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Sergi Serrano

Publications and source records attributed to Sergi Serrano.

At least 37 records · Page 2Linked to original sources

Is fluorescence in situ hybridization a useful method in diagnosis of polycythemia vera patients?

Polycythemia vera (PV) is a clonal stem cell disease with trilineage myeloid involvement, characterized by a growth factor-independent erythroid proliferation. At the time of diagnosis, the percentage of cytogenetic abnormalities using conventional cytogenetic techniques is less than 20% of all PV patients. In the present study, we compare the results between conventional cytogenetic methods and fluorescence in situ hybridization (FISH) probes in 31 untreated PV patients. The karyotypes of all 31 cases were obtained from 24-hour bone marrow cell cultures. The fixed material, proceeding from conventional cytogenetics cultures, was analyzed with FISH, using centromeric probes for chromosomes 8 and 9 and locus-specific probes for 13q14 and 20q12 regions. Five cases (17.8%) showed an abnormal karyotype with conventional cytogenetics. When FISH probes were used, three alterations not detected with conventional cytogenetics, were found: two cases with D20S108 deletions and one with a D13S319 deletion, increasing the percentage of abnormal karyotypes to 19.3%. We conclude that, probably, the application of FISH with the mentioned probes, is not very useful to detect cytogenetic aberrations in untreated PV patients.

Female↗

Oral solid form of primary effusion lymphoma mimicking plasmablastic lymphoma.

Primary effusion lymphoma (PEL) is a rare large cell lymphoma subtype that usually is associated with human immunodeficiency virus infection. Features facilitating PEL identification are its clinical presentation, cytologic findings, immunophenotypic profile, and particularly, relation to human herpesvirus 8 (HHV8) infection. Uncommonly, PEL may present as a solid form that predominantly involves the distal digestive tract and poses major diagnostic problems, especially when unassociated with body cavity effusions. We herein report the case of an HIV-positive 42-year-old male with synchronous presentation of a pleural cavity PEL and a tongue-based lesion, both displaying plasmablastic features. Demonstration of HHV8 presence in the lingual lesion excluded a plasmablastic lymphoma and established the diagnosis of an oral solid form of PEL. This case illustrates the need for investigating HHV8 in any plasmablastic-looking lymphoma, especially in HIV-infected patients.

Adult↗

Comparative analysis of TCR-gamma gene rearrangements by Genescan and polyacrylamide gel-electrophoresis in cutaneous T-cell lymphoma.

Demonstrating T-cell clonality has become an important approach supporting a diagnosis of malignant T-cell neoplasms. A comparative study between Genescan analysis, polyacrylamide gel and agarose gel electrophoresis in visualizing T-cell receptor gamma gene rearrangement was performed on 25 biopsy specimens from 18 patients with different forms of cutaneous T-cell lymphomas. Clonality was detected in 17 biopsy specimens when PCR products were evaluated by Genescan analysis. Seventeen showed discrete bands when visualized in polyacrylamide gel and 14 cases were clonal when visualized with agarose gel. In five cases, a clonal population was seen in the gels, but not with Genescan. On sequencing the PCR products we demonstrated non-clonality of these five samples. Our results confirm that PCR-Genescan is a useful, reliable and specific screening method for detecting dominant clones in patients with T-cell lymphoma.

Electrophoresis, Polyacrylamide Gel↗

Lymphomatoid papulosis associated with mycosis fungoides: clinicopathological and molecular studies of 12 cases.

The association of mycosis fungoides and a primary cutaneous CD30+ lymphoproliferative disorder has been reported and probably represents different clinical aspects of a unique T-cell monoclonal expansion. In this study, 12 patients (6 men and 6 women) presented with lymphomatoid papulosis and mycosis fungoides. A TCRgamma gene rearrangement study was performed by an automated high-resolution PCR fragment analysis method on skin biopsy specimens taken from the different clinical lesions in each patient. An indolent clinical course was observed in the majority of patients. T-cell clonality was identified in 7 of 12 lymphomatoid papulosis lesions (58%) and in 6 skin biopsies of plaque stage mycosis fungoides (50%). In each individual case, where T-cell clonality was detected, both mycosis fungoides and lymphomatoid papulosis specimens exhibited an identical peak pattern by automated high-resolution PCR fragment analysis, confirming a common clonal origin. Only one case showed a clonal TCRgamma rearrangement from the lymphomatoid papulosis lesion, which could not be demonstrated in the mycosis fungoides specimen. The demonstration of an identical clone seems to confirm that both disorders are different clinical manifestations of a unique T-cell monoclonal proliferation. Our results also seem to confirm that the association of mycosis fungoides with a primary cutaneous CD30+ lymphoproliferative disorder usually carries a favourable prognosis.

Adult↗

Genetic characterization of Sézary's syndrome by conventional cytogenetics and cross-species color banding fluorescent in situhybridization.

BACKGROUND AND OBJECTIVES: Sezary's syndrome is a peripheral T-cell neoplasm characterized by a pruritic exfoliative or infiltrated erythroderma, lymphadenopathies, and atypical T lymphocytes in the peripheral blood. Cytogenetic studies are scarce. This study was designed to increase cytogenetic information on this disorder. DESIGN AND METHODS: Peripheral blood samples were collected from 21 patients with Sezary's syndrome (10 men, 11 women, mean age 64 years) and analyzed by conventional cytogenetics (72-hr cultures with phytohemagglutinin). For a better characterization of multiple chromosomal rearrangements, cross-species color banding (RxFISH) was used in four cases. RESULTS: Fifteen (71.4%) of the 21 cases showed cytogenetic aberrations, with the karyotype being complex in 14. Among the 15 patients with an abnormal karyotype, 8 presented a diploid/near-diploid karyotype and 7 a near-tetraploid karyotype. The chromosomes most frequently involved were 1, 6, 8, 9, 10, 11, and 17. The most common structural rearrangements affected 1q, 2q, 6q23-27, and 8q22. Monosomies of chromosomes 9 and 10 and trisomies of chromosome 18 were recurrently observed. A statistical trend between abnormal and complex karyotypes, the presence of monosomy 10, the number of Sezary cells, and a decreased overall survival was observed. RxFISH technology allowed the description of 27 previously undetected chromosomal abnormalities. INTERPRETATION AND CONCLUSIONS: Abnormal karyotypes, particularly complex karyotypes, were frequently detected in patients with Sezary's syndrome. Monosomy 10 was the most frequent recurrent cytogenetic marker (73% in abnormal cases). There was a high diversity of chromosomal breakpoints. RxFISH is a useful novel technology for redefining complex karyotypes.

Adult↗

Cytogenetic findings in familial B-cell chronic lymphocytic leukemia: a report of two cases in a family.

Familial B-cell chronic lymphocytic (B-CLL) leukemia has been defined as an entity epidemiologically different from sporadic B-CLL. Cytogenetic abnormalities in familial B-CLL, studied either by conventional cytogenetics or by interphase fluorescence in situ hybridization (i-FISH), have rarely been reported. We report a two-case family affected with B-CLL showing two different abnormal karyotypes detected by conventional cytogenetics [46,XX,del(7)(q32) and 46,XY,add(1)(p36),del(6)(q21)] but sharing a del(13)(q14) at the D13S319 locus, detected by interphase fluorescence in situ hybridization.

Chromosome Aberrations↗

Catalyzed signal amplification for cyclin D1 detection in mantle cell lymphoma.

Mantle cell lymphoma is characterized by a t(11;14)(q13;q32) translocation resulting in cyclin D1 protein overexpression. Immunohistochemical detection of the latter, therefore, is a useful marker for the diagnosis of mantle cell lymphoma. Nevertheless, interpretation of results is often hampered by the weak immunoreactivity obtained with routine detection techniques. This problem can be overcome by resorting to highly sensitive catalyzed signal amplification methods based on peroxidase-catalyzed deposition of a biotinylated phenolic compound. The present study compares the results obtained with catalyzed signal amplification, labeled streptavidin biotin, and dextran polymeric conjugate (EnVision+) techniques in cyclin D1 demonstration in mantle cell lymphoma. The study was performed on formalin-fixed, paraffin-embedded archival tissue from 20 mantle cell lymphoma cases. Ten cases of small lymphocytic lymphoma and 10 instances of follicular center cell lymphoma were used as controls. Antigen retrieval was done by autoclaving under controlled pressure (2 bar) and temperature (120 degrees C) conditions. The best results were obtained after 1 minute of exposure with catalyzed signal amplification and after 6 minutes with other detection systems. Regarding cyclin D1 expression in mantle cell lymphoma cases, 17 (85%) were weakly positive and 3 (15%), moderately positive with labeled streptavidin biotin, whereas 15 (75%) were weakly positive and 5 (25%) moderately positive with EnVision+. In contrast, all 20 mantle cell lymphoma cases were strongly cyclin D1 positive with catalyzed signal amplification. No evidence of cyclin D1 immunostaining was obtained in any of the small lymphocytic lymphoma and follicular center cell lymphoma instances with any of the three methods used. In conclusion, catalyzed signal amplification methods provide a very useful tool for cyclin D1 demonstration in cases in which other immunohistochemical techniques yield inconclusive results.

Biomarkers, Tumor↗

Primary epidural lymphoma. Case report.

A case of follicular center cell lymphoma arising in the spinal dura mater is presented. To the authors' knowledge, this is the first case of primary epidural lymphoma in which immunohistochemical and molecular investigations demonstrated a follicular center cell origin.

Aged↗

The current role of electron microscopy in the diagnosis of epithelial and epithelioid tumors.

Electron microscopy may be applied to the study of epithelial or epithelial-like tumors with benefits similar to those encountered when it is applied to other diseases. Thus, it may complement and allow us to understand the light microscopic appearance of tumors, help in tailoring or reducing the number of antibodies, or lead to diagnosis in cases with paradoxical or nonspecific immunocytochemical results. An important, newly suggested application is to use it as a quality assurance tool in the evaluation of cases already diagnosed by other methods. Tumors with epithelial phenotype are highly prevalent, and therefore the number of problem cases can also be relatively high. In this article, we review the main ultrastructural features used in the differential diagnosis of epithelial and epithelioid tumors and some potential pitfalls. In addition, we summarize the criteria for differential diagnosis in specific topographical areas and analyze some examples of how electron microscopy may improve the accuracy of pathological diagnosis by interacting with currently available immunocytochemical panels.

Diagnosis, Differential↗

Ultrastructural features of highly active antiretroviral therapy-associated partial lipodystrophy.

Chronic treatment with highly active antiretroviral therapy (HAART) results in a novel variety of partial lipodystrophy, combining lipoatrophic and hypertrophic areas. We have previously reported the histopathological features of this disease and have also shown that adipocyte apoptosis is involved in its origin. With the aim of further elucidating the mechanisms underlying this peculiar disorder, we performed an ultrastructural study of the adipocytes of ten HIV-1-infected patients treated with HAART for 20-42 months. In all ten cases, two main sets of ultrastructural changes were identified. Some adipocytes showed disruption of cell membranes, fragmented cytoplasmic rims, irregular cell outlines, and eventually fat droplets laying free in the connective tissue, with a histiocytic reaction around them. In addition, many adipocytes showed variable compartmentalization of fat droplets with decrease in cell size and abundant, mitochondria-rich cytoplasm. Often, a dual "white and brown" fat appearance was observed with a large unilocular vacuole surrounded by a rim of multilocular cytoplasm containing smaller isometric fat droplets and numerous mitochondria. These findings suggest that HAART-associated partial lipodystrophy is probably the result of a remodeling process of fat cells involving variable combinations of apoptosis, defective lipogenesis, and increased metabolic activity in different adipose areas of the body.

Acquired Immunodeficiency Syndrome↗

Host cell-derived cardiomyocytes in sex-mismatch cardiac allografts.

BACKGROUND: Mesenchymal precursor cells are able to respond to tissue signals and differentiate into a phenotype characteristic of mature cells of that tissue. We sought to investigate whether adult human cardiomyocytes can be derived from recipient precursor cells in sex-mismatched cardiac allografts. METHODS: We studied four male patients who received hearts from female donors, and four female patients who received an allograft from a male donor. Four sex-matched transplant patients, two of each sex served as controls. Combined fluorescence in situ hybridization with probes specific for X- and Y-chromosomes and immunohistochemistry with alpha-actin was used to identify cardiac muscle cells 4 and 12 months after transplantation. Slides were examined with a fluorescence microscope to detect the presence of male cells with one X and one Y signal in the nucleus, and female cells containing two X signals. RESULTS: Mature cardiomyocytes from the host (1-2%) were found in five endomyocardial biopsy specimens at 4 months, and in three specimens at 12 months. In addition, recipient cells negative for cytoplasmic alpha-actin were also identified (1-21% per slide). The number of infiltrating recipient cells was not associated with the degree of rejection of the sample or with the number of prior rejection episodes. Echocardiographic evaluation showed no improvement in cardiac performance in hearts from patients with more than 10% chimeric recipient cells. CONCLUSIONS: Our data confirm the existence of mature cardiomyocytes derived from host cells, likely mesenchymal precursors, in the adult cardiac allograft in vivo.

Actins↗

Genetic characterization of the paraimmunoblastic variant of small lymphocytic lymphoma/chronic lymphocytic leukemia: A case report and review of the literature.

Paraimmunoblastic variant of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) is characterized by a diffuse proliferation of cells, called paraimmunoblasts, normally located on the pseudoproliferation centers. Patients usually present with multiple lymphadenopathies and a rapid and aggressive progression of the disease. We report a case with paraimmunoblastic variant of SLL/CLL genetically well-characterized by conventional cytogenetics, comparative genomic hybridization (CGH), IgH/BCL-1, IgH/BCL-2, and p53 fluorescent in situ hybridization (FISH) probes and polymerase chain reaction (PCR) for detection of IgH/BCL-2 translocation. A complex karyotype was found, with p53 deletion confirmed by CGH and FISH; however, no translocations involving either BCL-2 or BCL-1 and the immunoglobulin heavy chain gene were identified. A literature review shows only 20 previously reported cases, 6 of which involve genetic studies.

Aged↗

Bone metabolism and histomorphometric changes in rheumatoid arthritis.

OBJECTIVE: We studied bone metabolism and histomorphometry in 66 patients with rheumatoid arthritis. METHODS: Cross-sectional study. RESULTS: BMD at the forearm but not at the lumbar spine was decreased. Age. body mass index and fibrinogen correlated significantly with decreased BMD, whereas age and disease duration were predictors of vertebral fractures. Biochemical parameters were normal but 25 vitamin D levels were markedly reduced. There were significant decreases in bone volume, mean wall thickness, mineral apposition rate (with highly prolonged mineralisation lag time), number of osteoclasts, and osteoclast surface, and increases in resorption surfaces. Mean plate trabecular separation and density were also deeply affected. CONCLUSIONS: Patients with rheumatoid arthritis showed a reduced bone volume and decreased bone turnover, which is further aggravated by microarchitectural deterioration stressing the severe osteoporosis associated with the disease. These findings are consistent with the effect of hypovitaminosis D and low values of vitamin D in serum.

Absorptiometry, Photon↗

Prediction of recurrence and nucleolar features in node-negative breast carcinoma, ductal type, grade II. An ultrastructural study.

One-third of patients with node-negative breast carcinoma develop a local recurrence that will decisively influence their outcome. We conducted this quantitative ultrastructural study to determine the value of nucleolar features in predicting recurrence of node-negative breast carcinomas. Forty-three node-negative infiltrating duct carcinomas were examined by means of electron microscopy. The number of cells with three or more nucleoli (N3), percentage of nucleoli contacting the nuclear membrane (NC), patient age, tumor size, grading, treatment, follow-up time, development of recurrence, and status were recorded. There were no differences in patient age, tumor grade, or modality of surgical treatment. Significant differences were found among patients with and without recurrence for N3 ( P=0.02), NC ( P=0.01), and tumor size ( P=0.01). For N3, the positive predictive value (PPV) was 64.3, and the negative predictive value (NPV) was 72.4 (sensitivity=52.9%; specificity=80.8%; P=0.04). For NC, the PPV was 62.5, and the NPV was 74.1 (sensitivity=58.8%; specificity=76.9%; P=0.02). For tumor size, the PPV was 66.7, and the NPV was 64.9 (sensitivity=23.5%; specificity=92.3%; P not significant). Using logistic regression analysis, independent predictive value was shown for N3, NC, and tumor size. The number of nucleoli per cell and the number of cells with nucleoli in contact with the nuclear membrane have independent predictive value for the development of recurrence in lymph node-negative infiltrating duct carcinoma of the breast. Although electron microscopy is a highly accurate method, improving the precision of light microscopic techniques would allow more universal assessment of these nucleolar features.

Adult↗