Transcription of Workshop Case #2 (H 331/ 09) - IAP-AD
1 Workshop Case #2 (H 331/ 09). Age 24 years Sex male Localization lymph node dorsal musc. sternocleidomastoideus Clinical data NHL? follicle follicle HE ; 5X. Giemsa X40. CD30 x20. KI 67. CD20 Ki-67. CD3. CD 30 CD 20 KI 67. W case H3403-08; Fig. : 6. Kappa Lambda Microscopic findings Preserved lymph node structure. Inconspicuous primary and some secondary follicles with germinal centers. Diffuse hyperplasia of paracortical pulp area with massive increase of blast cells. Blast cells are CD30 + , CD 20 and CD79a negative. Areas infiltrated by these blasts are illdefined mostly around small vessels and sinus. Very high proliferative activity .Immunoglobulin light chains are polytypic. Molecular data IgH FR3a and FR2a PCR : polyclonal TCR-gamma PCR : polyclonal Differential diagnosis Partial infiltration of by NHL ( ALCL)? If reactive: Functional interpretation of findings? Etiopathogenesis?
2 Donkey r CD3 anti Rabbit m Ki67. Donkey anti Mouse Donkey anti Goat m CD79a Goat anti FITC. germinal center reaction Extrafollicular reaction CD79a ICSAT KI67. Ki67 CD79a IRF-4. germinal center reaction Extrafollicular reaction Bild intrafollicular icsat+ cells are CD79a+ IgL+. super 15310_01. Chef spezial Mantel, Keim, Aussen3_Ov4 Ausse n CD79a gruen, Igl rot, Icsat CD79a IgL IRF-4. H1317/01. CD79a IgL. CD138 germinal center reaction Extrafollicular pathways of the B-cell activation IgM +. CD27 . CD138 . short - lived . IgG +. CD27 +. CD138 +. long - lived . B-cell development in lymph nodes plasma cell protective memory memory cell reactive memory Ki67. CD20. CD79a PAX5. PU1. BCL2. CD10. BCL6. IRF-4. BLIMP-1. IgG. CD27. CD138. Etiopathogenesis Polyclonal activation of prefollicular ( naive) B. cells due to T cell independant antigens or superantigen ( Bacterial polysaccharides or capsule components).
3 Polyclonal activation of memory B cells (anamnestic response, Virus, immune deficiency,BMTx ?). Diagnosis Case #3. Hyperimmune reaction: Marked extrafollicular activation of lymph node Serology of Antibody Response Serum level IgG. IgM. time Antigen challenge Antigen booster germinal center reaction Extrafollicular reaction EFH 15310. 9113/01. Extrafollicular activation Medullary cords germinal center Memory cell Reactive Memory Plasma cell Protektive Memory Antigen Antigen Ki67. CD20. CD79a PAX5. PU1. BCL2. CD10. BCL6. IRF-4. BLIMP-1. IgL. CD27. CD138. CD30. Literature Brighenti A, Andrulis M, Geissinger E et al. (2005) Extrafollicular proliferation of B cells in the absence of follicular hyperplasia: a distinct reaction pattern in lymph nodes correlated with primary or recall type responses. Histopathology 47:90-100. Liu YJ, Zhang J, Lane PJ, Chan EY, MacLennan IC. Sites of specific B.
4 Cell activation in primary and secondary responses to T cell-dependent and T cell-independent antigens. Eur J Immunol. 1991;21(12):2951- 2962. germinal Center Proliferation Affinity maturation by somatic Plasma- B Cell hypermutation and selection cell Class switch CD27- CD27+. IgM+ IgM- IgG/A+.
