Hematopathology Diagnosis

血液病理诊断

• 批准号: 8552966
• 负责人: Elaine Jaffe
• 金额: $ 56.99万
• 依托单位: DIVISION OF BASIC SCIENCES - NCI
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8552966
• 关键词: Adopted; American; Area; Autoimmune Diseases; B-Cell Lymphomas; B-Lymphocytes; Basic Science; Behavior; Benign; Biological Markers; Blood; Case Series; Cell Differentiation process; Cell physiology; Childhood; Chronic Lymphocytic Leukemia; Classification; Clinical; Clinical Protocols; Clinical Research; Collaborations; Communities; Consultations; Cutaneous Involvement; Cytogenetics; Cytotoxic T-Lymphocytes; Dendritic Cell Sarcoma; Dermatology; Detection; Development; Diagnosis; Diagnostic; Diagnostic Services; Disease; Education; Educational process of instructing; Educational workshop; European; Extranodal; Fellowship Program; Flow Cytometry; Follicular Lymphoma; Genes; Goals; Growth; Hematologic Neoplasms; Hematology; Hematopathology; Hodgkin Disease; Hyperplasia; Immunoglobulins; Immunohistochemistry; Immunologic Deficiency Syndromes; In Situ; In Situ Hybridization; Incidental Findings; Indolent; Institutes; Institution; International; Intestines; Journals; Knowledge; Laboratories; Laboratory Technicians; Lesion; Libraries; Lymphoblastic Leukemia; Lymphocyte Function; Lymphoid; Lymphoid Cell; Lymphoma; Lymphomatoid Granulomatosis; Lymphoproliferative Disorders; MS4A1 gene; Malignant Neoplasms; Malignant lymphoid neoplasm; Mantle Cell Lymphoma; Medical Oncology; Mission; Molecular; Molecular Analysis; National Heart, Lung, and Blood Institute; National Human Genome Research Institute; National Institute of Allergy and Infectious Disease; Natural Killer Cells; Nature; Neoplasms; Newly Diagnosed; Nodal; Pathogenesis; Pathologist; Pathology; Patients; Pediatric Oncology; Peripheral; Physicians; Physiology; Plasmacytoma; Production; Productivity; Protocols documentation; Publications; Research; Research Personnel; Research Training; Risk; Sampling; Services; Small-Cell Lymphoma; Societies; Staging; Surgical Pathology; Sweden; T-Cell Lymphoma; T-Cell and NK-Cell Neoplasm; T-Lymphocyte; TNFRSF8 gene; Testing; Time; Transplantation; Transplantation Immunology; Triage; Uncertainty; United States National Institutes of Health; Variant; Viral; Work; autoimmune lymphoproliferative syndrome; base; clinical Diagnosis; clinical practice; disease classification; follow-up; in vivo; lymphoid neoplasm; meetings; multidisciplinary; neoplastic; novel; programs; promoter; sarcoma; symposium; tool; translational study

The Hematopathology Section of the Laboratory of Pathology, NCI, offers expert diagnostic services in the field of hematopathology. Dr. Stefania Pittaluga, Staff Clinician, and I handle diagnostic service responsibilities equally, each rotating as the staff on service 50% of the time. However, because of the challenging nature of the material we receive for review, and obligations related to specific clinical protocols and teaching conferences, our clinical obligations extend well beyond the designated ?on-service? time. In the past year we were responsible for more than 2200 cases. Dr. Pittaluga oversees triage of clinical samples received by the laboratory, a time consuming activity due to the complicated and sometimes competing demands of clinical protocols. In addition to serving as a Staff Hematopathologist, she assists in supervising the Immunohistochemistry service, and does the laboratory development for new hematopathology tests that are later introduced into the routine test library. She also directs the In Situ Hybridization service. She is supported in these activities by a laboratory technician, and a Post-Baccalaureate fellow. Dr. Pittaluga is also Program Director of the Hematology Fellowship program. Dr. Pittaluga and I provide assistance in the diagnosis and classification of reactive and neoplastic lymphoproliferative disorders, immunodeficiency states, and diverse hematological malignancies. We provide consultative and collaborative services to physicians in the NCI, as well as to physicians studying patients with hematolymphoid disorders in other institutes, in particular NIAID, NHLBI, NHGRI, and NIAMSD. We cosponsor a monthly multidisciplinary case review conference discussing diagnostic or management problems in lymphoma, and in addition regularly present at conferences sponsored by NCI clinical branches (Pediatric Oncology, Medical Oncology, Dermatology, Experimental Transplantation & Immunology), and by NIAID, NHLBI, and NHGRI. We serve as Associate Investigators on more than 40 clinical protocols being conducted in the NCI and other NIH institutes. These protocols frequently mandate specialized testing to characterize the biological markers relevant to the particular study. In collaboration with other service units (Specialized Diagnostics, Cytogenetics, Flow Cytometry), we utilize a variety of diagnostic tools. The Section also provides in situ hybridization services for detection of Epstein Barr viral (EBV) sequences, and other diagnostic and experimental targets. We receive more than 2000 cases in consultation each year. Recent studies have highlighted the importance of secondary review for the diagnosis and proper treatment of patients with lymphoma. 1 Because of the demands that the consultation service places on our time, we try to restrict consultations to difficult or challenging cases. Many cases are submitted by other academic institutions, based on diagnostic uncertainty, or because of differences of opinion among several institutions. We regularly refuse to accept consultations that we regard to be of a routine nature, and recommend that such cases be sent to routine reference laboratories. We frequently make novel observations based on this unique clinical practice, and a number of publications have emanated from case material originally reviewed in consultation. Thus, I believe our clinical work enhances, rather than detracts, from our academic productivity. In many instances consultation cases are submitted to us based on prior publications from our laboratory. These cases contribute to our research mission, as they help us to expand our knowledge of rare entities, and characterize these disorders. Specific examples and the relevant publications are discussed under other projects. However, among them they include in situ follicular lymphoma,2,3 in situ mantle cell lymphoma,4 pediatric follicular lymphoma, pediatric marginal zone lymphomas, NK-cell enteropathy, 5novel variants of peripheral T-cell lymphomas, 6 7-9histiocytic sarcomas arising in B-cell or T-cell malignancies, 10 and plasmacytomas with production of IgA.111.Jaffe ES. Centralized review offers promise for the clinician, the pathologist, and the patient with newly diagnosed lymphoma. J Clin Oncol 2011;29:1398-9.2.Fend F, Cabecadas J, Gaulard P, et al. Early lesions in lymphoid neoplasia: Conclusions based on the Workshop of the XV. meeting of the European Association of Hematopathology and the Society of Hematopathology in Uppsala, Sweden. Journal of Hematopathology in press 3.Jegalian AG, Eberle FC, Pack SD, et al. Follicular lymphoma in situ: clinical implications and comparisons with partial involvement by follicular lymphoma. Blood 2011;118:2976-84.4.Carvajal-Cuenca A, Sua LF, Silva NM, et al. In situ mantle cell lymphoma: clinical implications of an incidental finding with indolent clinical behavior. Haematologica 2011;4:4.5.Mansoor A, Pittaluga S, Beck PL, Wilson WH, Ferry JA, Jaffe ES. NK-cell enteropathy: a benign NK-cell lymphoproliferative disease mimicking intestinal lymphoma: clinicopathologic features and follow-up in a unique case series. Blood 2011;117:1447-52.6.Garcia-Herrera A, Song JY, Chuang SS, et al. Nonhepatosplenic gammadelta T-cell Lymphomas Represent a Spectrum of Aggressive Cytotoxic T-cell Lymphomas With a Mainly Extranodal Presentation. The American journal of surgical pathology 2011;35:1214-25.7.Song JY, Strom T, Raffeld M, Pittaluga S, Jaffe ES. Peripheral T-Cell Lymphoma With Aberrant Expression of CD30, CD15, and CD20. J Clin Oncol 2011.8.Eberle FC, Song JY, Xi L, et al. Nodal Involvement by Cutaneous CD30-positive T-cell Lymphoma Mimicking Classical Hodgkin Lymphoma. The American journal of surgical pathology 2012;36:716-25.9.Menon MP, Jegalion A, Raffeld M, Pittaluga S, Xi L, Jaffe ES. Primary CNS T-Cell Lymphomas: Clinical, Morphologic, Immunophenotypic and Molecular Analysis. Mod Pathol 2012;25:355A-A.10.Shao H, Xi L, Raffeld M, et al. Clonally related histiocytic/dendritic cell sarcoma and chronic lymphocytic leukemia/small lymphocytic lymphoma: a study of seven cases. Mod Pathol 2011;24:1421-32.11.Shao H, Xi L, Raffeld M, et al. Nodal and extranodal plasmacytomas expressing immunoglobulin a: an indolent lymphoproliferative disorder with a low risk of clinical progression. The American journal of surgical pathology 2010;34:1425-35.

NCI病理学实验室的血液病理学科提供血液病理学领域的专家诊断服务。Stefania Pittaluga医生，临床医生，和我平等地承担诊断服务职责，每人轮流担任50%的服务时间。然而，由于我们收到的审查材料具有挑战性，以及与特定临床方案和教学会议相关的义务，我们的临床义务远远超出了指定的“在职”范围。时间。在过去的一年里，我们处理了2200多起案件。皮塔卢加负责对实验室收到的临床样本进行分诊，这是一项耗时的工作，因为临床方案的要求很复杂，有时还会相互矛盾。除了作为一名工作人员血液病理学家，她还协助监督免疫组织化学服务，并为新的血液病理学测试进行实验室开发，这些测试后来被引入常规测试库。她还指导原位杂交服务。在这些活动中，她得到了一名实验室技术员和一名学士学位后研究员的支持。Pittaluga博士也是血液学奖学金项目的项目主任。Pittaluga博士和我在反应性和肿瘤性淋巴增生性疾病、免疫缺陷状态和各种血液恶性肿瘤的诊断和分类方面提供帮助。我们为NCI的医生以及其他机构（特别是NIAID、NHLBI、NHGRI和NIAMSD）研究血淋巴疾病患者的医生提供咨询和协作服务。我们每月共同主办一次多学科病例回顾会议，讨论淋巴瘤的诊断或管理问题，此外，我们还定期出席由NCI临床分支（儿科肿瘤学、内科肿瘤学、皮肤病学、实验移植与免疫学）以及NIAID、NHLBI和NHGRI主办的会议。我们在NCI和其他NIH研究所进行的40多个临床方案中担任副研究员。这些方案通常要求进行专门的测试，以表征与特定研究相关的生物标志物。我们与其他服务单位（专业诊断、细胞遗传学、流式细胞术）合作，利用各种诊断工具。该科还提供原位杂交服务，用于检测eb病毒（EBV）序列，以及其他诊断和实验目标。我们每年会诊超过2000宗个案。最近的研究强调了二次复查对淋巴瘤患者的诊断和适当治疗的重要性。由于咨询服务对我们时间的要求，我们尽量将咨询限制在困难或有挑战性的情况下。许多病例是由其他学术机构提交的，基于诊断的不确定性，或者因为几个机构之间的意见分歧。我们通常拒绝接受我们认为属于常规性质的咨询，并建议将此类病例送到常规参考实验室。我们经常根据这种独特的临床实践做出新的观察，许多出版物来自最初在咨询中审查的病例材料。因此，我相信我们的临床工作提高而不是减损了我们的学术生产力。在许多情况下，咨询病例是根据我们实验室先前的出版物提交给我们的。这些病例有助于我们的研究任务，因为它们帮助我们扩大对罕见实体的了解，并确定这些疾病的特征。具体的例子和相关的出版物将在其他项目中讨论。然而，其中包括原位滤泡性淋巴瘤，2、3原位套细胞淋巴瘤，4例儿童滤泡性淋巴瘤，儿童边缘带淋巴瘤，nk细胞肠病，5例新型外周t细胞淋巴瘤，6 -9例b细胞或t细胞恶性肿瘤中出现的组织细胞肉瘤，10例和产生IgA.111的浆细胞瘤。Jaffe ES。集中复查为临床医生、病理学家和新诊断的淋巴瘤患者提供了希望。中华临床医学杂志，2011;29(3):998 - 992。fendf, Cabecadas J, Gaulard P，等。淋巴样肿瘤的早期病变：基于XV研讨会的结论。欧洲血液病理学协会和血液病理学学会在瑞典乌普萨拉举行的会议。《血液病杂志》第3版。Jegalian AG, Eberle FC, Pack SD，等。滤泡性原位淋巴瘤：临床意义及与滤泡性淋巴瘤部分受累的比较。血2011;118:2976 - 84.4。Carvajal-Cuenca, Sua LF, Silva NM，等。原位套细胞淋巴瘤：偶然发现与惰性临床行为的临床意义。Haematologica 2011; 4:4.5。Mansoor A, Pittaluga S, Beck PL, Wilson WH, Ferry JA, Jaffe ES。nk细胞性肠病：一种类似肠淋巴瘤的良性nk细胞淋巴增生性疾病：临床病理特征和独特病例系列的随访。血2011;117:1447 - 52.6。Garcia-Herrera A，宋建勇，庄世生，等。非肝脾γ - t细胞淋巴瘤是侵袭性细胞毒性t细胞淋巴瘤的一种表现，主要表现在结外。美国外科病理学杂志2011；35:1214-25.7。宋建勇，Strom T, Raffeld M, Pittaluga S, Jaffe ES。外周t细胞淋巴瘤伴CD30、CD15和CD20异常表达。中华临床医学杂志，2011。埃伯利FC，宋建勇，奚磊，等。模拟经典霍奇金淋巴瘤的皮肤cd30阳性t细胞淋巴瘤累及淋巴结。美国外科病理学杂志2012；36:716-25.9。Menon MP, Jegalion A, Raffeld M, Pittaluga S, Xi L, Jaffe ES。原发性中枢神经系统t细胞淋巴瘤：临床、形态学、免疫表型和分子分析。中华医学杂志2012；25:355 - 355。邵辉，席磊，Raffeld M，等。克隆相关的组织细胞/树突状细胞肉瘤和慢性淋巴细胞白血病/小淋巴细胞淋巴瘤：7例研究现代病理杂志2011；24:1421-32.11。邵辉，席磊，Raffeld M，等。表达免疫球蛋白a的淋巴结和结外浆细胞瘤：一种临床进展风险低的惰性淋巴增生性疾病。美国外科病理杂志2010；34:1425-35。