Clinicopathological Significance of Perivascular Mesenchymal Cell Clusters in Imprint Cytology of Lymph Nodes
Tomoko Wakasa, Miyuki Noda, Masayuki Shintaku, Kenichi Wakasa, Masahiko Ohsawa. Osaka Red Cross Hospital, Osaka, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan
Background: In stump cytology specimens of lymph nodes, other than lymphocytes, there are many mesenchymal cells. Particularly, the high endothelial venule (HEV) is well known. Furthermore, large mesenchymal cell clusters composed of smooth muscle actin-positive spindle cells and CD34-positive endothelial cells are observed in cytological specimens. We termed these spindle cells Perivascular Mesenchymal Cell Clusters (PVMCCs).
In the last meeting, we reported that PVMCCs were observed in 76% of T-cell lymphoma and 47% of Hodgkin lymphoma, but rarely in reactive lymphoid hyperplasia. Further, PVMCCs are very useful to differentiate between malignant lymphoma and reactive lymphoid hyperplasia.In this study, we report the clinicopathologic features of PVMCC-positive lymphomas.
Design: Between October 2008 and August 2010, cases involved 143 imprint specimens of lymph nodes, 65 cases of B-cell lymphoma, 16 cases of T-cell lymphoma, 17 case of Hodgkin lymphoma, 35 cases of reactive lymphoid hyperplasia, 5 cases of Castleman disease, and 5 cases of EBV-associated B cell lymphoproliferative disorder.
Two consecutive slides were prepared from each biopsy specimen. The slides were immediately fixed in 95% ethanol and stained using the standard Papanicolaou method.
Clinicopathologic data were obtained from medical records. Cytogenetic analysis was performed in all cases.
Results: PVMCCs were found in 10 of the 65 cases of B-cell lymphoma, in 13 of the 16 cases of T-cell lymphoma, and 8 of the 17 cases of Hodgkin lymphoma. But PVMCCs were seen in only 2 of the 35 cases of reactive lymphoid hyperplasia. No PVMCCs was observed in the cases of Castleman disease.
The average soluble IL-2 receptor (sIL-2R) levels were 2,318 U/ml in PVMCC-negative cases and 6,393U/ml in PVMCC-positive ones (p<0.01). The median overall survival was 896 days in PVMCC-positive cases and 1074 days in negative cases, with a median follow-up of 1029 days (p=0.038).
Four of the 5 cases of EBV associated B cell lymphoproliferative disorder showed many PVMCCs, and a higher sIL-2R level (average: 3823U/ml), and 3 cases died (345, 435, 913 days after the diagnosis).
Conclusions: In the PVMCC-positive cases, sIL-2R levels were significantly higher than those of negative cases. The PVMCC-positive cases show a poor prognosis. The presence of PVMCCs suggested an unfavorable outcome.
Wednesday, March 21, 2012 1:00 PM
Poster Session VI # 91, Wednesday Afternoon