A parallel comparison of T-cell clonality assessment between an in-house PCR assay and the BIOMED-2 assay leading to an efficient and cost-effective strategy.

Aims: Diagnosis of T-cell lymphoproliferation is sometimes challenging, and in certain instances pathologists rely heavily on the clonality assessment results of T-cell receptor (TCR) gene rearrangement (TCR-GR). Many investigators have designed various in-house primer sets for PCR-based study targeting different loci of TCR genes. In recent years, the commercial BIOMED-2 protocols have become available.

Hepatitis C virus infection is significantly associated with malignant lymphoma in Taiwan, particularly with nodal and splenic marginal zone lymphomas.

Aims: Hepatitis C virus (HCV) is a hepatotropic and lymphotropic RNA virus causally linked to lymphoma with a strong geographic variation. The aim of this study was to investigate the association of HCV and lymphoma in Taiwan, in which HCV is endemic.

Methods: Patients diagnosed with lymphoma from January 2004 to December 2008 were investigated for serum anti-HCV, and the infection rate was compared with that in healthy controls.

Multicentric primary intestinal EBV-positive diffuse large B cell lymphoma of the elderly presenting with perforation.

Epstein-Barr virus (EBV)-positive diffuse large B cell lymphoma (DLBCL) of the elderly is a recently defined subgroup of DLBCL in the 2008 WHO classification of lymphoid neoplasms. It is characterized by an EBV-positive clonal B cell lymphoproliferation that occurs in patients aged over 50 years without any known immunodeficiency. This disease shows frequent extranodal involvement, a morphological spectrum from polymorphous to monomorphic large cells, and a poor prognosis.

Angioimmunoblastic T-cell lymphoma of cytotoxic T-cell phenotype containing a large B-cell proliferation with an undersized B-cell clonal product.

Angioimmunoblastic T-cell lymphoma is a nodal peripheral T-cell lymphoma considered to be derived from CD4 follicular helper T cells. It is characterized by the proliferation of arborizing vessels, hyperplastic follicular dendritic cells, and a polymorphous lymphoid infiltrate including large B immunoblasts, which could be polyclonal, oligoclonal, or monoclonal. The polymerase chain reaction-based clonality study of lymphoproliferations is increasingly popular in the diagnostic workup.

NK-cell lymphoma with nodal presentation and expression of cutaneous lymphocyte-associated antigen.

Nasal and nasal-type NK/T-cell lymphomas are predominantly extranodal tumors with a specific immunophenotype and a strong association with EBV. The cutaneous lymphocyte-associated antigen (CLA) is the homing receptor for skin-homing T cells and NK cells. In the literature, the prognostic impact of CLA expression in primary cutaneous T-cell lymphomas and nasal NK-cell lymphomas is contradictory.

NK-cell lineage predicts poor survival in primary intestinal NK-cell and T-cell lymphomas.

Most primary intestinal natural killer (NK)-cell and T-cell lymphomas (PINKTL) in the Northern Europe are enteropathy-associated T-cell lymphomas, a complication of celiac disease, which is rare in the East. Primary intestinal NK-cell lymphoma is extremely rare and is poorly characterized. We investigated 30 cases of PINKTL from Taiwan with male: female at 2:1, median age at 55.

Chronic lymphocytic leukemia with paraimmunoblastic transformation - with comparative genomic hybridization and review of the literature.

Richter's transformation (RT) is the development of a high-grade lymphoma in patients with B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). We report an extremely rare case with paraimmunoblastic transformation. A 78-year-old Taiwanese male had Rai stage 1 and Binet stage B CLL/SLL involving skin, peripheral blood (PB), and bone marrow (BM) with paraimmunoblastic transformation in the lymph node.

Cytologic diagnosis of primary effusion lymphoma in an HIV-negative patient.

Primary effusion lymphoma (PEL) is an unusual and rare type of non-Hodgkin's lymphoma characterized by lymphomatous effusion of pleural, pericardial or peritoneal cavities without lymphadenopathy or organomegaly. It is associated with human herpes virus-8 (HHV-8) and occurs most often in immunodeficient patients. We present a case of PEL in a 69-year-old male presenting with pleural effusion and ascites.

EBV-associated diffuse large B-cell lymphoma in a psoriatic treated with methotrexate.

Methotrexate-associated lymphoproliferative disorder (MTX-LPD) is a lymphoid proliferation or lymphoma in a patient immunosuppressed with MTX, which is usually administered for treating autoimmune diseases. The majority of MTX-LPD cases develop in patients with rheumatoid arthritis and occasionally with psoriasis who had been treated with MTX. Here, we report on a 50-year-old Taiwanese male with severe psoriasis, who received high doses of MTX.

Polymorphisms of the uridine-diphosphoglucuronosyltransferase 1A1 gene and coronary artery disease.

Bilirubin, an antioxidant in the blood, plays a role in protection from atherosclerosis. The level of bilirubin is highly correlated to the incidence of coronary artery disease (CAD). Unconjugated bilirubin is conjugated with glucuronic acid through the reaction of uridine 5'-diphosphate-glucuronosyl transferase 1A1 (UGT1A1).

Plasmablastic cytomorphologic features in plasma cell neoplasms in immunocompetent patients are significantly associated with EBV.

Multiple myeloma (MM) is rarely associated with Epstein-Barr virus (EBV) irrespective of HIV status, in contrast with its morphologic mimic, plasmablastic lymphoma, which occurs mainly in immunocompromised patients with frequent EBV association. Among 58 consecutive immunocompetent patients, we found plasmablastic cytomorphologic features in 2 of 4 with plasmacytomas and 14 (26%) of 54 with MM. Of the tumors, 4 (7%; 1 plasmacytoma and 3 MMs) were EBV-encoded RNA (EBER)-positive with plasmablastic cytomorphologic features in 3.

Detecting clonal rearrangement in non-Hodgkin's lymphomas in Taiwan by polymerase chain reaction.

The detection of monoclonal expansions of the immunoglobulin heavy chain (IgH) or the T-cell receptor-gamma (TCRgamma) chain genes is an important supplement for the diagnosis of the non-Hodgkin's lymphomas (NHLs). Detection of monoclonality by polymerase chain reaction (PCR) method has offered an efficient approach for rapid diagnosis and monitoring of the therapeutic effects. Here we conducted a retrospective PCR clonality study on 49 cases of NHLs including 23 B-cell lymphomas (BCLs), 20 peripheral T-cell lymphomas (PTCLs), 6 natural killer (NK)/T-cell lymphomas and 3 reactive lymphoid tissues from southern Taiwan.