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Rodriguez-Pinilla SM, Dojcinov S, Dotlic S, Gibson SE, Hartmann S, Klimkowska M, Sabattini E, Tousseyn TA, de Jong D, Hsi ED. Aggressive B-cell non-Hodgkin lymphomas: a report of the lymphoma workshop of the 20th meeting of the European Association for Haematopathology. Virchows Arch 2024; 484:15-29. [PMID: 37530792 PMCID: PMC10791773 DOI: 10.1007/s00428-023-03579-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/22/2023] [Accepted: 06/07/2023] [Indexed: 08/03/2023]
Abstract
Aggressive B-cell non-Hodgkin lymphomas are a heterogeneous group of diseases and our concepts are evolving as we learn more about their clinical, pathologic, molecular genetic features. Session IV of the 2020 EAHP Workshop covered aggressive, predominantly high-grade B-cell lymphomas, many that were difficult to classify. In this manuscript, we summarize the features of the submitted cases and highlight differential diagnostic difficulties. We specifically review issues related to high-grade B-cell lymphomas (HGBCLs) with MYC and BCL2 and/or BCL6 rearrangements including TdT expression in these cases, HGBCL, not otherwise specified, large B-cell lymphomas with IRF4 rearrangement, high-grade/large B-cell lymphomas with 11q aberration, Burkitt lymphoma, and pleomorphic mantle cell lymphoma. Since the workshop, the 5th edition of the WHO Classification for Haematolymphoid Tumours (WHO-HAEM5) and International Consensus Classification (ICC) 2022 were published. We endeavor to use the updated terminology.
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Affiliation(s)
| | - Stefan Dojcinov
- Department of Pathology, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Snjezana Dotlic
- Department of Pathology and Cytology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Sarah E Gibson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ, USA
| | - Sylvia Hartmann
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt Am Main, Frankfurt Am Main, Germany
| | - Monika Klimkowska
- Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Elena Sabattini
- Haematopathology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Thomas A Tousseyn
- Department of Imaging and Pathology, Translational Cell and Tissue Research Lab, KU Leuven, Leuven, Belgium
| | - Daphne de Jong
- Department of Pathology, Amsterdam UMC, Location VUMC, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
| | - Eric D Hsi
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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de Sousa FA, Millan NM, Correia RP, da Costa Vaz A, Schimidell D, Miyamoto PC, Passaro MS, Nogueira BG, Souto EX, Bacal NS, Bento LC. ROR1 expression in mature B lymphoid neoplasms by flow cytometry. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2024; 106:74-81. [PMID: 38273649 DOI: 10.1002/cyto.b.22157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024]
Abstract
Immunophenotyping by flow cytometry is an integral part of the diagnosis and classification of leukemias/lymphomas. The expression of ROR1 associated with chronic B lymphocytic leukemia (CLL) is well described in the literature, both in its diagnosis and in the follow-up of minimal residual disease (MRD) research, however, there are few studies regarding the expression pattern of ROR1 in other subtypes of mature B lymphoid neoplasms. With the aim of evaluating the expression of ROR1 and associating it with the expression of other important markers for the differentiation of mature B lymphoid neoplasms (MBLN), 767 samples of cases that entered our laboratory for immunophenotyping with clinical suspicion of MBLN were studied. ROR1 expression is predominant in CD5+/CD10- neoplasms. Overall, positive ROR1 expression was observed in 461 (60.1%) cases. The CD5+/CD10- group had a significantly higher proportion of ROR1 positive samples (89.9%) and more brightly expressed ROR1 than the other groups. Our results highlight the importance of evaluating ROR1 expression in the diagnosis of MBLN to contribute to the differential diagnosis, and possibly therapy of mainly CLL, and indicate that this marker could be considered as a useful addition to immunophenotypic panels, particularly for more challenging cases.
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Affiliation(s)
- Flávia Arandas de Sousa
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Nádila Magalhães Millan
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Rodolfo Patussi Correia
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Andressa da Costa Vaz
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Daniela Schimidell
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Priscila Carmona Miyamoto
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Marilia Sandoval Passaro
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Bruna Garcia Nogueira
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Elizabeth Xisto Souto
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Nydia Strachman Bacal
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Laiz Camerão Bento
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, São Paulo, Brazil
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Raman A, Jinkala SR, Murugan R, Manivannan P. Blastoid Variant of Mantle Cell Lymphoma with Extranodal Presentation and Aberrant CD10 Expression. Int J Appl Basic Med Res 2024; 14:63-66. [PMID: 38504844 PMCID: PMC10947762 DOI: 10.4103/ijabmr.ijabmr_406_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 03/21/2024] Open
Abstract
Mantle cell lymphoma (MCL) constitutes 3%-10% of non-Hodgkin lymphoma and is characterized by t (11:14)(q13;q32). The common presentation is generalized lymphadenopathy with weight loss, infrequently night sweats, and fever. Among histological subtypes of MCL, the blastoid variant of MCL constitutes 10%-15% of all the cases. It is challenging to diagnose the blastoid variant of MCL based on its morphology alone as it mimics large B-cell lymphoma. Hence, the immunophenotyping and molecular studies aid in its correct diagnosis. We report an elderly man diagnosed with blastoid variant MCL. He presented with disseminated soft-tissue and subcutaneous nodules, and showed aberrant CD10 expression. Presentation of the extranodal site and aberrant CD10 expressions carries an overall poor prognosis. CD10-positive MCL can be mistaken for large B-cell lymphoma.
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Affiliation(s)
- Arthy Raman
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sree Rekha Jinkala
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Roobashri Murugan
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Prabhu Manivannan
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Hino C, Pham B, Gray AL, Wang J, Castillo DR, Akhtari M, Liu Y. Clinicopathologic Features and Treatment of CD10-Positive Mantle Cell Lymphoma: A Case Report and Review of Literature. Pathol Oncol Res 2022; 28:1610588. [PMID: 36091937 PMCID: PMC9454308 DOI: 10.3389/pore.2022.1610588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022]
Abstract
Mantle cell lymphoma (MCL) is a rare and aggressive non-Hodgkin’s B cell lymphoma characterized by the translocation t(11;14) (q13;32) and overexpression of CCND1. MCL is immunophenotypically identified as CD20+, CD5+, CyclinD1+, CD43+, CD10−, BCL6−, and CD23−. It is often distinguished from B cell lymphomas of germinal center cell origin by the absence of CD10 expression. Here we report the unique clinicopathologic features of a patient with CD10+ MCL with gastrointestinal involvement and review current literature identifying this unique immunophenotype.
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Affiliation(s)
- Christopher Hino
- Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, United States
| | - Bryan Pham
- Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, United States
| | - Austin L. Gray
- Department of Pathology, Loma Linda University, Loma Linda, CA, United States
| | - Jun Wang
- Department of Pathology, Loma Linda University, Loma Linda, CA, United States
| | - Dan Ran Castillo
- Department of Oncology/Hematology, Loma Linda University, Loma Linda, CA, United States
| | - Mojtaba Akhtari
- Department of Oncology/Hematology, Loma Linda University, Loma Linda, CA, United States
| | - Yan Liu
- Department of Pathology, Loma Linda University, Loma Linda, CA, United States
- *Correspondence: Yan Liu,
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Gisriel SD, Jacobs JW, Siddon AJ. CD5‐positive, CD10‐positive large B‐cell lymphoma with t(14;18) mimicking acute leukemia. Int J Lab Hematol 2022; 44:698-699. [DOI: 10.1111/ijlh.13812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/22/2022] [Accepted: 02/03/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Savanah D. Gisriel
- Department of Pathology Yale School of Medicine New Haven Connecticut USA
- Department of Laboratory Medicine Yale School of Medicine New Haven Connecticut USA
| | - Jeremy W. Jacobs
- Department of Laboratory Medicine Yale School of Medicine New Haven Connecticut USA
| | - Alexa J. Siddon
- Department of Pathology Yale School of Medicine New Haven Connecticut USA
- Department of Laboratory Medicine Yale School of Medicine New Haven Connecticut USA
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6
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Abdulbaki R, Tizro P, Nava VE, Gomes da Silva M, Ascensão JL. Low-Grade Primary Splenic CD10-Positive Small B-Cell Lymphoma/Follicular Lymphoma. Curr Oncol 2021; 28:4821-4831. [PMID: 34898578 PMCID: PMC8628768 DOI: 10.3390/curroncol28060407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 01/19/2023] Open
Abstract
Primary splenic lymphoma (PSL) is a rare malignancy representing about 1% of all lymphoproliferative disorders, when using a strict definition that allows only involvement of spleen and hilar lymph nodes. In contrast, secondary low-grade B-cell lymphomas in the spleen, such as follicular lymphomas (FL), lymphoplasmacytic lymphoma and chronic lymphocytic leukemia/ small lymphocytic lymphoma, particularly as part of advanced stage disease, are more common. Indolent B cell lymphomas expressing CD10 almost always represent FL, which in its primary splenic form is the focus of this review. Primary splenic follicular lymphoma (PSFL) is exceedingly infrequent. This type of lymphoproliferative disorder is understudied and, in most cases, clinically characterized by splenomegaly or cytopenias related to hypersplenism. The diagnosis requires correlation of histopathology of spleen, blood and/or bone marrow with the correct immunophenotype (determined by flow cytometry and/or immunohistochemistry) and if necessary, additional molecular profiling. Management of this incurable disease is evolving, and splenectomy remains the mainstream treatment for stage I PSFL.
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Affiliation(s)
- Rami Abdulbaki
- Department of Pathology, George Washington University, Washington, DC 20037, USA; (R.A.); (V.E.N.)
| | - Parastou Tizro
- City of Hope Medical Canter, Department of Pathology, Duarte, CA 91010, USA;
| | - Victor E. Nava
- Department of Pathology, George Washington University, Washington, DC 20037, USA; (R.A.); (V.E.N.)
- Veterans Affairs Medical Center, Washington, DC 20052, USA
| | - Maria Gomes da Silva
- Department of Hematology, Initituto Português de Oncologia, 1649-028 Lisboa, Portugal;
| | - João L. Ascensão
- Veterans Affairs Medical Center, Department of Hematology, Washington, DC 20052, USA
- Correspondence:
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Debord C, Wuillème S, Eveillard M, Theisen O, Godon C, Le Bris Y, Béné MC. Flow cytometry in the diagnosis of mature B-cell lymphoproliferative disorders. Int J Lab Hematol 2021; 42 Suppl 1:113-120. [PMID: 32543070 DOI: 10.1111/ijlh.13170] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/27/2020] [Accepted: 01/31/2020] [Indexed: 12/19/2022]
Abstract
B-lineage lymphoproliferative disorders (LPD) are rather frequent diseases, associated with specific clinical or biological features but also sometimes of fortuitous discovery. Multiparameter flow cytometry plays a major role for a rapid diagnostic indication, on peripheral blood or bone marrow samples in most instances, guiding complementary analyses and allowing for the proper therapeutic management of patients. After describing the important pre-analytical precautions required for an adequate assessment, the immunophenotypic features of small-cell and large-cell lymphomas are described in this review. The ubiquitous expression of CD19 is a first mandatory gating step. A possible clonal proliferation is then suspected by the demonstration of surface immunoglobulin light chain restriction. The aberrant presence of CD5 allows to segregate chronic lymphocytic leukemia and mantle cell lymphoma in most cases. Other LPD exhibit specific immunophenotypic features. A table of useful markers and a decision tree are provided. Of note, immunophenotypic data should as much as possible be interpreted in an integrated manner, involving the patient's clinical and other biological features, and be completed by further chromosomal and/or molecular investigations.
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Affiliation(s)
- Camille Debord
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
| | - Soraya Wuillème
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
| | - Marion Eveillard
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
| | - Olivier Theisen
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
| | - Catherine Godon
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
| | - Yanick Le Bris
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
| | - Marie C Béné
- Hematology Biology Department, Nantes University Hospital and CRCINA, Nantes, France
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McCorkle C, Graffeo V. A rare case of dual expression of CD5 and CD10 in primary central nervous system diffuse large B-cell lymphoma with prominent starry sky appearance. Clin Case Rep 2020; 8:2973-2975. [PMID: 33363862 PMCID: PMC7752341 DOI: 10.1002/ccr3.3293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/09/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022] Open
Abstract
This case highlights the need for both tissue biopsy for diagnosis in suspected CNS malignancy and comprehensive immune profiling for accurate subclassification.
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Affiliation(s)
- Colin McCorkle
- Marshall University Joan C. Edwards School of MedicineHuntingtonWest VirginiaUSA
| | - Vincent Graffeo
- Marshall University Joan C. Edwards School of MedicineHuntingtonWest VirginiaUSA
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9
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Marques JAS, Ferreira F, Melo DP, Santos M, Vaz RP. Palatine Tonsils Primary Presentation of Blastoid Variant of Mantle Cell Lymphoma: Case Report. Head Neck Pathol 2020; 15:588-592. [PMID: 33091144 PMCID: PMC8134596 DOI: 10.1007/s12105-020-01238-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
Head and neck lymphomas can present with a wide range of symptoms. Timely and accurate diagnosis is often challenging. The blastoid variant of mantle cell lymphoma (MCL) accounts for less than one-third of all MCL cases. Isolated primary presentation on the palatine tonsils is rare, and prognosis and outcome are seemingly unfavorable. An 81-year-old man presented with persistent odynophagia, dysphagia, and obstructive hypertrophic palatine tonsils with purulent exudate. The signs and symptoms were non-responsive to antibiotic therapy, and the tonsils were biopsied. The cellular morphology, immunophenotype, and genotype supported a diagnosis of the blastoid variant of MCL. After staging, the patient underwent chemotherapy with Rituximab-Bendamustine (R-Benda). The patient is in clinical remission more than two years after therapy. We report an exceedingly rare case of blastoid MCL that is prone to be misdiagnosed as tonsillitis. We review the literature and discuss treatment options of this uncommon malignancy.
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Affiliation(s)
- Joana A. S. Marques
- Department of Otorhinolaryngology, Centro Hospitalar Universitário S. João, EPE, Porto, Portugal ,Unit of Otorhinolaryngology - Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Fátima Ferreira
- Department of Clinical Haematology, Centro Hospitalar Universitário S. João, EPE, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Daniel P. Melo
- Department of Anatomic Pathology, Centro Hospitalar Universitário S. João, EPE, Porto, Portugal ,Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Margarida Santos
- Department of Otorhinolaryngology, Centro Hospitalar Universitário S. João, EPE, Porto, Portugal
| | - Ricardo P. Vaz
- Department of Otorhinolaryngology, Centro Hospitalar Universitário S. João, EPE, Porto, Portugal ,Unit of Anatomy - Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal ,Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
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10
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Aqil B, Triska G, Frater J, Hassan A, Ruzinova MB, Cashen A, Reese Y, Kreisel F. Immunophenotypic Variations in Mantle Cell Lymphoma and Their Impact on Clinical Behavior and Outcome. Arch Pathol Lab Med 2018; 142:1268-1274. [DOI: 10.5858/arpa.2017-0368-oa] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
Immunophenotypic variations in mantle cell lymphoma (MCL) from the classic CD5+/CD10−/CD23−/FMC-7+ immunophenotype have been reported in the literature, but correlation with clinical behavior and outcome has not been fully studied.
Objective.—
To investigate clinicopathologic and prognostic differences between immunophenotypically aberrant MCL and immunophenotypically typical MCL.
Design.—
We evaluated differences in clinical presentation, laboratory parameters, prognostic indices, response to initial treatment, and progression-free and overall survival between patients with aberrant MCL and patients with immunophenotypically typical MCL.
