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Цель - определить характерные особенности гистоархитектоники селезенки человека в сопоставлении с основными этапами иммунного ответа. Материал и методы. Работа выполнена на аутопсийном материале селезенок 20 человек, не имевших в анамнезе патологии системы кроветворения. Медиана возраста составила 39 (27; 65) лет. С помощью гистологических, иммуногистохимических и морфометрических методик изучали площади красной и белой пульпы на срезе, а также клеточный состав в ткани селезенки на разных этапах иммунного ответа. Результаты. Установлено, что изменения морфометрических параметров белой и красной пульпы, а также ее составляющих зависят от степени активности иммунных процессов, происходящих в тканевых компартментах селезенки на различных этапах иммунного ответа. Выявлены различия в содержании клеточных элементов в изученных функциональных зонах органа. Выводы. Для исследования гистоархитектоники селезенки важно учитывать особенности миграции клеточных элементов, динамику и численность их распределения в белой пульпе и красной пульпе на основных этапах иммунного ответа, что, несомненно, влияет на массу органа и, соответственно, его функциональных компартментов. Полученные результаты могут быть использованы для анализа гистоархитектоники селезенки и изучения ее клеточного состава при диагностике заболеваний с поражением органов иммунной системы. Objective - to determine the characteristic features of the human spleen histoarchitectonics in correlation with the main stages of the immune response. Material and methods. The work was performed on the autopsy material of spleen taken from 20 people, who had no history of the pathology of the hematopoietic system. The median age was 39 (27; 65) years. Histological, immunohistochemical, and morphometric study of white and red pulp areas and cellular composition of spleen at different stages of immune response was carried out. Results. It was found that changes in the morphometric para­meters of white and red pulp, as well as its components, depended on the degree of activity of the immune processes that occur in tissue compartments of the spleen at various stages of the immune response. Differences in the content of cellular elements in the functional zones of the organ were revealed. Conclusions. To study the histoarchitectonics of the spleen, it is important to take into account the specifics of the migration of cellular elements, the dynamics and abundance of their distribution in white and red pulp at the main stages of the immune response, which undoubtedly affects the mass of the organ and, accordingly, its functional compartments. The results can be used to analyze the histoarchitectonics of the spleen and study its cellular composition in the diagnosis of diseases causing damage to the organs of the immune system.

Introduction. Intravascular large B-cell lymphoma is a rare variant of large B-cell, highly invasive extranodal tumors of the lymphatic system. The pathogenesis of the disease lies in the ability of tumor cells to penetrate into small vessels and capillaries of various organs. The clinical presentation is atypical for diffuse large B-cell lymphoma. In the relevant literature, information on the diagnosis and treatment of this pathology is extremely rare, therefore each publication makes a significant contribution to expanding the horizons of hematologists and morphologists.Aim – to present a case of diagnosing intravascular B-cell lymphoma.Main findings. A clinical case of a 78-year-old patient who fell ill acutely is presented. At the onset of the disease, febrile fever was noted. In the general blood test: hemoglobin – 104 g/L; erythrocytes – 3.0 × 1012/L; ESR – 24 mm/h; platelets – 112 × 109/L, leukocytes – 4.9 × 109/L, 4 % of cells with lymphoblast morphology were found in the leukocyte formula. Blood serum tests revealed: an increase in uric acid concentrations – up to 639 μmol/L, LDH – up to 1885 U/L, beta-2-microglobulin – up to 8.9 mmol/L, C-reactive protein – up to 0.6 g/L, a decrease in the concentration of total protein – up to 45 g/L, an increase in the concentration of aspartate aminotransferase – up to 48 units/L at normal concentrations of bilirubin and alanine aminotransferase.The histological and immunohistochemical picture, according to the study of bone biopsy, most corresponded to bone marrow damage by intravascular large B-cell lymphoma. Immunophenotyping was carried out – 15.7 % of blast cells with immunophenotype CD19+HLA/DR+CD24+CD37+CD20+CD10+IgM+ were detected. Cytogenetic studies revealed no karyotype abnormalities. The result of fluorescence in situ hybridization of the IGH locus (14q32) was normal. Based on the data obtained, the final clinical diagnosis was established: diffuse large B-cell lymphoma, stage IVB, intravascular variant with bone marrow involvement, aggressive course. The patient was prescribed the first line of therapy according to the R-CHOP scheme (rituximab, cyclophosphamide, vincristine, prednisolone). In the control study of the bone marrow, after the first course of therapy, the number of lymphoid elements was 3.6 %, laboratory parameters returned to normal.

Background. A significant role in the pathogenesis, resistance to treatment and progression of many types of lymphomas, including diffuse large B-cell lymphoma, is assigned to the TP53 gene. Literature data on the prognostic significance of the expression of its product, the p53 protein, and its association with aberrations at the 17p13 locus are ambiguous. Aim. To assess the relationship of p53 protein expression with the presence of a 17p13 locus deletion of the TP53 gene and the survival of patients with diffuse large B-cell lymphoma. Material and methods. The study included 75 patients with newly diagnosed diffuse large B-cell lymphoma who received R-CHOP therapy. The calculation of the relative content of tumor cells expressing p53 was carried out using immunohistochemical and morphometric methods on biopsy samples of lymph nodes. The 17p13/TP53 deletion was determined by fluorescent in situ hybridization. The threshold level of p53-positive tumor cells, corresponding to 43%, was calculated by ROC analysis. The association between p53 protein expression and the presence of a 17p13 deletion was assessed using Fisher's (F) and Pearson's 2 tests. The correlation dependence was evaluated by the Cramer method (V). Five-year overall and progression-free survival was calculated using the KaplanMeier method. Differences between the indicators were considered statistically significant at p 0.05. Results. The frequency of 17p13/TP53 deletion was higher in patients with high expression of p53 (43%) compared to the group of patients with low expression: 87.5 and 12.5%, respectively (p=0.018). A direct correlation between a high level of p53 expression (43%) and the presence of a 17p13/TP53 deletion was found (p=0.018). Five-year overall and progression-free survival in patients with a proportion of p53-positive cells 43% was significantly lower than in patients with its subthreshold value: 54.5 versus 81.0% (p=0.014) and 45.5 versus 66.7% (p=0.022), respectively. Conclusion. High expression of the p53 protein is associated with the presence of a 17p13 locus deletion and a low five-year survival rate in patients with diffuse large B-cell lymphoma.