Hematopathology Diagnosis

血液病理诊断

• 批准号: 8763334
• 负责人: Elaine Jaffe
• 金额: $ 56万
• 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/8763334
• 关键词: Adopted; Adult; American; Antigens; Area; Autoimmune Diseases; B-Cell Lymphomas; B-Lymphocytes; Basic Science; Biological Markers; Blood; CD4 Positive T Lymphocytes; Cell Differentiation process; Cell Lineage; Cell Proliferation; Cell physiology; Cells; Child; Childhood; Classification; Clinical; Clinical Protocols; Clinical Research; Collaborations; Communities; Consultations; Cytogenetics; Derivation procedure; Dermatology; Detection; Development; Diagnosis; Diagnostic; Diagnostic Services; Disease; Disease-Free Survival; Education; Educational process of instructing; Fellowship Program; Flow Cytometry; Follicular Lymphoma; Genes; Goals; Growth; Helper-Inducer T-Lymphocyte; Hematologic Neoplasms; Hematology; Hematopathology; Hematopoietic Neoplasms; Hodgkin Disease; Human Herpesvirus 4; Hyperplasia; Immunoblastic Lymphadenopathy; Immunohistochemistry; Immunologic Deficiency Syndromes; In Situ Hybridization; Institutes; Institution; International; Investigation; Journals; Knowledge; Laboratories; Laboratory Technicians; Lesion; Libraries; Lymphoblastic Leukemia; Lymphocyte; Lymphocyte Function; Lymphoid Cell; Lymphoma; Lymphomatoid Granulomatosis; Lymphoproliferative Disorders; Malignant - descriptor; Malignant lymphoid neoplasm; Medical Oncology; Mission; Molecular; National Heart, Lung, and Blood Institute; National Human Genome Research Institute; National Institute of Allergy and Infectious Disease; Natural Killer Cells; Nature; Newly Diagnosed; Panniculitis; Pathogenesis; Pathologist; Pathology; Patients; Pediatric Oncology; Peripheral; Physicians; Physiology; Plasma Cells; Productivity; Prognostic Factor; Protocols documentation; Publications; Reed-Sternberg Cells; Research; Research Personnel; Research Training; Role; Sampling; Services; Staging; Surgical Pathology; T-Cell Lymphoma; T-Cell and NK-Cell Neoplasm; T-Lymphocyte; Testing; Time; Transplantation; Transplantation Immunology; Triage; Uncertainty; United States National Institutes of Health; Variant; Viral; Work; age group; autoimmune lymphoproliferative syndrome; base; clinical Diagnosis; clinical practice; disease classification; in vivo; kohl; lymphoid neoplasm; multidisciplinary; neoplastic; novel; programs; promoter; subcutaneous; symposium; tool; translational study; young adult

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 prognostic factors in classical Hodkgin lymphoma,2 classification of peripheral T-cell lymphomas,3 4,5 the role of EBV in lymphoma,6,7 and pediatric lymphomas.8,9 1. 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. Venkataraman G, Song JY, Tzankov A, Dirnhofer S, Heinze G, Kohl M, Traverse-Glehen A, Eberle FC, Hanson JC, Raffeld MA, Pittaluga S, Jaffe ES. Aberrant T-cell antigen expression in classical Hodgkin lymphoma is associated with decreased event-free survival and overall survival. Blood 2013;121:1795-804. 3. Nicolae A, Pittaluga S, Venkataraman G, Vijnovich-Baron A, Xi L, Raffeld M, Jaffe ES. Peripheral T-cell Lymphomas of Follicular T-Helper Cell Derivation With Hodgkin/Reed-Sternberg Cells of B-cell Lineage: Both EBV-positive and EBV-negative Variants Exist. The American journal of surgical pathology 2013;37:816-26. 4. Huppmann AR, Roullet MR, Raffeld M, Jaffe ES. Angioimmunoblastic T-cell lymphoma partially obscured by an Epstein-Barr virus-negative clonal plasma cell proliferation. J Clin Oncol 2013;31:e28-30. 5. Bajor-Dattilo EB, Pittaluga S, Jaffe ES. Pathobiology of T-cell and NK-cell lymphomas. Best practice & research 2013;26:75-87. 6. Nicolae A, Huppmann AR, Slack GW, Ferry JA, Harris NL, Pittaluga S, Jaffe ES, Hasserjian RP. EBV Is Infrequently Expressed in the LP Cells of Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) in Both Children and Adults. Laboratory Investigation 2013;93:352A-A. 7. Menon MP, Hutchinson L, Garver J, Jaffe ES, Woda BA. Transformation of follicular lymphoma to Epstein-Barr virus-related Hodgkin-like lymphoma. J Clin Oncol 2013;31:e53-6. 8. Liu Q, Salaverria I, Pittaluga S, Jegalian AG, Xi L, Siebert R, Raffeld M, Hewitt SM, Jaffe ES. Follicular lymphomas in children and young adults: a comparison of the pediatric variant with usual follicular lymphoma. The American journal of surgical pathology 2013;37:333-43. 9. Huppmann AR, Xi L, Raffeld M, Pittaluga S, Jaffe ES. Subcutaneous panniculitis-like T-cell lymphoma in the pediatric age group: A lymphoma of low malignant potential. Pediatr Blood Cancer 2013.

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，由于我们收到的材料具有挑战性，以及与特定临床协议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”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，其中包括经典Hodkgin淋巴瘤的预后因素，2周围t细胞淋巴瘤的分类，3,4,5 EBV在淋巴瘤中的作用，6,7和儿童淋巴瘤。8、9 1。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 - 998。2. Venkataraman G, Song JY, Tzankov A, Dirnhofer S, Heinze G, Kohl M, Traverse-Glehen A, Eberle FC, Hanson JC, Raffeld MA, Pittaluga S, Jaffe ES。经典霍奇金淋巴瘤中异常t细胞抗原表达与无事件生存期和总生存期降低相关。血2013;121:1795 - 804。3. 陈建军，陈建军，陈建军，陈建军，陈建军，陈建军。与b细胞谱系的霍奇金/里德-斯滕伯格细胞衍生的滤泡t辅助细胞衍生的周围t细胞淋巴瘤：ebv阳性和ebv阴性变体均存在。美国外科病理杂志2013；37:816-26。4. Huppmann AR, Roullet MR, Raffeld M, Jaffe ES。血管免疫母细胞t细胞淋巴瘤部分被eb病毒阴性克隆浆细胞增殖掩盖。中华临床医学杂志，2013;31(1):28-30。5. Bajor-Dattilo EB, Pittaluga S, Jaffe ES。t细胞和nk细胞淋巴瘤的病理生物学。最佳实践与研究2013；26:75-87。6. Nicolae A, Huppmann AR, Slack GW, Ferry JA, Harris NL, Pittaluga S, Jaffe ES, Hasserjian RP。EBV在儿童和成人结节性淋巴细胞显性霍奇金淋巴瘤（NLPHL）的LP细胞中很少表达。实验室调查2013；93:352A-A。7. Menon MP, Hutchinson L, Garver J, Jaffe ES, Woda BA。滤泡性淋巴瘤向eb病毒相关霍奇金样淋巴瘤的转化。中华临床医学杂志，2013;31(1):56 - 56。8. 刘强，Salaverria I, Pittaluga S, Jegalian AG, Xi L, Siebert R, Raffeld M, Hewitt SM, Jaffe ES。滤泡性淋巴瘤在儿童和年轻人：儿童变异与正常滤泡性淋巴瘤的比较。美国外科病理杂志2013；37:33 -43。9. 胡普曼，席L， Raffeld M, Pittaluga S, Jaffe ES。儿童年龄组皮下泛膜炎样t细胞淋巴瘤：一种低恶性潜能的淋巴瘤。儿科血癌2013。