Candace Reveles

Interests

Research

I am interested in myeloid malignancies, including acute myeloid leukemias as well as myeloproliferative neoplasms.

Teaching

I have a keen interest in the edification of residents. I hope that by the end of residency, all residents graduating from our program will be able to recognize and diagnose basic hematopathology diagnostic entities and perceive which cases should be sent out for expert opinion in the private practice setting.

Courses

Scholarly Contributions

Journals/Publications

• Menghani, S. V., Diaz-Hanson, J. P., Heimbigner, A., Wakefield, C., Fuchs, D., Reveles, C. Y., Spier, C. M., Amaraneni, A., & Kumar, A. (2023). Peripheral T-Cell Lymphoma in a Patient Previously Diagnosed With Sarcoidosis. Journal of Hematology, 272-276. doi:10.14740/jh1173
  More info

  Sarcoidosis is a multisystem disorder characterized by granulomatous inflammation on histopathological evaluation. Diagnosis of sarcoidosis requires thorough elimination of malignancy and alternative causes of noncaseating granulomatous inflammation. Sarcoidosis and several subtypes of lymphoma have similar clinical presentations and can potentially have similar histopathological findings. Patients with a histopathology-confirmed diagnosis of sarcoidosis are at higher risk of developing malignancies. In this report, we present a case of a 64-year-old male diagnosed with sarcoidosis 2 years before presenting to the emergency department with a 4-month history of generalized weakness, cough, and very high fever. After a thorough workup involving cervical lymph node biopsy and bone marrow biopsy, he was diagnosed with peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS). Due to the patient's current lymphoma diagnosis and features noted on pathology, a retrospective review of the prior biopsy specimen was performed, finding similar hematopathological features on both initial lymph node biopsy diagnosing sarcoidosis and current biopsies diagnosing lymphoma. Given these findings, our patient likely had early manifestation of PTCL misdiagnosed as sarcoidosis. In summary, lymphoma should be considered in all patients with suspected sarcoidosis, especially those who do not respond to treatment or who present with persistent hematological abnormalities.
• Shponka, V., Rimsza, L. M., Reveles, C. Y., Maguire, A., Kendrick, S., Jaramillo, M. C., & Alam, S. (2020). Frequent expression of activation-induced cytidine deaminase in diffuse large B-cell lymphoma tissues from persons living with HIV.. AIDS (London, England), 34(14), 2025-2035. doi:10.1097/qad.0000000000002653
  More info

  The increased risk for persons living with HIV to develop diffuse large B-cell lymphoma (DLBCL) even in the post-antiretroviral therapy eras suggests a role beyond immunosuppression in lymphoma development. However, the mechanisms leading to lymphoma in the HIV setting are not fully understood. HIV is known to induce activation-induced cytidine deaminase (AID) levels in nonneoplastic B cells in vitro and chronic AID expression may play an important role in lymphomagenesis. Although AID expression is observed in B-cell lymphoma, studies in HIV-associated DLBCL are limited..In this study, we conducted a retrospective review of DLBCL tissues from patients with and without HIV infection to compare expression of AID and B-cell receptors potentially involved in HIV and B-cell interaction..We evaluated DLBCL formalin-fixed paraffin-embedded tissues from 72 HIV-seropositive and 58 HIV-seronegative patients for AID, DC-SIGN, and CD40 protein expression. BCL2 and MYC, two well established prognostically significant oncoproteins in DLBCL, were also assessed at the protein and mRNA levels. Subset analysis was performed according to DLBCL subtype and EBV status..Of note, AID expression was more frequent in HIV-associated DLBCL compared with non-HIV-associated DLBCL regardless of cell-of-origin subtype, and also displayed significantly less BCL2 expression. Despite no direct correlation with AID expression, the HIV-DLBCL tissues also exhibited high levels of the DC-SIGN receptor..Collectively, these findings support a potential role for AID in the pathogenesis of HIV-associated lymphomas and suggest the need of further investigations into the involvement of the DC-SIGN receptor-signaling pathway.
• Reveles, C. Y., Pryor, J. H., & Spier, C. (2018). 57 Inability to Report Platelet Counts Due to Interference of Automated Platelet Counting by Microschistocytes: A Caveat in Severely Ill Patients. American Society for Clinical Pathology. doi:10.1093/ajcp/aqx116.056
• Anwer, F., Reveles, C. Y., Katsanis, E., Okolo, O. N., & Yun, S. (2017). Allogeneic Transplant in ELANE and MEFV Mutation Positive Severe Cyclic Neutropenia: Review of Prognostic Factors for Secondary Severe Events. Case Reports in Hematology, 2017, 1-7. doi:10.1155/2017/5375793

Presentations

• Reveles, C., Perry, C. S., Fuchs, D., Heimbigner, A., & Hansen Smith, M. (2023, November). From Sarcoidosis to Lymphoma: A Diagnostic Journey to Peripheral T Cell Lymphoma, NOS
  
  Presentation by Mary Hansen Smith, MD. Progress in T- and NK-Cell Lymphomas/LeukemiasSociety for Hematopathology.