PCR-based immunoglobulin (Ig)/T-cell receptor (TCR) clonality testing in suspected lymphoproliferations has largely been standardized and has consequently become technically feasible in a routine diagnostic setting. Standardization of the pre-analytical and post-analytical phases is now essential to prevent misinterpretation and incorrect conclusions derived from clonality data. As clonality testing is not a quantitative assay, but rather concerns recognition of molecular patterns, guidelines for reliable interpretation and reporting are mandatory. Here, the EuroClonality (BIOMED-2) consortium summarizes important pre- and post-analytical aspects of clonality testing, provides guidelines for interpretation of clonality testing results, and presents a uniform way to report the results of the Ig/TCR assays. Starting from an immunobiological concept, two levels to report Ig/TCR profiles are discerned: the technical description of individual (multiplex) PCR reactions and the overall molecular conclusion for B and T cells. Collectively, the EuroClonality (BIOMED-2) guidelines and consensus reporting system should help to improve the general performance level of clonality assessment and interpretation, which will directly impact on routine clinical management (standardized best-practice) in patients with suspected lymphoproliferations.

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992-996. 7. Lucendo AJ, Navarro M, Comas C et al. Immunophenotype characterization and quantitation of the epithelial inflammatory infiltrate in eosinophilic esophagitis through stereology. Am. J. Surg. Pathol. 2007; 31; 598-606. 8. Aceves SS, Newbury RO, Dohil R et al. Distinguishing eosinophilic esophagitis in pediatric patients. Clinical, endoscopic and histological features of an emerging disorder. J. Clin. Gastroenterol. 2007; 41; 252-256. 9. Kagalwalla AF, Shah A, Ritz DS, Melin-Aldana H, Li B. Cow's milk protein-induced eosinophilic esophagitis in a child with gluten-sensitive enteropathy. J. Pediatr. Gastroenterol. Nutr. 2007; 44; 386-388. 10. Ronkainen J, Talley NJ, Aro P et al. Prevalence of oesophageal eosinophils and eosinophilic oesophagitis in adults: the population-based Kalixanda study. Gut 2007; 56; 615-620. 11. Rothenberg ME. Pathogenesis and clinical features of eosinophilic esophagitis. J. Allergy Clin. Immunol. 2001; 108; 891-894. 12. Spechler SJ, Genta RM, Souza RF. Thoughts on the complex relationship between gastroesophageal reflux disease and eosinophilic esophagitis.Sir: The cell cycle regulatory protein cyclin D1 is aberrantly expressed in mantle cell lymphomas (MCL) as a result of the t(11;14)(q13;q32) ⁄ CCND1-IGH. 1,2 Consequently, immunohistochemistry for cyclin D1 is a valuable tool in the distinction of MCL from other small B-cell lymphomas. 2 Cyclin D1 immunohistochemistry is also central to the discrimination between the pleomorphic blastoid variant of MCL, an aggressive form of MCL with large cell morphology, high proliferative activity and complex karyotypes, and diffuse large B-cell lymphoma (DLBCL), a biologically and genetically heterogeneous group of aggressive lymphomas not associated with t(11;14)(q13;q32). 2 However, in this report we present a case of DLBCL expressing cyclin D1 in the absence of t(11;14)(q13;q32), suggesting that aberrant expression of cyclin D1 may play a role in the pathogenesis of some DLBCLs and demonstrating that cyclin D1 immunopositivity alone is not sufficient for distinction between pleomorphic blastoid MCL and DLBCL in all cases. The patient, a 77-year-old woman, had widespread lymphadenopathy, pulmonary and splenic nodules and erythematous cutaneous papules on the thigh, but no bone marrow involvement (Ann Arbor stage 4A disease). Laboratory investigation showed a normal white cell count (5.7 · 10 9 ⁄ l) and a markedly raised lactate dehydrogenase level (1572 units ⁄ l). The patient began immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP), but died before completion of therapy.Examination of an inguinal lymph node biopsy specimen ( Figure 1) showed a diffuse infiltrate of large atypical lymphoid cells with round, oval or elongated nuclei, one or more prominent nucleoli and moderately abundant cytoplasm. There were numerous mitoses and scattered tingible body macrophages and apoptotic cells. Immunohistochemistry showed the neoplastic cells to be CD20+ B cells which expressed Bcl-6, MUM1 and ...

Active galactic nuclei (AGN) release a huge amount of energy into the intracluster medium (ICM) with the consequence of offsetting cooling and star formation (AGN feedback) in the centers of cool core clusters. The Phoenix cluster is among the most massive clusters of galaxies known in the Universe. It hosts a powerful starburst of several hundreds of Solar masses per year and a large amount of molecular gas in the center. In this work we use the high-resolution Reflection Grating Spectrometer (RGS) on board XMM-Newton to study the X-ray emitting cool gas in the Phoenix cluster and heating-cooling balance. We detect for the first time evidence of O VIII and Fe XXI-XXII emission lines, the latter demonstrating the presence of gas below 2 keV. We find a cooling rate of 350 ± 250 200 M yr −1 below 2 keV (at the 90% confidence level), which is consistent with the star formation rate in this object. This cooling rate is high enough to produce the molecular gas found in the filaments via instabilities during the buoyant rising time. The line broadening indicates that the turbulence (∼ 300 km s −1 or less) is below the level required to produce and propagate the heat throughout the cool core. This provides a natural explanation for the coexistence of large amounts of cool gas, star formation and a powerful AGN in the core. The AGN activity may be either at a young stage or in a different feedback mode, due to a high accretion rate.

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