Results.—
There were 158 patients with newly diagnosed cyclin D1 or t(11;14)(q13;q32)+ MCL identified in the original search, of which, 29 patients (18%) showed immunophenotypic aberrancies, with CD23 coexpression being the most common. When compared with 33 randomly selected patients with immunophenotypically typical MCL, statistically significant differences were seen in white blood cell counts (P = .02), in the presence of absolute lymphocytosis (P = .03), in the MCL International Prognostic Index score (P = .02), and in response to initial treatment (P = .04). The “immunophenotypic status” of the MCL was the only independent factor associated with response to treatment (P = .05), but not with the MCL International Prognostic Index score, absolute lymphocytosis, or white blood cell count. No significant differences were seen for progression-free or overall survival.
Conclusions.—
Immunophenotypic variations in MCL are associated with differences in clinical presentation and response to therapy when compared with immunophenotypically typical MCL. However, with current intensive frontline immunochemotherapy, immunophenotypic aberrations do not appear to affect progression-free or overall survival.
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Affiliation(s)
| | | | | | | | | | | | | | - Friederike Kreisel
- From the Departments of Pathology and Immunology (Drs Aqil, Frater, Hassan, Ruzinova, and Kreisel), and Internal Medicine (Ms Triska and Dr Cashen), Washington University School of Medicine, St Louis, Missouri; and the Clinical Laboratories, Barnes-Jewish Hospital, St Louis (Ms Reese)
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11
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Park S, Ko YH. A Unique Case of Blastoid Variant of Mantle Cell Lymphoma with an Aberrant CD5-/CD10+/Bcl-6+/CD56+ Immunophenotype: A Case Report. TUMORI JOURNAL 2018; 98:e111-4. [DOI: 10.1177/030089161209800424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The neural adhesion molecule CD56 is normally expressed on natural killer cells and subsets of T cells and is commonly found in hematolymphoid neoplasms. Expression of CD56 is very rare in B-cell lymphoma and most reported CD56-positive cases were diffuse large B-cell lymphomas. Cases of CD56-positive mantle cell lymphoma (MCL) have not previously been described in the literature. We present a case of CD56-positive MCL. To the best of our knowledge, this is the first case report of MCL expressing CD56.
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Affiliation(s)
- Sanghui Park
- Department of Pathology, Ewha Womans University School of Medicine, Seoul
| | - Young Hyeh Ko
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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12
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Starostka D, Kriegova E, Kudelka M, Mikula P, Zehnalova S, Radvansky M, Papajik T, Kolacek D, Chasakova K, Talianova H. Quantitative assessment of informative immunophenotypic markers increases the diagnostic value of immunophenotyping in mature CD5-positive B-cell neoplasms. CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 94:576-587. [DOI: 10.1002/cyto.b.21607] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 11/16/2017] [Accepted: 12/05/2017] [Indexed: 02/06/2023]
Affiliation(s)
- David Starostka
- Department of Clinical Haematology; Hospital in Havirov; Czech Republic
| | - Eva Kriegova
- Department of Immunology; Palacky University & University Hospital Olomouc; Czech Republic
| | - Milos Kudelka
- Department of Computer Science, Faculty of Electrical Engineering and Computer Science; Technical University of Ostrava; Czech Republic
| | - Peter Mikula
- Department of Clinical Haematology; Hospital in Havirov; Czech Republic
| | - Sarka Zehnalova
- Department of Computer Science, Faculty of Electrical Engineering and Computer Science; Technical University of Ostrava; Czech Republic
| | - Martin Radvansky
- Department of Computer Science, Faculty of Electrical Engineering and Computer Science; Technical University of Ostrava; Czech Republic
| | - Tomas Papajik
- Department of Haemato-oncology; Palacky University & University Hospital Olomouc; Czech Republic
| | - David Kolacek
- Department of Clinical Haematology; Hospital in Havirov; Czech Republic
| | | | - Hana Talianova
- Department of Clinical Haematology; Hospital in Havirov; Czech Republic
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13
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Xu J, Medeiros LJ, Saksena A, Wang M, Zhou J, Li J, Yin CC, Tang G, Wang L, Lin P, Li S. CD10-positive mantle cell lymphoma: clinicopathologic and prognostic study of 30 cases. Oncotarget 2017; 9:11441-11450. [PMID: 29545910 PMCID: PMC5837746 DOI: 10.18632/oncotarget.23571] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/13/2017] [Indexed: 12/23/2022] Open
Abstract
Mantle cell lymphoma is usually negative for CD10 which is useful in distinguishing MCL from other CD10 + B cell lymphomas. Here we assessed the clinicopathologic features of 30 cases of CD10+ MCL, the largest series to date in the English literature, and compared them with a group of 212 typical MCL cases (CD5+, CD10-negative, CD23-negative, cyclin D1+). The 30 patients with CD10+ MCL included 17 men and 13 women with a median age of 68 years. Compared with CD10-negative MCL, patients with CD10+ MCL showed a lower male predominance (p = 0.01), more often had a diffuse growth pattern (p = 0.04) and blastoid/pleomorphic morphology (p < 0.0001), and more often showed BCL6 expression (p = 0.009). In all MCL patients, CD10 expression was not associated with overall survival (OS) (p = 0.16). However, in more aggressive subsets of MCL patients including those with high Ki67 (> 60%), blastoid/pleomorphic morphology, or high MCL International Prognostic Index (MIPI), CD10 expression was associated with a worse OS (p = 0.003, 0.04, and 0.001, respectively). High Ki67 (> 60%), blastoid/pleomorphic morphology, and high MIPI were also been identified as poor prognostic factors patients with in CD10+ MCL (p = 0.001, 0.0003, and 0.01, respectively). In summary, CD10+ MCL more often has a diffuse growth pattern, blastoid/pleomorphic morphology, and BCL6 expression. In MCL patients with a high Ki-67 (> 60%), blastoid/pleomorphic morphology, or high MIPI, CD10 expression contributes to an even worse prognosis. MCL should be included in the differential diagnosis of CD10 + B cell lymphomas.
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Affiliation(s)
- Jie Xu
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Annapurna Saksena
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Wang
- Department of Lymphoma and Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Jiehao Zhou
- Department of Pathology, Indiana University, Indianapolis, IN, USA
| | - Jingyi Li
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.,Department of Hematology, Tianjin First Center Hospital, China
| | - C Cameron Yin
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Guilin Tang
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Lifu Wang
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.,Department of Pathology, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Pei Lin
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
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15
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Pizzi M, Agostinelli C, Righi S, Gazzola A, Mannu C, Galuppini F, Fassan M, Visentin A, Piazza F, Semenzato GC, Rugge M, Sabattini E. Aberrant expression of CD10 and BCL6 in mantle cell lymphoma. Histopathology 2017. [PMID: 28628241 DOI: 10.1111/his.13286] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIMS Mantle cell lymphoma (MCL) is characterized by distinctive histological and molecular features. Aberrant expression of BCL6 and CD10 has been reported occasionally, but the biological features of such cases are largely unknown. This study aimed to define the epidemiological, histological and cytogenetic characteristics of BCL6 and CD10-positive MCLs, also investigating possible biological features. METHODS AND RESULTS A total of 165 cases of cyclin D1 and t(11;14)(q13;q34)-positive MCLs were studied for CD10 and BCL6 immunohistochemical expression, which was documented in 26 of 165 (15.8%) cases (BCL6 17 of 165; CD10 11 of 165; BCL6 and CD10 co-expression two of 165). CD10-positivity was significantly more frequent in females (63.3%; P < 0.01). Either expression correlated significantly with higher mean proliferation index and higher prevalence of MUM1 positivity (P < 0.05). Fluorescence in-situ hybridization (FISH) for BCL6 (3q27) gene derangements was performed on the BCL6- and CD10-positive cases and 98 matched controls: amplifications were documented more frequently in BCL6-positive than -negative cases (50.0% versus 19.4% of cases) (P < 0.05). The mutational status of the variable immunoglobulin heavy chain genes (IGVH) was investigated by Sanger sequencing: five of the six successfully tested cases (83.3%) showed no somatic hypermutations. CONCLUSIONS Aberrant CD10 and BCL6 expression defines a subset of MCLs with higher mean Ki-67 index and higher prevalence of MUM1 expression. BCL6 protein positivity correlates with cytogenetic aberrations involving the BCL6 gene. Although examined successfully in few cases, the high prevalence of unmutated IGVH genes also points at a pregerminal cell origin for these phenotypically aberrant cases.
