Publications by authors named "Elena Sabattini"

Introduction: Investigation of bone marrow (BM) trephine biopsies and/or clot sections by CD34 immunohistochemistry (IHC) testing has been used by pathologists for several decades, and its clinical value has been well established with QBEND10 being the most frequently used primary antibody (Ab) clone. However, most other parameters related to the IHC protocol as well as the readout vary widely between clinical laboratories and in the published literature. The ICSH Working Group having reviewed the published evidence has established guidelines that will help to harmonize performance and reporting of CD34 IHC on BM biopsies.

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  • - CCR4 receptor plays a key role in cutaneous T-cell lymphoma (CTCL) therapy by weakening immune responses against cancerous T-cells, making it a critical target for treatment.
  • - Monoclonal antibodies like mogamulizumab help decrease tumor size and improve patient outcomes by blocking CCR4’s interaction with ligands, preventing harmful T-cell movement and survival; further combinations with other treatments are being researched.
  • - Challenges such as drug resistance and off-target effects remain, leading to the need for improved patient selection and ongoing trials; despite advances, more real-world data is essential to set realistic expectations for these new therapies.
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Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorders (PCSM-LPDs), represent a rare group of haematological diseases primarily affecting the skin. In this retrospective single-centre case series study, we aimed to investigate the demographic, clinical, therapeutic and prognostic aspects of PCSM-LPD. We collected data from cases diagnosed between 2010 and the present, employing histopathological and immunohistochemical methods following the World Health Organization criteria.

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Activated phosphoinositide 3-kinase-δ syndrome 2 (APDS2) is characterized by lymphoproliferation and increased risk of malignancy. FDG-PET/CT may represent a helpful diagnostic tool for differentiating these clinical features and correctly diagnosing inborn errors of immunity (IEI). We present the case of a female patient diagnosed with Hodgkin's lymphoma at 19 years of age, although atypical imaging aspects emerged: baseline FDG-PET/CT revealed several hot lymph nodes with a symmetrical distribution, and increased tracer uptake in spleen, axial, and appendicular bone marrow.

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Cutaneous T cell lymphomas (CTCLs), encompassing mycosis fungoides (MF) and Sézary syndrome (SS), present a complex landscape influenced by cytokines and cellular responses. In this work, the intricate relationship between these inflammatory proteins and disease pathogenesis is examined, focusing on what is known at the clinical and therapeutic levels regarding the most well-known inflammatory mediators. An in-depth look is given to their possible alterations caused by novel immunomodulatory drugs and how they may alter disease progression.

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  • Rearranged neoplasms are rare blood cancers, with about 80 cases, involving myeloid and lymphoid leukemias, linked to gene translocations that activate partner genes.
  • A case of a 54-year-old woman revealed a rare cryptic insertion of the gene associated with such neoplasms, initially diagnosed as idiopathic hypereosinophilic syndrome.
  • Advanced sequencing techniques led to the identification of specific fusion transcripts, confirming the diagnosis and prompting effective treatment with imatinib mesylate, resulting in lasting positive outcomes after over a year.
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  • Large B-cell lymphoma with IRF4 rearrangement (LBCL-IRF4) is a rare type of cancer mainly found in younger patients, but can also occur in older adults, sometimes mimicking other aggressive lymphomas like blastoid/pleomorphic mantle cell lymphoma.
  • A study of 12 cases revealed that while most cases had typical features, some patients were older or presented in unusual locations, complicating diagnosis.
  • The study found that CD5 was positive in some cases, but Cyclin D1 was always negative, and SOX11 expression was limited, helping differentiate LBCL-IRF4 from similar lymphomas.
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Background: Intravascular large B-cell lymphoma (IVLBCL) is a rare extranodal lymphoma that is characterized by the selective growth of neoplastic cells in blood vessels, representing a potentially treatable cause of rapidly progressive dementia (RPD). Given its diverse clinical and instrumental presentation, it is often misdiagnosed with more common RPD causes, for example, Creutzfeldt-Jakob disease (CJD) or vascular dementia.

Methods: This study presents the clinical and histopathological characteristics of four IVLBCL cases that we diagnosed post-mortem over 20 years among over 600 brain samples received as suspected CJD cases at our prion disease reference center.

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Primary diffuse large B-cell lymphoma of the primary central nervous system (CNS-DLBCL) is an aggressive disease, with dismal prognosis despite the use of high-dose methotrexate-based polychemotherapy. Our study aimed to expand the biologic profiles of CNS-DLBCL and to correlate them with clinical/imaging findings to gain diagnostic insight and possibly identify new therapeutic targets. We selected 61 CNS-DLBCL whose formalin-fixed paraffin-embedded samples were available at first diagnosis.

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Lymphomas with plasmablastic features are a heterogeneous group of aggressive and mostly uncommon neoplasms of varied aetiologies, presenting in immunocompetent individuals as well as in immunodeficiency, associated with EBV and Kaposi sarcoma virus infections, and some as progression from indolent B-cell lymphomas. They show overlapping diagnostic features and pose a differential diagnosis with other aggressive B-cell lymphomas that can downregulate the B-cell expression programme. The spectrum of rare reactive proliferations and all lymphomas defined by plasmablastic features, together with an expanding range of poorly characterised, uncommon conditions at the interface between reactive lymphoid proliferations and neoplasia submitted to the session V of the 20 European Association for Haematopathology/Society for Hematopathology lymphoma workshop are summarised and discussed in this paper.

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  • Aggressive B-cell non-Hodgkin lymphomas are a diverse group of diseases, and new research is continually reshaping our understanding of their clinical and genetic characteristics.
  • The 2020 EAHP Workshop focused on challenging cases of high-grade B-cell lymphomas, highlighting diagnostic difficulties and specific types such as those with MYC and BCL2/BCL6 rearrangements.
  • This manuscript aims to summarize findings from the workshop and incorporate updated classifications from the latest WHO and ICC guidelines for a clearer understanding of these lymphomas.
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Session 3 of the 2021 European Association for Haematopathology/Society for Hematopathology Workshop focused on mediastinal large B cell lymphomas and surrounding gray areas. One half of the session was dedicated to primary mediastinal large B cell lymphoma (PMBL) and included cases with classic clinicopathologic features, as well as cases with either morphologic or immunophenotypic variation, and PMBL-like cases with primary extramediastinal disease. The role of additional immunophenotyping and/or molecular testing to aid in the diagnosis of PMBL was discussed.

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Session 4 of the 2021 European Association of Haematopathology/Society for Hematopathology Workshop focused on nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). First, the spectrum of immunophenotypic variations in NLPHL and the defining criteria for classic Hodgkin Lymphoma (CHL) were discussed. The added value of further immunophenotypic characterization of both tumor cells and microenvironment to support the differential diagnosis was presented.

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  • Follicular Lymphoma (FL) often leads to cycles of remission and relapse, making it nearly incurable, and current prognostic scores don't work well for all patients.
  • This study analyzed 49 FL lymph node biopsies to explore the relationship between immune cell types in the tumor microenvironment and patient outcomes, focusing on specific markers like CD56 and CD163.
  • Results indicated that certain ratios of immune cells were linked to survival rates, suggesting enhancing macrophage characterization could improve prognosis for FL patients, but further research is needed.
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  • - Kikuchi-Fujimoto disease (KFD) is a relatively harmless condition that mainly causes swollen lymph nodes in young women and can be mistaken for more serious diseases due to similar T-cell features.
  • - A recent study analyzed 88 KFD cases to see if clonal T-cell receptor (TCR) amplifications could be detected, finding clonal peaks in 18% of cases without significant differences in other clinical parameters.
  • - The findings suggest that while clonal TCR gamma results can occur in KFD, care must be taken not to misinterpret these as signs of a serious illness, like T-cell neoplasia.
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Castleman disease describes a group of heterogeneous clinicopathological disorders now included in the tumor-like lesions with B-cell predominance of the World Health Organization classification. Managing idiopathic multicentric Castleman disease (iMCD) is challenging, because few systematic studies or comparative randomized clinical trials have been conducted. International, consensus evidence-based guidelines for iMCD were published in 2018, but gaps in the therapeutic options for difficult-to-treat patients, who do not respond to siltuximab and other conventional therapies, still exist.

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The concomitant presence of Castleman disease (CD) with other hematological pathology is an event described in the literature with increasing frequency, able to modify the diagnostic and curative approach in such patients. Very few studies in the literature describe the association of CD with concomitant neoplastic diseases; the most frequent are Kaposi's sarcomas (especially in HIV and human herpes virus-8-positive patients) and lymphoproliferative disorders, such as lymphomas. Instead, since the association with plasma cell diseases such as multiple myeloma and plasmacytoma is infrequent, there is a lack of literature.

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Secondary hyperparathyroidism (SHPT) in dialysis is common. A young man on chronic hemodialysis with SHPT developed pancytopenia with resistant anemia requiring transfusions. A bone marrow biopsy showed grade 3 fibrosis, depleted cellularity, osteosclerosis, and decreased myelopoiesis.

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