scholarly journals De novo thymic carcinoma or malignant transformation: a myasthenic patient presented with multiple mediastinal tumours

2020 ◽  
Vol 8 (7) ◽  
Author(s):  
Chu‐Pin Pai ◽  
Chih‐Ming Lin ◽  
Yi‐Chen Yeh ◽  
Chien‐Sheng Huang ◽  
Biing‐Shiun Huang
Blood ◽  
1995 ◽  
Vol 86 (8) ◽  
pp. 2906-2912 ◽  
Author(s):  
D Haase ◽  
M Feuring-Buske ◽  
S Konemann ◽  
C Fonatsch ◽  
C Troff ◽  
...  

Acute myeloid leukemia (AML) is a heterogenous disease according to morphology, immunophenotype, and genetics. The retained capacity of differentiation is the basis for the phenotypic classification of the bulk population of leukemic blasts and the identification of distinct subpopulations. Within the hierarchy of hematopoietic development and differentiation it is still unknown at which stage the malignant transformation occurs. It was our aim to analyze the potential involvement of cells with the immunophenotype of pluripotent stem cells in the leukemic process by the use of cytogenetic and cell sorting techniques. Cytogenetic analyses of bone marrow aspirates were performed in 13 patients with AML (11 de novo and 2 secondary) and showed karyotype abnormalities in 10 cases [2q+, +4, 6p, t(6:9), 7, +8 in 1 patient each and inv(16) in 4 patients each]. Aliquots of the samples were fractionated by fluorescence-activated cell sorting of CD34+ cells. Two subpopulations, CD34+/CD38-(early hematopoietic stem cells) and CD34+/CD38+ (more mature progenitor cells), were screened for karyotype aberations as a marker for leukemic cells. Clonal abnormalities and evaluable metaphases were found in 8 highly purified CD34+/CD38-populations and in 9 of the CD34+/CD38-specimens, respectively. In the majority of cases (CD34+/CD38-, 6 of 8 informative samples; CD34+/CD38+, 5 of 9 informative samples), the highly purified CD34+ specimens also contained cytogenetically normal cells. Secondary, progression-associated chromosomal changes (+8, 12) were identified in the CD34+/CD38-cells of 2 patients. We conclude that clonal karyotypic abnormalities are frequently found in the stem cell-like (CD34+/CD38-) and more mature (CD34+/CD38+) populations of patients with AML, irrespective of the phenotype of the bulk population of leukemic blasts and of the primary or secondary character of the leukemia. Our data suggest that, in AML, malignant transformation as well as disease progression may occur at the level of CD34+/CD38-cells with multilineage potential.


2017 ◽  
Vol 118 (2-3) ◽  
pp. 87-94
Author(s):  
Karel Medek ◽  
Jiří Zeman ◽  
Tomáš Honzík ◽  
Hana Hansíková ◽  
Štěpánka Švecová ◽  
...  

Hereditary multiple exostoses (HME) represents a heterogeneous group of diseases often associated with progressive skeletal deformities. Most frequently, mutations inEXT1andEXT2genes with autosomal dominant inheritance are responsible for HME. In our group of 9 families with HME we evaluated the clinical course of the disease and analysed molecular background using Sanger sequencing and MLPA inEXT1andEXT2genes. The mean age in our group of patients, when the first exostosis was recognised was 4.5 years (range 2–10 years) and the number of exostoses per one patient documented on X-ray ranged from 2 to 54. Most of the exostoses developed before the growth was completed and they were dominantly localised in the distal femurs, proximal tibia, proximal humerus and distal radius. In all patients, at least one to 8 surgeries were necessary due to complaints and local complications, but neither patient developed malignant transformation. In half of the patients, the disease resulted in short stature. DNA analyses were positive in 7 families. In five probands, differentEXT1gene mutations resulting in premature stop-codon (p.Gly124Argfs*65, p.Leu191*, p.Trp364Lysfs*11, p.Val371Glyfs*10, p.Leu490Profs*31) were found. In two probands, nonsense mutations were found inEXT2gene (p.Val187Profs*115, p.Cys319fs*46). Five mutations have been novel and two mutations have occurredde novoin probands. Although the risk for malignant transformation is usually low, especially in patients with low number of exostoses, early diagnostics and longitudinal follow up of patients is of a big importance, because early surgery can prevent progression of secondary bone deformities.


1997 ◽  
Vol 3 (S2) ◽  
pp. 5-6
Author(s):  
N. G. Wolf ◽  
F. W. Abdul-Karim ◽  
N. J. Schork ◽  
S. Schwartz

Although ovarian carcinomas are the most lethal gynecologic tumors, their origins remain unclear. Do they develop from malignant transformation of benign neoplasms through a multistep process of tumor progression, or do they arise de novo? The histologically benign and/or low malignant potential (LMP) components in heterogeneous ovarian carcinomas have been considered as evidence supporting the theory of tumor progression. These components are interpretted as the remnants of pre-existing neoplasms that underwent malignant transformation. In two other possible interpretations, however, such components may be clones which developed independently (de novo hypothesis) or they may represent malignant epithelium which underwent focal maturation (maturation hypothesis).To evaluate genetic relationships of the histological components in heterogeneous ovarian carcinomas, 10 such neoplasms and 5 normal ovary controls were examined using fluorescence in situhybridization (FISH) on intact paraffin sections (6 μm).The retention of tissue architecture allowed direct correlation of detectable genetic aberrations with histology, and comparison of malignant components with adjacent histologically benign or LMP components.


2019 ◽  
Vol 139 (5) ◽  
pp. S63
Author(s):  
J. Brosseau ◽  
C. Liao ◽  
Y. Wang ◽  
V. Ramani ◽  
T. Vandergriff ◽  
...  

2015 ◽  
Vol 30 (2) ◽  
pp. 43-46
Author(s):  
Daryl Anne A. Del Mundo

Objective: To report the possible malignant transformation of primary sinonasal ameloblastoma into sinonasal ameloblastic carcinoma. Methods: Design: Case Report Setting: Tertiary Public University Hospital Patient: One (1) Result: A 50-year-old woman with a previous diagnosis of sinonasal ameloblastoma reported recurrence of symptoms of right-sided nasal obstruction and epistaxis two years after endoscopic sinus surgery. Clinical examination, CT scans, and subsequent total maxillectomy with orbital exenteration revealed a left intranasal mass with maxillary, ethmoid, and orbital floor extension and pulmonary and hepatic metastases.  Histopathologic findings of palisading columnar epithelium with reverse polarity with malignant features were consistent with ameloblastic carcinoma. Despite subsequent cycles of chemotherapy, the patient died two years after surgery. To the best of our knowledge, there have been no published reports of a primary sinonasal ameloblastoma with malignant transformation in the English literature. Conclusion: Ameloblastic carcinoma is a rare neoplasm which may arise de novo or from malignant transformation of an ameloblastoma. Because ameloblastoma is commonly encountered in our setting, clinicians should be aware of this possibility and closely follow their patients accordingly. Keywords: sinonasal, maxillary, ameloblastic carcinoma, malignant transformation


Blood ◽  
1995 ◽  
Vol 86 (8) ◽  
pp. 2906-2912 ◽  
Author(s):  
D Haase ◽  
M Feuring-Buske ◽  
S Konemann ◽  
C Fonatsch ◽  
C Troff ◽  
...  

Abstract Acute myeloid leukemia (AML) is a heterogenous disease according to morphology, immunophenotype, and genetics. The retained capacity of differentiation is the basis for the phenotypic classification of the bulk population of leukemic blasts and the identification of distinct subpopulations. Within the hierarchy of hematopoietic development and differentiation it is still unknown at which stage the malignant transformation occurs. It was our aim to analyze the potential involvement of cells with the immunophenotype of pluripotent stem cells in the leukemic process by the use of cytogenetic and cell sorting techniques. Cytogenetic analyses of bone marrow aspirates were performed in 13 patients with AML (11 de novo and 2 secondary) and showed karyotype abnormalities in 10 cases [2q+, +4, 6p, t(6:9), 7, +8 in 1 patient each and inv(16) in 4 patients each]. Aliquots of the samples were fractionated by fluorescence-activated cell sorting of CD34+ cells. Two subpopulations, CD34+/CD38-(early hematopoietic stem cells) and CD34+/CD38+ (more mature progenitor cells), were screened for karyotype aberations as a marker for leukemic cells. Clonal abnormalities and evaluable metaphases were found in 8 highly purified CD34+/CD38-populations and in 9 of the CD34+/CD38-specimens, respectively. In the majority of cases (CD34+/CD38-, 6 of 8 informative samples; CD34+/CD38+, 5 of 9 informative samples), the highly purified CD34+ specimens also contained cytogenetically normal cells. Secondary, progression-associated chromosomal changes (+8, 12) were identified in the CD34+/CD38-cells of 2 patients. We conclude that clonal karyotypic abnormalities are frequently found in the stem cell-like (CD34+/CD38-) and more mature (CD34+/CD38+) populations of patients with AML, irrespective of the phenotype of the bulk population of leukemic blasts and of the primary or secondary character of the leukemia. Our data suggest that, in AML, malignant transformation as well as disease progression may occur at the level of CD34+/CD38-cells with multilineage potential.


Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4774-4774
Author(s):  
Olivier Decaux ◽  
Sophie Besnard ◽  
Antoinette Perlat ◽  
Claire Cazalets ◽  
Berengere Cador ◽  
...  

Abstract Background: Monoclonal gammapathy of unknown significance (MGUS) is a frequent disorder that carries a 1% per year risk of progression to multiple myeloma (MM). Patients should be monitored annually to detect malignant transformation before complications occur. Objective: To assess if MGUS regular follow-up allow early detection of malignant transformation before severe complications occur. Progression to multiple myeloma was established according to the criteria defined by the International Working Group. Criteria for severe complication were: hypercalcemia (> 3 mmol/l), acute renal insufficiency needing dialysis, bone fracture, sepsis. Methods: We retrospectively reviewed medical data of patients treated for post-MGUS multiple myeloma in Internal Medicine Departement of Rennes University Hospital (France) between 1980 and 2006. Results: Forty two patients were identified (23 men and 19 women). Median age was 66 years old (49 – 79) at the time of MGUS diagnosis and 70,5 years old (51 – 84) at the time of MM diagnosis. Isotype was: IgG in 37 patients (88%), IgA in 2 (5%) and biclonal IgG/IgA in 3 (7%). Median level of monoclonal component was 19,9 g/L (4,9 – 42,2) at MGUS diagnosis and 35,3 g/L (15,2 – 68) at the time of MM diagnosis. Median bone marrow plasmocytosis was 4% (0–10) for MGUS and 12% (1–30) for MM. Median time from MGUS diagnosis to malignant transformation was 4 years (1 – 12). Anemia (hemoglobin concentration ≤12 g/dL) was present at the time of MM diagnosis in 16 (38%) patients. It was generally moderate in severity; only 6 (14,2%) patients had a hemoglobin value of 10 g/dL or less and no patients had a haemoglobin value of 8 g/dL or less. The serum creatinine level was increased (more than 100 μmol/L) in 6 (14,2%) patients and no patients had a serum creatinine value of 200 μmol/L or more at the time of MM diagnosis. Two patients had an hypercalcemia (2,60 mmol/L or more) at the time of MM diagnosis. In 30 patients (71%), malignant transformation was detected before a severe complication occurs. In 8 patients (19%) a severe complication occurred before multiple myeloma diagnosis: hypercalcemia (2 cases), sepsis (2 cases), spinal fracture with epiduritis (3 cases), spontaneous sternum fracture (1 case). Four of these patients had refused follow-up and were not monitored for MGUS evolution despite medical explanations as regards to the risk of malignant transformation. In 4 patients (10%) criteria of MM diagnosis were not found in medical file because diagnosis was made in another hospital.) Most patients were treated with conventional chemotherapy (40% with MP) and two with autologous hematopoietic stem cell transplantation. The median survival after malignant transformation was 48 months. Conclusions: Regular follow up of patients with MGUS allows earlier diagnostis of MM and prevent them for severe complications. We plan to compare this group with patients treated in our department for de novo MM during the same period of time.


Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4198-4198
Author(s):  
Allison Mayle ◽  
Liubin Yang ◽  
Grant A Challen ◽  
Ting Zhou ◽  
Vivienne I. Rebel ◽  
...  

Abstract DNA methyltransferase 3A (DNMT3A), a de novo DNA methyltransferase, is mutated in various hematological malignancies affecting both myeloid (20%), mixed (50%), and lymphoid (18%) malignancies and is associated with poor prognosis. The most frequently reported DNMT3A mutation is R882 in acute myeloid leukemia (AML), which results in altered enzyme activity, but various missense and nonsense mutations have also been found throughout the gene, suggesting that loss-of-function mutations in DNMT3A may also contribute to leukemogenesis. Our group recently showed that transplantation of HSCs from Dnmt3a knock-out (KO) mice led to increased hematopoietic stem cell (HSC) self-renewal and inhibition of differentiation, but was insufficient to cause transformation. However, in these experiments, Dnmt3a-KO HSCs were transplanted alongside wild-type whole bone marrow to quantitate HSC function, potentially protecting against malignant transformation. We hypothesized that if Dnmt3a-KO HSCs were transplanted alone, a predisposition to transformation would be uncovered. We established a large non-competitive transplantation cohort receiving 500 control or Dnmt3a-KO HSCs and monitored the mice closely for disease. Strikingly, mice with Dnmt3a-KO HSCs had significantly shorter survival (246d vs 467d, p<0.0001, Figure 1). As mice succumbed to disease, we analyzed histological changes in hematopoietic organs and performed CBCs and immunophenotyping to diagnose the diseases. We identified multiple disease classes within the Dnmt3a-KO recipients, including T-cell acute lymphoblastic leukemia, myeloproliferative disease (MPD), myelofibrosis (MF), and myelodysplastic syndromes (MDS). The relatively long disease latency suggests that acquisition of secondary hits promotes disease; identification of these secondary mutations is ongoing.Figure 1Mice transplanted with Dnmt3a-KO HSCs succumb to hematologic malignanciesFigure 1. Mice transplanted with Dnmt3a-KO HSCs succumb to hematologic malignancies Here, we show that Dnmt3a deletion in noncompetitive transplanted HSCs leads to an array of hematologic disorders that models the spectrum of disorders seen in human malignancies. Since DNMT3A mutations are known early genetic lesions in leukemia development, mutations that cooperate with DNMT3A might influence the type of disease developed. This mouse model serves to validate an important role for Dnmt3a in the development of hematologic malignancies, and is also valuable for the study of future targeted therapies. Mice transplanted with Dnmt3a-KO HSCs died significantly earlier than mice transplanted with control HSCs (median survival 246 days and 467 days, p<0.0001). Fifty and 20 female mice were transplanted with 500 Dnmt3a-KO or control HSCs respectively, all at 6-8 weeks of age. Censored points indicate mice that were euthanized for unrelated reasons. Disclosures: No relevant conflicts of interest to declare.


2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Jean-Philippe Brosseau ◽  
Chung-Ping Liao ◽  
Yong Wang ◽  
Vijay Ramani ◽  
Travis Vandergriff ◽  
...  

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