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Affiliation(s)
- Marco Pizzi
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Claudio Agostinelli
- Haematopathology Unit, Department of Hematology and Oncology/Department of Experimental Diagnostic and Specialty Medicine, Sant'Orsola University Hospital, Bologna, Italy
| | - Simona Righi
- Haematopathology Unit, Department of Hematology and Oncology/Department of Experimental Diagnostic and Specialty Medicine, Sant'Orsola University Hospital, Bologna, Italy
| | - Anna Gazzola
- Haematopathology Unit, Department of Hematology and Oncology/Department of Experimental Diagnostic and Specialty Medicine, Sant'Orsola University Hospital, Bologna, Italy
| | - Claudia Mannu
- Haematopathology Unit, Department of Hematology and Oncology/Department of Experimental Diagnostic and Specialty Medicine, Sant'Orsola University Hospital, Bologna, Italy
| | - Francesca Galuppini
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Matteo Fassan
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Francesco Piazza
- Hematology and Clinical Immunology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Gianpietro C Semenzato
- Hematology and Clinical Immunology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Massimo Rugge
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Elena Sabattini
- Haematopathology Unit, Department of Hematology and Oncology/Department of Experimental Diagnostic and Specialty Medicine, Sant'Orsola University Hospital, Bologna, Italy
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Ismail A, Mallick JA, Qin D, Hussaini MO. Sentinel case of Richter transformation from chronic lymphocytic leukaemia/small lymphocytic lymphoma to CD3+ diffuse large B-cell lymphoma. J Clin Pathol 2016; 70:575-578. [PMID: 27899414 DOI: 10.1136/jclinpath-2016-204024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/02/2016] [Accepted: 11/04/2016] [Indexed: 11/04/2022]
Abstract
AIM To report the first case of a Richter syndrome where small lymphocytic lymphoma (SLL) progressed to a CD3+ diffuse large B-cell lymphoma (DLBCL). METHODS Macrodissection of small and large cell lymphomatous components was performed. This was followed by flow cytometric analysis along with molecular B-cell immunoglobulin (heavy and light chains) and T-cell receptor (γ and β chains) gene rearrangement studies to investigate a clonal relationship between the components. RESULTS The immunophenotypic profile was similar between small and large cell components of the lymphoma by flow cytometry. Furthermore, shared clonal peaks were observed between both components based on molecular B-cell and T-cell receptor gene rearrangement studies, confirming a clonal relationship. CONCLUSIONS Chronic lymphocytic leukaemia/SLL may rarely undergo Richter transformation to a DLBCL demonstrating lineage infidelity. This is a potentially important diagnostic pitfall and such cases should not be confused with a de novo T-cell lymphoma.
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Affiliation(s)
- Ali Ismail
- University of Pikeville Kentucky College of Osteopathic Medicine, Pikeville, Kentucky, USA
| | | | - Dahui Qin
- Moffitt Cancer Center, Tampa, Florida, USA
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17
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Zhang C, Xin H, Zhang W, Yazaki PJ, Zhang Z, Le K, Li W, Lee H, Kwak L, Forman S, Jove R, Yu H. CD5 Binds to Interleukin-6 and Induces a Feed-Forward Loop with the Transcription Factor STAT3 in B Cells to Promote Cancer. Immunity 2016; 44:913-923. [PMID: 27096320 DOI: 10.1016/j.immuni.2016.04.003] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 11/16/2015] [Accepted: 12/29/2015] [Indexed: 12/18/2022]
Abstract
The participation of a specific subset of B cells and how they are regulated in cancer is unclear. Here, we demonstrate that the proportion of CD5(+) relative to interleukin-6 receptor α (IL-6Rα)-expressing B cells was greatly increased in tumors. CD5(+) B cells responded to IL-6 in the absence of IL-6Rα. IL-6 directly bound to CD5, leading to activation of the transcription factor STAT3 via gp130 and its downstream kinase JAK2. STAT3 upregulated CD5 expression, thereby forming a feed-forward loop in the B cells. In mouse tumor models, CD5(+) but not CD5(-) B cells promoted tumor growth. CD5(+) B cells also showed activation of STAT3 in multiple types of human tumor tissues. Thus, our findings demonstrate a critical role of CD5(+) B cells in promoting cancer.
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Affiliation(s)
- Chunyan Zhang
- Department of Cancer Immunotherapeutics and Tumor Immunology, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Hong Xin
- Department of Cancer Immunotherapeutics and Tumor Immunology, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Wang Zhang
- Department of Cancer Immunotherapeutics and Tumor Immunology, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Paul J Yazaki
- Department of Immunology, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Zhifang Zhang
- Department of Immunology, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Keith Le
- Department of Immunology, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Wenzhao Li
- Department of Cancer Immunotherapeutics and Tumor Immunology, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Heehyoung Lee
- Department of Cancer Immunotherapeutics and Tumor Immunology, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Larry Kwak
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Stephen Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Richard Jove
- Cell Therapy Institute, Nova Southeastern University, Ft Lauderdale, FL. 33314, USA
| | - Hua Yu
- Department of Cancer Immunotherapeutics and Tumor Immunology, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA.,Center for Translational Medicine, Zhangjiang Hi-Tech Park, Pudong New Area, Shanghai 201203, China
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18
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Sales MM, Ferreira SIACP, Ikoma MRV, Sandes AF, Beltrame MP, Bacal NS, Silva MCA, Malvezzi M, Lorand-Metze IGH, Orfao A, Yamamoto M. Diagnosis of chronic lymphoproliferative disorders by flow cytometry using four-color combinations for immunophenotyping: A proposal of the brazilian group of flow cytometry (GBCFLUX). CYTOMETRY PART B-CLINICAL CYTOMETRY 2016; 92:398-410. [PMID: 27362793 DOI: 10.1002/cyto.b.21396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 06/20/2016] [Accepted: 06/27/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Multiparametric flow cytometry (MFC) is a powerful tool for the diagnosis of hematological malignancies and has been useful for the classification of chronic lymphoproliferative disorders (CLPD) according to the WHO criteria. Following the purposes of the Brazilian Group of Flow Cytometry (GBCFLUX), the aim of this report was to standardize the minimum requirements to achieve an accurate diagnosis in CLPDs, considering the different economic possibilities of the laboratories in our country. Most laboratories in Brazil work with 4-fluorescence flow cytometers, which is why the GBCFLUX CLPD Committee has proposed 4-color monoclonal antibody (MoAb) panels. METHODS/RESULTS Panels for screening and diagnosis in B, T and NK lymphoproliferative disorders were developed based on the normal differentiation pathways of these cells and the most frequent phenotypic aberrations. Important markers for prognosis and for minimal residual disease (MRD) evaluation were also included. The MoAb panels presented here were designed based on the diagnostic expertise of the participating laboratories and an extensive literature review. CONCLUSION The 4-color panels presented to aid in the diagnosis of lymphoproliferative neoplasms by GBCFLUX aim to provide clinical laboratories with a systematic, step-wise, cost-effective, and reproducible approach to obtain an accurate immunophenotypic diagnosis of the most frequent of these disorders. © 2016 International Clinical Cytometry Society.
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Affiliation(s)
- M M Sales
- Hospital Das Clínicas Da Faculdade De Medicina Da Universidade De São Paulo, SP, Brazil
| | | | | | - A F Sandes
- Division of Hematology and Flow Cytometry, Fleury Group, São Paulo, SP, Brazil
| | - M P Beltrame
- Unidade De Apoio Diagnóstico, Hospital De Clínicas - UFPR, Brazil
| | - N S Bacal
- Hospital Albert Einstein, São Paulo, SP, Brazil
| | - M C A Silva
- Hospital Das Clínicas Da Faculdade De Medicina Da Universidade De São Paulo, SP, Brazil
| | - M Malvezzi
- Disciplina De Hematologia Do Departamento De Clínica Médica Da Universidade Federal Do Paraná, PR, Brazil
| | | | - A Orfao
- Cancer Research Centre (IBMCC, CSIC-USAL), Institute of Biomedical Research of Salamanca (IBSAL), Cytometry Service and Department of Medicine, University of Salamanca, Spain
| | - M Yamamoto
- Escola Paulista De Medicina, Universidade Federal De São Paulo (EPM-UNIFESP), SP, Brazil
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Bansal A, Mittal S, Dass J, Gupta N, Agarwal PK, Kotwal J. A Case Presenting with Splenic Infarct Diagnosed as Primary Bone Marrow CD5 Positive DLBCL: A Clinicopathological Correlation. Indian J Hematol Blood Transfus 2016; 32:159-62. [PMID: 27408381 DOI: 10.1007/s12288-016-0646-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 01/15/2016] [Indexed: 12/22/2022] Open
Abstract
De novo CD5+ Diffuse large B cell lymphoma (DLBCL) is a rare and aggressive subtype of DLBCL. It is a distinct clinicopathologic entity with complex molecular profile and poor prognosis. A 59 year old female presented with pyrexia of unknown origin since 1 month. On examination, there was severe pallor, hepatosplenomegaly and no palpable lymphadenopathy. Complete blood count revealed bicytopenia with normal total leucocyte count. Liver and renal function tests were normal. Ultrasonography abdomen revealed splenic enlargement with two focal lesions attributed to either splenic abscess or infarcts. Patient was being managed as splenic infarct but continued to have bicytopenia. Further investigation showed elevated serum ferritin, triglycerides and LDH. With a clinical suspicion of infection and haemophagocytic lymphohistiocytosis bone marrow aspiration (BMA) and biopsy (BMBx) was done. BMA showed extensive haemophagocytosis and ~7.4 % large lymphoma-like cells. On this basis PET-CT was suggested which showed enlarged spleen with diffuse uptake. BMBx showed nodular and intrasinusoidal collection of abnormal lymphoid cells. On immunohistochemistry, these cells were positive for CD20, CD5, MUM1, BCL-2, BCL-6 and negative for CD3, CD10 and CD23. CD34 highlighted focal intrasinusoidal pattern. The complete clinicopathological profile suggested the diagnosis of de novo CD5+ DLBCL, with primary hepatosplenic pattern of involvement. CD5+ DLBCL presenting as splenic infarct is very rare. This case was unusual as the diagnosis of a primary aggressive lymphoma with haemophagocytosis was established in a patient who presented with fever and splenic infarct without lymphadenopathy. This indicates the importance of good morphological assessment of a bone marrow aspirate and biopsy to make a correct diagnosis.
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Affiliation(s)
- Anupriya Bansal
- Department of Hematology, Sir Ganga Ram Hospital, 1st Floor, SSRB Building, New Delhi, India
| | - Suchi Mittal
- Department of Hematology, Sir Ganga Ram Hospital, 1st Floor, SSRB Building, New Delhi, India
| | - Jasmita Dass
- Department of Hematology, Sir Ganga Ram Hospital, 1st Floor, SSRB Building, New Delhi, India
| | - Nitin Gupta
- Department of Clinical Hematology, Sir Ganga Ram Hospital, New Delhi, India
| | - P K Agarwal
- Department of Medicine, Sir Ganga Ram Hospital, New Delhi, India
| | - Jyoti Kotwal
- Department of Hematology, Sir Ganga Ram Hospital, 1st Floor, SSRB Building, New Delhi, India
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20
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Jackson JM, Taylor JB, Witek MA, Hunsucker SA, Waugh JP, Fedoriw Y, Shea TC, Soper SA, Armistead PM. Microfluidics for the detection of minimal residual disease in acute myeloid leukemia patients using circulating leukemic cells selected from blood. Analyst 2016; 141:640-51. [PMID: 26523411 PMCID: PMC4701594 DOI: 10.1039/c5an01836f] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We report a highly sensitive microfluidic assay to detect minimal residual disease (MRD) in patients with acute myeloid leukemia (AML) that samples peripheral blood to search for circulating leukemic cells (CLCs). Antibodies immobilized within three separate microfluidic devices affinity-selected CLC subpopulations directly from peripheral blood without requiring pre-processing. The microfluidic devices targeted CD33, CD34, and CD117 cell surface antigens commonly expressed by AML leukemic cells so that each subpopulation's CLC numbers could be tracked to determine the onset of relapse. Staining against aberrant markers (e.g. CD7, CD56) identified low levels (11-2684 mL(-1)) of CLCs. The commonly used platforms for the detection of MRD for AML patients are multi-parameter flow cytometry (MFC), typically from highly invasive bone marrow biopsies, or PCR from blood samples, which is limited to <50% of AML patients. In contrast, the microfluidic assay is a highly sensitive blood test that permits frequent sampling for >90% of all AML patients using the markers selected for this study (selection markers CD33, CD34, CD117 and aberrant markers such as CD7 and CD56). We present data from AML patients after stem cell transplant (SCT) therapy using our assay. We observed high agreement of the microfluidic assay with therapeutic treatment and overall outcome. We could detect MRD at an earlier stage compared to both MFC and PCR directly from peripheral blood, obviating the need for a painful bone marrow biopsy. Using the microfluidic assay, we detected MRD 28 days following one patient's SCT and the onset of relapse at day 57, while PCR from a bone marrow biopsy did not detect MRD until day 85 for the same patient. Earlier detection of MRD in AML post-SCT enabled by peripheral blood sampling using the microfluidic assay we report herein can influence curative clinical decisions for AML patients.
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MESH Headings
- Animals
- Hematopoietic Stem Cell Transplantation
- Humans
- Lab-On-A-Chip Devices
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/surgery
- Neoplasm, Residual/blood
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/pathology
- Neoplastic Cells, Circulating/pathology
- Recurrence
- Sensitivity and Specificity
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Affiliation(s)
- Joshua M Jackson
- Department of Chemistry, UNC-Chapel Hill, USA. and Center for Biomodular Multi-scale Systems for Precision Medicine, UNC-Chapel Hill, USA
| | - James B Taylor
- Department of Chemistry, UNC-Chapel Hill, USA. and Center for Biomodular Multi-scale Systems for Precision Medicine, UNC-Chapel Hill, USA
| | - Małgorzata A Witek
- Center for Biomodular Multi-scale Systems for Precision Medicine, UNC-Chapel Hill, USA and Department of Biomedical Engineering, UNC-Chapel Hill, USA
| | - Sally A Hunsucker
- University of North Carolina Lineberger Comprehensive Cancer Center, UNC-Chapel Hill, USA.
| | | | - Yuri Fedoriw
- University of North Carolina Lineberger Comprehensive Cancer Center, UNC-Chapel Hill, USA. and Department of Medicine, UNC-Chapel Hill, USA
| | | | - Steven A Soper
- Department of Chemistry, UNC-Chapel Hill, USA. and Center for Biomodular Multi-scale Systems for Precision Medicine, UNC-Chapel Hill, USA
| | - Paul M Armistead
- University of North Carolina Lineberger Comprehensive Cancer Center, UNC-Chapel Hill, USA. and Department of Medicine, UNC-Chapel Hill, USA
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Astarci HM, Gurbuz GA, Sengul D, Hucumenoglu S, Kocer U, Ustun H. Significance of androgen receptor and CD10 expression in cutaneous basal cell carcinoma and trichoepithelioma. Oncol Lett 2015; 10:3466-3470. [PMID: 26788151 PMCID: PMC4665148 DOI: 10.3892/ol.2015.3804] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 08/25/2015] [Indexed: 11/23/2022] Open
Abstract
Differential diagnosis of trichoepithelioma (TE) and basal cell carcinoma (BCC) on the basis of clinical symptoms and laboratory investigations may be difficult in certain patients. The aim of the present study was to compare cluster of differentiation 10 (CD10) and androgen receptor (AR) expression patterns in BCC and TE, to investigate the predictive power of these proteins as markers of the two conditions. A total of 39 cases of BCC and 15 cases of TE were retrieved from the pathology department archives. AR and CD10 immunohistochemistry was performed on all of the specimens; 23 BCC cases displayed focal nuclear AR staining, however, none of the cases demonstrated diffuse nuclear staining and 16 BCC cases were negative for AR staining. Stromal CD10 staining was more common in TE cases than in BCC cases, and peripheral CD10 staining was more common in BCC cases than in TE cases. AR immunostaining of the BCC samples typically appeared as scattered clusters and individual cells. In addition, AR and CD10 staining exhibited varying staining intensities within each samples. Incisional punch biopsy specimens have the potential to present false-negative results. Therefore, AR and CD10 staining of total excision biopsies provides a more accurate differential diagnosis of BCC and TE for cases with difficulties in the histopathological analysis.
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Affiliation(s)
- Hesna M Astarci
- Department of Pathology, Abant Izzet Baysal University, Bolu 14280, Turkey
| | - Gulfem A Gurbuz
- Department of Dermatology, Dr. N.K. Sincan State Hospital, Ankara 06930, Turkey
| | - Demet Sengul
- Department of Pathology, Giresun University, Giresun 28200, Turkey
| | - Sema Hucumenoglu
- Department of Pathology, Ankara Training and Research Hospital, Ankara 06340, Turkey
| | - Ugur Kocer
- Department of Plastic and Reconstructive Surgery, Ankara Training and Research Hospital, Ankara 06340, Turkey
| | - Huseyin Ustun
- Department of Pathology, Kafkas University, Kars 36100, Turkey
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22
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Gaballah MA, Ahmed RA. Diagnostic value of CD10 and Bcl2 expression in distinguishing cutaneous basal cell carcinoma from squamous cell carcinoma and seborrheic keratosis. Pathol Res Pract 2015; 211:931-8. [PMID: 26573127 DOI: 10.1016/j.prp.2015.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 06/29/2015] [Accepted: 09/08/2015] [Indexed: 12/01/2022]
Abstract
The distinction between cutaneous basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and seborrheic keratosis (SK), which are common entities in clinical practice, can be difficult clinically and histologically. CD10 and Bcl2 antigens are important factors in tumor growth, survival and spread. The aim of the present study is to define the frequency of CD10 and Bcl2 expression in such cutaneous tumors and its relation to the clinicopathological characteristics as well as their possible diagnostic utility. CD10 and Bcl2 immunohistochemistry was performed on 30 BCC, 20 SCC and 15 SK. 93.3% of SK cases and 53.3% of BCC cases showed significant expression of CD10 in tumor cells when compared either with each other or with SCC cases (100% negative). Stromal CD10 expression was positive in 50% of BCC cases and 75% of SCC cases. Stromal CD10 expression was significantly higher in high risk BCC and BCC with infiltrating deep margins; furthermore, it showed a significant positive correlation with grade of SCC. A significant inverse correlation between CD10 expression in stromal and tumor cells of BCC was present. Bcl2 was significantly expressed in 93.3% of SK cases and 80% of BCC cases when compared with SCC cases (100% negative). It was found that for distinguishing BCC from SK, only CD10 expression in tumor cells provided a high diagnostic value with positive likelihood ratio (PLR) was 7.00. In addition, CD10 and Bcl2 expression in tumor cells could give convincing diagnostic value to distinguish SCC from SK (PLR=15.00 for each marker). Moreover, for differentiating BCC from SCC, only Bcl2 in the tumor cells could provide a high diagnostic value (PLR=5.5). In conclusion, CD10 and Bcl2 can help in differentiating cutaneous BCC from SK and SCC. The overexpression of CD10 in the stromal cells of SCC and some variants of BCC suggests the invasive properties of such tumors.
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Dorwal P, Mehra S, Pande A, Jain D, Smeeta G, Sachdev R, Raina V. Aberrant NK cell associated marker (CD56 and CD57) expression in chronic lymphocytic leukemia. CYTOMETRY PART B-CLINICAL CYTOMETRY 2015; 88:348-51. [PMID: 26013700 DOI: 10.1002/cyto.b.21254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 03/25/2015] [Accepted: 05/20/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Pranav Dorwal
- Department of Pathology and Laboratory Medicine; Medanta the Medicity; Gurgaon Haryana 122 001 India
| | - Simmi Mehra
- Department of Pathology and Laboratory Medicine; Medanta the Medicity; Gurgaon Haryana 122 001 India
| | - Amit Pande
- Department of Pathology and Laboratory Medicine; Medanta the Medicity; Gurgaon Haryana 122 001 India
| | - Dharmendra Jain
- Department of Pathology and Laboratory Medicine; Medanta the Medicity; Gurgaon Haryana 122 001 India
| | - G. Smeeta
- Department of Pathology and Laboratory Medicine; Medanta the Medicity; Gurgaon Haryana 122 001 India
| | - Ritesh Sachdev
- Department of Pathology and Laboratory Medicine; Medanta the Medicity; Gurgaon Haryana 122 001 India
| | - Vimarsh Raina
- Department of Pathology and Laboratory Medicine; Medanta the Medicity; Gurgaon Haryana 122 001 India
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Li Y, Hu S, Zuo Z, Hong M, Lin P, Li S, Konoplev S, Wang Z, Khoury JD, Young KH, Medeiros LJ, Yin CC. CD5-positive follicular lymphoma: clinicopathologic correlations and outcome in 88 cases. Mod Pathol 2015; 28:787-98. [PMID: 25743023 DOI: 10.1038/modpathol.2015.42] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 01/20/2015] [Accepted: 01/21/2015] [Indexed: 11/09/2022]
Abstract
Follicular lymphoma is a low-grade B-cell lymphoma of germinal center B-cell origin that typically lacks CD5 expression. We describe the clinicopathologic features of 88 cases of CD5+ follicular lymphoma (53 men, 35 women; median age, 60 years; range, 31-86). Follicular lymphoma was diagnosed initially in lymph nodes in 66 and extranodal sites in 22 patients. Eighty-one patients had lymphadenopathy, 66 had more than one involved site, 46 had bone marrow involvement, and 7 had splenomegaly. Staging information was available for 84 patients: 52 stage IV, 18 stage III, 12 stage II, and 2 stage I. Sixty-one cases were grade 1 or 2 and 27 were grade 3. The median proliferation index (Ki-67) was 30%. CD5 expression was detected by flow cytometry in 69, immunohistochemistry in 8, and both methods in 11 cases. The presence of t(14;18)(q32;q21)/IGH-BCL2 or other BCL2 translocation was detected in 28/44 (64%) cases. A total of 38 (43%) patients also had diffuse large B-cell lymphoma, concurrent with (n=20), subsequent to (n=13), or developing before CD5+ follicular lymphoma (n=5). All patients received chemotherapy; 12 also received stem-cell transplantation. With a median follow-up of 55 months (range, 0.5-207), 15 patients died, 46 were alive with disease, and 20 were in clinical remission. Compared with a matched group of patients with CD5- follicular lymphoma, patients with CD5+ follicular lymphoma more commonly had an International Prognostic Index >2 (35/80 vs 10/99, P<0.001), more often developed diffuse large B-cell lymphoma (38/88 vs 17/99; P<0.001), and had a shorter median progression-free survival (44 vs 89 months, P=0.0042). Higher Ki-67 and International Prognostic Index were identified as poor prognostic factors in both the groups. We conclude that CD5 expression in follicular lymphoma is associated with a higher International Prognostic Index, higher rate of transformation to diffuse large B-cell lymphoma, and shorter progression-free survival.
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Affiliation(s)
- Yu Li
- 1] Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA [2] Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Shimin Hu
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Zhuang Zuo
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Ming Hong
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Pei Lin
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Sergej Konoplev
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Zhen Wang
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph D Khoury
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Ken H Young
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - C Cameron Yin
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
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Shrestha R, Bhatt VR, Guru Murthy GS, Armitage JO. Clinicopathologic features and management of blastoid variant of mantle cell lymphoma. Leuk Lymphoma 2015; 56:2759-67. [PMID: 25747972 DOI: 10.3109/10428194.2015.1026902] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The blastoid variant of mantle cell lymphoma (MCL), which accounts for less than one-third of MCL, may arise de novo or as a transformation from the classical form of MCL. Blastoid variant, which predominantly involves men in their sixth decade, has frequent extranodal involvement (40-60%), stage IV disease (up to 85%) and central nervous system (CNS) involvement. Diagnosis relies on morphological features and is challenging. Immunophenotyping may display CD23 and CD10 positivity and CD5 negativity in a subset. Genetic analysis demonstrates an increased number of complex genetic alterations. Blastoid variant responds poorly to conventional chemotherapy and has a short duration of response. Although the optimal therapy remains to be established, CNS prophylaxis and the use of aggressive immunochemotherapy followed by autologous stem cell transplant may prolong the remission rate and survival. Further studies are crucial to expand our understanding of this disease entity and improve the clinical outcome.
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Affiliation(s)
- Rajesh Shrestha
- a Department of Internal Medicine , Memorial Hospital of Rhode Island , Pawtucket , RI , USA
| | - Vijaya Raj Bhatt
- b Department of Internal Medicine , Division of Hematology-Oncology, University of Nebraska Medical Center , Omaha , NE , USA
| | | | - James O Armitage
- b Department of Internal Medicine , Division of Hematology-Oncology, University of Nebraska Medical Center , Omaha , NE , USA
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Challagundla P, Jorgensen JL, Kanagal-Shamanna R, Gurevich I, Pierson DM, Ferrajoli A, Reyes SR, Medeiros LJ, Miranda RN. Utility of quantitative flow cytometry immunophenotypic analysis of CD5 expression in small B-cell neoplasms. Arch Pathol Lab Med 2014; 138:903-9. [PMID: 24978916 DOI: 10.5858/arpa.2013-0367-oa] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
CONTEXT The value of assessing CD5 expression in the differential diagnosis of small B-cell neoplasms is well established. Assessment is usually done qualitatively. OBJECTIVES To assess CD5 expression levels by quantitative flow cytometry immunophenotyping and to determine possible differences among various small B-cell neoplasms. DESIGN We performed 4-color flow cytometry analysis on specimens of peripheral blood and bone marrow aspirate and quantified CD5 expression in various small B-cell lymphomas and leukemias. We also assessed CD5 levels in peripheral blood samples of healthy blood donors. RESULTS Cases of chronic lymphocytic leukemia and mantle cell lymphoma had higher levels of CD5 compared with control B cells (P < .001). Cases of marginal zone lymphoma and hairy cell leukemia had CD5 levels similar to control B cells (P = .35 and P = .14, respectively), whereas cases of follicular lymphoma and lymphoplasmacytic lymphoma had significantly lower CD5 levels than control B cells (P < .001 and P = .04, respectively). In B-cell neoplasms, a high level of CD5 expression was correlated with a homogeneous pattern of positive events, whereas lower CD5 levels were correlated with heterogeneous patterns of positive events. CONCLUSIONS Using flow cytometric immunophenotypic analysis to quantify CD5 levels can aid in diagnosis. CD5 expression levels are higher in patients with chronic lymphocytic leukemia and mantle cell lymphoma, and expression is observed in a homogeneous pattern, as compared with other B-cell neoplasms that are either negative for CD5 or express CD5 at lower levels with a heterogeneous pattern. However, there is some overlap in CD5 expression levels between a subset of atypical chronic lymphocytic leukemia and marginal zone lymphoma cases.
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Affiliation(s)
- Pramoda Challagundla
- From the Departments of Hematopathology (Ms Challagundla, Mr Reyes, and Drs Jorgensen, Kanagal-Shamanna, Medeiros, and Miranda) and Leukemia (Dr Ferrajoli), University of Texas MD Anderson Cancer Center, Houston; the Department of Hematopathology, Genoptix Medical Laboratory, Carlsbad, California (Dr Gurevich); and the Department of Hematopathology, King's Daughters Medical Center, Ashland, Kentucky (Dr Pierson)
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27
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Mayson E, Saverimuttu J, Cartwright K. CD5-positive follicular lymphoma: prognostic significance of this aberrant marker? Intern Med J 2014; 44:417-22. [DOI: 10.1111/imj.12390] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 02/05/2014] [Indexed: 11/29/2022]
Affiliation(s)
- E. Mayson
- Haematology Department; Wollongong Hospital; Wollongong New South Wales Australia
| | - J. Saverimuttu
- Haematology Department; Wollongong Hospital; Wollongong New South Wales Australia
| | - K. Cartwright
- Haematology Department; Wollongong Hospital; Wollongong New South Wales Australia
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28
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Miyoshi H, Sato K, Yoshida M, Kimura Y, Kiyasu J, Ichikawa A, Ishibashi Y, Arakawa F, Nakamura Y, Nakashima S, Niino D, Sugita Y, Ohshima K. CD5-positive follicular lymphoma characterized by CD25, MUM1, low frequency of t(14;18) and poor prognosis. Pathol Int 2014; 64:95-103. [DOI: 10.1111/pin.12145] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 01/30/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - Kensaku Sato
- Biostatistics Center; School of Medicine; Kurume University; Kurume Japan
| | - Maki Yoshida
- Department of Pathology; Kurume University; Kurume Japan
| | - Yoshizo Kimura
- Department of Pathology; Kurume University; Kurume Japan
| | - Junichi Kiyasu
- Department of Pathology; Kurume University; Kurume Japan
| | - Ayako Ichikawa
- Department of Pathology; Kurume University; Kurume Japan
| | | | - Fumiko Arakawa
- Department of Pathology; Kurume University; Kurume Japan
| | | | | | - Daisuke Niino
- Department of Pathology; Kurume University; Kurume Japan
| | - Yasuo Sugita
- Department of Pathology; Kurume University; Kurume Japan
| | - Koichi Ohshima
- Department of Pathology; Kurume University; Kurume Japan
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29
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De Novo CD5+ Diffuse Large B-Cell Lymphoma With Cutaneous Involvement. PATHOLOGY CASE REVIEWS 2014. [DOI: 10.1097/pcr.0000000000000046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Tabata R, Tabata C, Nagai T, Yasumizu R, Kojima M. Richter syndrome with follicular colonization of chronic lymphocytic leukemia/small lymphocytic lymphoma cells mimicking follicular lymphoma. Int J Surg Pathol 2013; 22:736-43. [PMID: 24249845 DOI: 10.1177/1066896913509011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Follicular colonization is occasionally observed in marginal zone lymphoma. In rare cases, it has also been associated with mantle cell lymphoma. Chronic lymphocytic leukemia typically involves nodal or extranodal tissues as diffuse proliferation by complete effacement of the normal architecture. The involvement of chronic lymphocytic leukemia may be less frequently limited to the interfollicular areas. Here, we report a case of Richter syndrome of the small intestine that was initially diagnosed as follicular lymphoma of the gastrointestinal tract because of a partial follicular growth pattern in addition to a mainly diffuse proliferation pattern. The follicular pattern mimicking follicular lymphoma was shown to be composed of reactive follicles with follicular colonization of the original chronic lymphocytic leukemia cells. As the prognoses of Richter syndrome and follicular lymphoma of gastrointestinal tract are quite different, clinicians must carefully diagnose these conditions to avoid a misdiagnosis.
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Affiliation(s)
- Rie Tabata
- Hyogo Prefectural Tsukaguchi Hospital, Hyogo, Japan
| | | | - Tomoko Nagai
- Hyogo Prefectural Tsukaguchi Hospital, Hyogo, Japan
| | | | - Masaru Kojima
- Dokkyo Medical University School of Medicine, Tochigi, Japan
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31
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Jain P, Fayad LE, Rosenwald A, Young KH, O'Brien S. Recent advances in de novo CD5+ diffuse large B cell lymphoma. Am J Hematol 2013; 88:798-802. [PMID: 23695956 DOI: 10.1002/ajh.23467] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 04/08/2013] [Accepted: 04/22/2013] [Indexed: 02/03/2023]
Abstract
Various subsets of DLBCL are distinguished based on molecular and immunohistochemical features. CD5 expressing DLBCL (CD5+ DLBCL) is increasingly recognized as a subtype of DLBCL with an aggressive disease course. Primary CD5+ DLBCL comprises approximately 5-10% of DLBCL. Few studies of CD5+ DLBCL have been reported, primarily from Japan. Publications covered in this review include articles published on PubMed and abstracts from major international conferences until April 2013. Common features of patients with CD5+ DLBCL are older age, female preponderance, elevated LDH, more extra-nodal involvement, poor performance status (PS), higher incidence of CNS involvement, inferior response to rituximab-containing regimens (as compared to CD5- DLBCL) and advanced stage. The majority of these cases belong to the activated B cell subtype (ABC) of DLBCL. It is unclear whether CD5 expression in malignant B cells may confer chemo resistance, upregulate antiapoptotic signals and alter the microenvironment. Molecular techniques have helped in understanding CD5+ DLBCL. Gene expression signature was similar in ABC-DLBCL and CD5+ DLBCL in some studies. Despite the better characterization treatment outcomes are poor and additional studies are needed.
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Affiliation(s)
- Preetesh Jain
- Department of Leukemia, The University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030, USA
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32
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Demurtas A, Stacchini A, Aliberti S, Chiusa L, Chiarle R, Novero D. Tissue flow cytometry immunophenotyping in the diagnosis and classification of non-Hodgkin's lymphomas: a retrospective evaluation of 1,792 cases. CYTOMETRY PART B-CLINICAL CYTOMETRY 2013; 84:82-95. [PMID: 23325563 DOI: 10.1002/cyto.b.21065] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 10/23/2012] [Accepted: 11/21/2012] [Indexed: 12/17/2022]
Abstract
A retrospective analysis of 1,792 solid tissues suggestive of lymphoma, submitted over a 12-year period, was carried out and flow cytometry (FC) results were compared with histologic findings. The final histologic diagnosis of cases documented in this report is as follows: 1,270 non-Hodgkin's lymphomas (NHL); 17 composite lymphomas; four NHL plus carcinomas; five post-transplant lymphoproliferative disorders; 105 Hodgkin's lymphomas (HL); eight acute leukemias; 42 tissue cancers; and 341 non-neoplastic diseases. A strong correlation between morphology and FC data was observed among hematological malignancies (1,268/1,304, 97.2%) with the exception of HL. Among B-NHL, FC detection of clonally restricted B-cell allowed the identification of lymphomas that were not histologically clear and the differential diagnosis between follicular lymphoma and reactive hyperplasia. A high correlation level (r = 0.83; P < 0.0001) was obtained in comparing proliferation results obtained by FC and immunohistochemistry. Among T-NHL, FC detection of an aberrant phenotype direct histologic diagnosis in cases having less than 20% of neoplastic cells. In nine cases, FC suggested the need to evaluate a neoplastic population, not morphologically evident. Results show that FC routinely performed on tissue samples suspected of lymphomas is a fundamental adjunct to morphology in the diagnosis of NHL and may enhance the performance of the histologic evaluation so as to achieve the final diagnosis. To the best of our knowledge, this is the first report in the literature of a wide series of tissues also studied by FC.
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Affiliation(s)
- Anna Demurtas
- Flow Cytometry Unit, Anatomical Pathology Laboratory 2, Molinette Hospital, University of Turin, Italy
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33
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Piccaluga PP, Pileri SA, Agostinelli C, Klapper W, Lennert K. Follicular lymphoma: stillSix characters in search of an author? Leuk Lymphoma 2011; 52:1655-67. [PMID: 21657965 DOI: 10.3109/10428194.2011.575493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Follicular lymphoma (FL) is regarded as a distinct entity in the literature as well as in the 2008 edition of the WHO classification of tumours of haematopoietic and lymphoid tissues. Nevertheless, there are still several issues that are matters of controversy such as the grading system or the exact biological location of grade 3B FL. This makes FL somewhat like the Six characters in search of an author of Pirandello's comedy. Here, we revise the morphology and pathobiology of FL by highlighting both the areas remaining critical and future perspectives. This review was inspired by the reappraisal of Professor Lennert's personal archive that represents a unique legacy for the entire scientific community.
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Sekiguchi Y, Imai H, Wakabayashi M, Sawada T, Ichikawa K, Komatsu N, Noguchi M. CD5-positive follicular lymphoma: a case report and literature review. Intern Med 2011; 50:899-904. [PMID: 21498939 DOI: 10.2169/internalmedicine.50.4339] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 59-year-old man exhibited an enlarged right inguinal lymph node in February 2009. A pathological diagnosis of follicular lymphoma (FL), grade 3A, was made based on a biopsy specimen from the right inguinal lymph node. The immunophenotypes of the lymphoma cells were CD3-, CD5+, CD7-, CD10+, CD19+, CD20+, CD23+, IgM+, Igκ-, and Igλ+. Fluorescence-activated cell sorting (FACS) dual staining indicated that the cells were double-positive for both CD5 and CD20. Mantle cell lymphoma (MCL), small lymphocytic lymphoma (SLL) and CD5-positive diffuse large B-cell lymphoma (DLBCL) were ruled out by the presence of cyclin D1-, CD10+, and the pathological findings. Based on these findings, the patient was diagnosed as having CD5-positive FL. Eight cycles of rituximab plus six cycles of CHOP were performed, and complete remission was achieved. To our knowledge, this is a rare case of CD5-positive FL. A literature review suggested a relatively higher incidence in younger and male patients. Remarkably, patients with grade 3 tend to undergo a transformation from CD5-positive FL to DLBCL.
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MESH Headings
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- CD5 Antigens/metabolism
- Cyclophosphamide/therapeutic use
- Diagnosis, Differential
- Disease Progression
- Doxorubicin/therapeutic use
- Humans
- Immunophenotyping
- Lymphoma, Follicular/immunology
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/therapy
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Prednisone/therapeutic use
- Prognosis
- Rituximab
- Vincristine/therapeutic use
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35
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Abstract
Mantle cell lymphoma (MCL) characteristically express CD20, CD5, and cyclin-D1, carries the translocation t(11;14) (q13;q32) and typically has no expression of germinal center cell markers. So-called aberrant phenotypes such as CD5 negative and cyclin-D1-negative MCL have been described. Also few cases with CD10 and/or BCL-6 protein expression have been reported. We analyzed 127 MCL looking for the frequency of aberrant immunophenotype, CD10, BCL-6, and MUM1 expression. All cases were CD20 and cyclin-D1 positive, 96% expressed CD5, and 98% showed the t(11;14). BCL-6 expression was observed in 12% of the cases and MUM1 in 35%. No one case showed CD10 positivity in 30% or more neoplastic cells. Only 3 cases showed 10% to 20% of tumoral cells positive for CD10. MUM1 expression was observed in 67% of the BCL-6 positive cases. Thirty-two percent of the cases showed a MUM1+/BCL-6-/CD10- phenotype and 56% had a triple-negative-pattern. Aberrant phenotype is infrequent but not rare, and does not rule out a diagnosis of MCL in an otherwise typical case.
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36
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Lian DWQ, Chau YP, Lee LKM, Teo C, Yap WM, Chuah KL. Ocular mantle cell lymphoma with aberrant CD10 expression: a potential diagnostic pitfall. Pathology 2010; 41:704-6. [PMID: 20001358 DOI: 10.3109/00313020903306645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
MESH Headings
- Aged
- Biomarkers, Tumor/metabolism
- Chromosomes, Human, Pair 14
- Chromosomes, Human, Pair 18
- DNA, Neoplasm/analysis
- Diagnosis, Differential
- Diagnostic Errors/prevention & control
- Eye Neoplasms/diagnosis
- Eye Neoplasms/metabolism
- Eye Neoplasms/surgery
- Eyelids/pathology
- Eyelids/surgery
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, Follicular/diagnosis
- Lymphoma, Mantle-Cell/diagnosis
- Lymphoma, Mantle-Cell/metabolism
- Lymphoma, