cell lymphoma, 3 diffuse large B cell lymphoma, 2 Burkitt, 2 CLL/SLL, 2 small mature B cell lymphoma, NOS, 1 mantel, 1 MYC and BCL-2 double hits lymphoma, 1 primary effusion lymphoma, 1 plasma cell myeloma, 2 T lymphoblastic lymphoma, 1 anaplastic large cell lymphoma, 1 angioimmunoblastic T cell lymphoma. 11 patients had synchronous or follow-up tissue biopsies, and cytology had 100% agreement with the histology diagnosis.

Conclusion
The majority (81.8%) cases of body fluid involvement with lymphomas presented as the initial or synchronous sign of lymphomas in our study series indicating that high pathologic suspicion and adequate cytomorphological skills for lymphoproliferative disorders are necessary for making the diagnosis. Body fluid samples are excellent sources for diagnosis and classification of lymphomas using the available ancillary tools including immunohistochemistry, flow cytometry and molecular testing.
Idiopathic multicentric Castleman's disease with TAFRO syndrome: a case report
Authors: Khan A I , Khan A , Hanan A , Geetha S , Sticco K , Sheikh-Fayyaz S 
Published: November 2023

Abstract

Introduction/Objective
Multicentric Castleman's disease(MCD) is a nonneoplastic lymphoproliferative disorder. Individuals affected by MCD exhibit systemic symptoms accompanied by the presence of multiple enlarged lymph nodes. MCD can be associated with human herpesvirus type-8, POEMS syndrome, or idiopathic (iMCD). TAFRO syndrome, a clinical subtype of MCD is a recently recognized disorder with an unclear cause, it comes with a combination of symptoms, namely thrombocytopenia, anasarca, fever, renal dysfunction, and organomegaly. This case report aims to shed light on the diagnostic challenges due to the rarity and nonspecific nature of TAFRO syndrome.

Methods/Case Report
We report a 30-year-old female who presented with night sweats, fever, fatigue, and cough. She had significant leucocytosis, lymphopenia, thrombocytopenia, anemia requiring transfusion, and elevated creatinine, CT showed ground glass opacities in the lungs and extensive lymphadenopathy. Axillary lymph node excisional biopsy revealed paracortical hyperplasia with increased vascularity, extensive polytypic plasmacytosis, and some follicular hyperplasia. On IHC staining it was positive for CD20, CD79a, PAX 5, and negative cyclin D1 for B lymphocytes. T lymphocytes were positive for CD3, CD5, CD2, CD7, CD4&gt;CD8, Bcl2 and CD43. Plasma cells were composed mainly of IgG cells and some IgG4(IgG4/IgG &lt;20%). HHV8 was negative. Flow cytometry showed 89% lymphocytes with a heterogenous population of T-cells and polytypic B cells. Serology revealed markedly elevated IL- 6, IL-2, VEGF CRP, and ESR while HIV and ANA were negative. Bone marrow biopsy was suggested. A final diagnosis of idiopathic multicentric castle man disease suggestive of TAFRO syndrome was made. The patient received steroids and is currently on siltuximab.

Results (if a Case Study enter NA)
NA

Conclusion
Our case fulfills at least four of the five major diagnostic criteria of TAFRO syndrome. It serves as a valuable addition to the scarce literature on TAFRO syndrome, providing insights into its diagnostic challenges
Aldehyde Dehydrogenase Enzyme in Relation to Cord Blood stem cells Potency
Authors: Elbaz K M 
Published: November 2023

Abstract

Introduction/Objective
In umbilical cord blood transplantation (UCBT), the number of cluster of differentiation (CD)34+ cells and colony-forming units (CFUs) in the cord blood (CB) graft positively correlate with patient survival. Since aldehyde dehydrogenase (ALDH) activity is high in hematopoietic stem cells, the number of ALDH-bright (ALDHbr) cells was examined in comparison with the number of CD34+ cells and CFUs for the quality assessment of CB units, Aim and objectives; to correlate the aldehyde dehydrogenase (ALDH) enzyme assay with colony-forming unit–granulocyte/macrophage (CFU-GM) assay before cryopreservation of cord blood buffy coats (CBBC), in order to investigate the hypothesis that the ALDH assay might exclude apoptotic cells since it is based on enzyme activity.

