Only a few cases of extranodal Epstein-Barr virus (EBV)-associated B-cell lymphomas arising from patients with angioimmunoblastic T-cell lymphoma (AITL) have been described. We report a case of AITL of which secondary cutaneous EBV-associated diffuse large B-cell lymphoma (DLBCL) developed after the initial diagnosis of AITL. A 65-year-old Chinese male patient was diagnosed as AITL based on typical histological and immunohistochemical characteristics in biopsy of the enlarged right inguinal lymph nodes. The patient initially received 6 cycles of chemotherapy with CHOP regimen (cyclophosphamide, vincristine, adriamycin, prednisone), but his symptoms did not disappear. Nineteen months after initial diagnosis of AITL, the patient was hospitalized again because of multiple plaques and nodules on the skin. The skin biopsy was performed, but this time the tumor was composed of large, polymorphous population of lymphocytes with CD20 and CD79a positive on immunohistochemical staining. The tumor cells were strong positive for EBER by in situ hybridization. The findings of skin biopsy were compatible with EBV-associated DLBCL. CHOP-R chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab) was then administered, resulting in partial response of the disease with pancytopenia and suppression of cellular immunity. To our knowledge, this is the first case of cutaneous EBV-associated DLBCL originated from AITL in Chinese pepole. We suggest the patients with AITL should perform lymph node and skin biopsies regularly in the course of the disease to detect the progression of secondary lymphomas.Virtual slidesThe virtual slide(s) for this article can be found here:http://www.diagnosticpathology.diagnomx.eu/vs/1197421158639299

Background and aim: Both macrophage migration inhibitory factor (MIF) and DJ-1 protein have been shown to relate with cell invasion and metastasis in tumors. However, the role of DJ-1 in invasion and metastasis of nasopharyngeal carcinoma (NPC) and its relation to MIF expression in NPC are not fully understood. The aim of present study is to determine whether or not MIF and DJ-1 are correlated with tumor invasion and influence a worse outcome in NPC, as well as its related mechanism.Methods: 125 cases of NPC and 45 normal tissues of nasopharynx were collected. The expression of MIF and DJ-1 in tissue microarray was evaluated by immunohistochemical staining. Correlation between immunostainings and clinicopathological parameters, as well as the follow-up data of patients, was analyzed statistically. The association of MIF and DJ-1 with cell invasion and migration in NPC cell line were evaluated by small interfering RNA (siRNA) transfection, invasion assay and Western blotting.Results: MIF and DJ-1 staining was diffused and strong in tumor cells, whereas they were generally weaker and less common in normal lining epithelia of nasopharynx. High MIF expression in tumor cells (71.2%, 89/125 cases) were significantly associated with advanced clinical stage, lymph node metastasis, and worse prognosis of NPC patients. High expression of DJ-1 (75.2%, 94/125 cases) were closely correlated to lymph node metastasis and MIF high-expression. Only MIF high expression (P = 0.010) and lymph node metastasis (P = 0.004) emerged as strong independent prognostic factors for overall survival of NPC patients. In vitro, down-regulated expression of DJ-1 in NPC cell lines by siRNA was observed to reduce cell migration and invasion potential, however, exogenous MIF promoted cells invasion.Conclusions: The data provided evidence that increased expression of MIF and DJ-1 induced cell invasion and metastasis of NPC, supporting the idea that MIF and DJ-1 may play important roles as regulators in the progression of NPC.

Although the varicocele has been studied for many years, its pathophysiology remains unclear. In this study, we investigated the expression of the a subunit of hypoxia-inducible factor 1 (HIF-1a) and determined the apoptosis index (AI) in the testes of rats with varicoceles to study the mechanism by which varicoceles induce infertility. A total of 45 Wistar rats were divided into 3 groups: control group, sham surgery group, and experimental group. Forty-nine days after the initial partial ligation of the left renal vein, all of the rats underwent orchiectomy. HIF-1a expression in each testis was analyzed using immunohistochemical methods and enzyme-linked immunosorbent assay. The degree of apoptosis within each testicle was determined using terminal deoxynucleotidyl transferase dUTP nick end labeling. HIF-1a immunoreactivity in the testes of the experimental group was significantly higher than that in those of the control group (P , .05) or the sham group (P , .05). The AI of the germ cells of rats in the experimental group was significantly higher than that in germ cells of rats in the sham group (P , .001) or the control group (P , .001). Additionally, there was a significant positive correlation observed between the AI of germ cells and relative intensity of HIF-1a in the left testis (r 5 .631; P 5 .028) and right testis (r 5 .707; P 5 .01) of rats in the experimental group. The results of this study showed that a left-sided varicocele could cause bilateral testicular hypoxia and increased germ cell apoptosis, both of which play an important role in testicular dysfunction. Furthermore, HIF-1a is a useful factor that can be used to predict the degree of germ cell apoptosis in rat testes.

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