Cytological tumour cell characteristics and reactive small lymphocytes influence patient prognosis in acute and lymphoma type adult T‐cell leukaemia/lymphoma

Abstract

Objective: Acute and lymphoma type adult T-cell leukaemia/lymphoma (ATLL) patients show an aggressive clinical course. While some clinical signs indicate good prognosis, definitive cytohistological prognostic factors have yet to be described. Methods:We classified 65 ATLL patients into three groups by tumour cell size and nuclear pleomorphism on fine-needle aspiration and tumour touch smear samples.Semi-quantitative analysis of background small lymphocytes, reactive CD20-positive B cells and CD8-positive T cells was performed.Results: Thirty-one patients had pleomorphic lymphoma with predominantly medium-sized cells and coarse granular nuclei. Another 24 patients showed pleomorphic large cell lymphoma with stippled chromatin. The remaining 10 demonstrated monomorphic large lymphoma cells with fine granular chromatin. Patients with pleomorphic lymphoma with medium-sized cells showed significantly higher serum lactate dehydrogenase and lower CD30 and C-MYC expression in lymphoma cells than the other two groups (P = .0216, P < 0.01, respectively). Patients with pleomorphic medium-sized ATLL had few usual small lymphocytes observed on routine morphological examination and showed less concurrent detection of CD20-positive B cells and CD8-positive T cells, both of which were lower than in the other two groups (P = .006, P = .019, respectively). Furthermore, ATLL patients with predominantly medium-sized lymphocytes exhibited a worse prognosis than patients with pleomorphic large cells (P = .0197). Background small lymphocytes and concurrent detection of CD20-positive B cells and CD8-positive T cells may thus be good prognostic factors (P = .011, P = .021, respectively). Conclusions:Morphological features, size of neoplastic cells and background nonneoplastic lymphocyte (B cells and CD8-positive T cells) volume appear to influence the prognosis of patients with aggressive-type ATLL. K E Y W O R D Sadult T-cell leukaemia/lymphoma, cytology, prognosis, tumour-infiltrating lymphocytes | 403 KOBATA eT Al.

Clinical and cytopathological characteristics of HTLV‐1+ hodgkin lymphoma

“…Nuclear size, nuclear contours, nuclear chromatin patterns (fine granular, coarse granular, stippled) and nucleoli of lymphoid cells, and giant nuclear neoplastic cells were cytologically analyzed, mainly using the Pap stain. Nuclear diameter was measured using scale bars in the Pap stained samples 12,13 . Cells with a nuclear diameter smaller than 5 µm were tentatively defined as small lymphocytes, irrespective of whether they were nonneoplastic (normal) or neoplastic.…”

“…Nuclear diameter was measured using scale bars in the Pap stained samples. 12,13 Cells with a nuclear diameter smaller than 5 µm were tentatively defined as small lymphocytes, irrespective of whether they were nonneoplastic (normal) or neoplastic. Lymphocytes with nuclei of 5-8 µm and greater than 8 µm in diameter were defined as medium-sized and large lymphocytes, respectively.…”

An Experimental Investigation of the Impact of Gas Phase Prepolymerization of Propylene

“…In such processes a first, smaller reactor dedicated to continuous prepolymerization, and is run under much milder conditions of temperature and pressure than those of the main reactor. [ 1 ] Prepolymerization can also be conducted off‐line to prepare so‐called “prepolymerized catalyst.” [ 2–10 ] Regardless of how it is carried out, for the early generations of TiCl 3 ‐based catalysts, prepolymerization could reduce the amorphous fraction of the final product, enhance the catalyst stability and improve the particle morphology. [ 11–13 ] For the modern high yield magnesium dichloride (MgCl 2 )‐supported catalysts, prepolymerization has been employed mainly to allow the polymer/catalyst particles to fragment in a controlled manner so that the particle morphology and the activity can be improved, sometimes improving the stability of the catalyst and preventing the clogging of the catalyst transfer lines are also purposes.…”

The role of cytology in the diagnosis of haematological malignancies

“…The awareness of these findings in the right clinical settings facilitates a prompt diagnosis at presentation and assessment of disease relapse. Kobata et al describe a fascinating correlation between cytological findings and prognosis in a large series (65 cases) of adult T cell lymphoma/leukaemia. They show how morphological features, size of neoplastic cells and number of non‐neoplastic lymphocytes in the background appear to influence the prognosis of patients with aggressive‐type adult T cell lymphoma/leukaemia.…”

“…The cytological diagnosis of two different types of T cell malignancies is discussed in the two papers by Kanwalpreet et al and Kobata et al . The former is a retrospective analysis of histologically confirmed cases of extranodal nasal type NK/T cell lymphomas.…”