Methods/Case Report
This study was carried out at Benha University Hospital on Fifty (50) samples of Human Umbilical Cord Blood which were processed for mononuclear cells (MNC) separation by density gradient centrifugation method using Ficoll-Paque media that layered on the diluted blood.
In parallel, 1 million nucleated cells were sampled and prepared for flow cytometry for analysis of ALDH activity according to the manufacturer’s
instructions.

Results (if a Case Study enter NA)
CD34+ ALDH+ (%) (Of MNC) showed significant positive correlation with ALDH++ (%) (Of CD34+) and numbers of total CFU/40000 cells. Also ALDH++ (%) (Of CD34+) showed significant positive correlation with numbers of total CFU/40000 cells.

Conclusion
The ALDH assay excludes nonviable and apoptotic cells, and therefore correlates well with CFU enumeration compared to the number of viable CD34+ cells. We propose that the ALDH assay might replace the CFU-GM method in CBU potency measurements.
Impact of Achieving Hospital Accreditation on Assuring Quality in Clinical Laboratories: Experience of an Oncology Hospital in low middle income country
Authors: Abdou B A , Ghaleb F 
Published: November 2023

Abstract

Introduction/Objective
Shefaa Al-Orman Oncology Hospital (SOH) is a leading cancer care facility in Upper Egypt dedicated to providing specialized treatment to cancer patients for free.
The General Authority of Healthcare Accreditation and Regulation (GAHAR, accredited from the International Society for Quality in Health Care) is the regulatory and accreditation body that ensures that healthcare facilities in Egypt comply with the highest standards of quality and safety.
Here, we aim to assess the impact of GAHAR accreditation process on:
Streamlining workflow, contributing to staff professional development and knowledge, increasing loyalty, and creating a more productive and fair work environment.
- Optimizing turnaround time (TAT).
- Compliance with the minimum retesting interval (MRI) guidelines.
- Healthcare providers' satisfaction with the laboratory services.
- Patients’ satisfaction.
Finally, we aim to emphasize the role of building an integrated lab quality management system that addresses different lab processes/procedures as a basis for la accreditation.

Methods/Case Report
laboratory personnel, healthcare providers and patients responses were measured using questionnaire method to assess the impact of accreditation on various aspects of laboratory services.
Comparative lab statistics were collected from laboratory information system.

Results (if a Case Study enter NA)
As shown by questionnaires, 95% of lab staff reported positive impact on streamlining of workflow, 100% reported in professional development and improvement in knowledge, and increased loyalty and created a fair work environment (80% in each). Healthcare providers satisfaction reached 88%, and patient satisfaction reached 93%. TAT optimization increased from 84.1% to 98.1%.
Prior to accreditation, the lab had an effective internal quality control program. GAHAR mandated enrollment in External Quality Assurance Services (EQAS) to ensure reliable results. In addition, GAHAR mandated a policy/procedure to enforce minimum retesting interval. Application of this policy led to better utilization.
Finally, pre and post-analytical processes were streamlined, leading to improved overall laboratory performance.

Conclusion
Achieving GAHAR accreditation had positive impact on laboratory workflow, staff professional development, compliance with guidelines, ensure reliable laboratory results, and overall laboratory performance. Laboratories should consider accreditation and implementing quality assurance measures to enhance the delivery of high-quality laboratory services and patient safety.
Comparative study on the effect of bacteriophage on MDR E.coli from Urinary tract infections
Authors: Abdelmonem M , Eldaly R , Abdelmageed M , Saleh Abdelfattah M , Wasim H 
Published: November 2023

Abstract

Introduction/Objective
Background: Urinary tract infections (UTIs) associated with urethral catheters are the most common infections during hospitalization. Hospitalization's most common infections are urethral catheter-related UTIs. Bacteriophages infect bacteria exclusively. Phage therapy, especially in Eastern Europe, was widely used before antibiotics. Due to the overuse of antibiotics and the development of resistant bacteria, this therapy approach is regaining popularity.

Methods/Case Report
Subjects and methods: 2223 UAE-based UTI patients (4–68 years old) were examined. The isolated bacteria were identified biochemically and tested for antimicrobial susceptibility using Mueller-Hinton agar disk diffusion (Kirby Bauer's). TSA (Liofilchem, Italy) kept isolates at 4 °C.for each examination. Tryptic Soy agar (TSA; Liofilchem, Italy) was used to grow one isolated colony overnight at 37 °C. This culture was transferred aseptically to 10 mL of fresh TSB medium and grown overnight at 37 °C to 0.8 optical density.
10 ml CaCl2 in 100 ml LB homogenized EMIRATE sewage water. Overnight homogenates with 9 E. coli isolates—24 hours of 37°C incubation. Samples were centrifuged at 12,000x g for five minutes—a 0.45 mm Millipore (France) filter produced phage lysate. TSA (Liofilchem, Italy) was used as a culture medium, and the centrifuged supernatant as phage suspension for the double-layer method. After 37 °C, plaques were examined. Single-plaque isolations followed. EOP was measured on double-layer agar for bacteria with a clear lysis zone (Adams, 1959). calculated EOP. Phages tested individually. EZ1 and EZ2 were negatively stained with Na-phosphotungstate for morphotype.

Results (if a Case Study enter NA)
Results: This study found presumptive E. coli colonies in 478 of 2223 (21.5%) samples by plating pre-enriched samples on MacConkey.
E. coli B2 and B4 were sensitive to Ciprofloxacin, but most strains were resistant to antibiotics. E. coli B3 was Metronidazole-sensitive. Individual E. coli strains were susceptible to phage infection. Podoviruses were the two phages. 3 log decreased due to E. coli growth.

Conclusion
This study shows that a single dose of phage can reduce pathogenic MDR E.coli. Phages' high bacterial inactivation efficiency, safety, and prolonged survival, even in urine samples, allow depth studies, especially in vivo studies, to control urinary tract infection and overcome E.coli resistance.
Sustained Culture of Safety After Select Agent Exposure
Authors: Larsen J , Lau J , Karsten J , Grys T , Graf E , Wrobel R , Francis D 
Published: November 2023

Abstract

Introduction/Objective
In January of 2021 our laboratory experienced the occupational exposure of 3 technologists to the select agent Burkholderia pseudomallei due to improper recognition and manipulation outside a biosafety cabinet. Subsequently, an interactive computer module was created to train technologists on timely recognition, followed by a “fake” patient test to evaluate comprehension. In that initial period, 100% compliance and successful recognition was demonstrated. To evaluate sustained compliance and recognition, another wave of evaluation was performed Jan- Dec 2022.

Methods/Case Report
During the study period several new staff members were hired and demonstrated compliance with completing the computer module. Clinical isolates suspicious for a select agent were reported to the Medical Director on rounds daily and reviewed for potential exposure, which was defined as manipulation of the suspicious isolate outside of the biosafety cabinet. Additional challenge “fake” patients were circulated.

Results (if a Case Study enter NA)
During the study period, 16 isolates were deemed suspicious for select agents based on macroscopic and microscopic morphology and biochemical reactions. Of these, 0 resulted in laboratory exposures. Of the challenge isolates, 1 resulted in a near-miss potential for exposure due to the lack of recognition of macroscopic characteristics.

Conclusion
The use of an interactive computer module focused around timely recognition and safe handling of potential select agents resulted in sustained laboratory safety and avoidance of potential occupational exposures.