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Pediatric Hodgkin Lymphoma in a South Indian Regional Cancer Center: Its Immunomorphology, Tumor-Associated Macrophages, and Association with Epstein-Barr Virus.
[hodgkin lymphoma, classical]
Pediatric
Hodgkin
lymphoma
(
HL
)
comprises
approximately
a
fifth
of
all
patients
with
HL
in
India
.
Seventy
-
four
cases
of
pediatric
classical
Hodgkin
Lymphoma
(
cHL
)
from
a
regional
cancer
center
in
southern
India
were
analyzed
on
a
tissue
microarray
(
TMA
)
for
the
stage
of
B-
cell
differentiation
of
the
Hodgkin
/
Reed
Sternberg
(
HRS
)
cell
by
immunohistochemistry
(
IHC
)
using
CD
10
,
bcl
6
,
MUM
1
/
IRF
4
,
and
CD
138
.
Fifty
-
two
of
seventy-
four
(
70
.
3
%
)
cases
were
of
late
germinal
center
/
early
post-germinal
center
phenotype
(
CD
10
-
/
bcl
6
-
/
MUM
1
+
/
CD
138
-
)
.
Epstein-
Barr
virus
(
EBV
)
association
using
Epstein-
Barr
virus
encoded
RNA
(
EBER
)
RISH
and
EBV-LMP
1
immunohistochemistry
(
IHC
)
revealed
an
EBV
association
of
93
%
.
Tumor
-associated
macrophages
(
TAM
)
in
the
microenvironment
were
also
assessed
on
the
TMA
by
CD
68
IHC
,
and
most
cases
(
59
.
7
%
)
showed
>
25
%
TAMs
,
with
no
case
showing
≤
5
%
.
These
findings
indicate
that
pediatric
cHL
in
India
is
a
tumor
,
predominantly
,
of
late
germinal
center
/
early
post-germinal
center
B
cells
,
is
almost
invariably
EBV
associated
,
and
with
a
high
number
of
TAMs
in
the
microenvironment
.
This
latter
finding
suggests
that
criteria
other
than
TAM
scores
need
to
be
developed
for
risk
stratification
of
pediatric
EBV-associated
HL
especially
in
developing
countries
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated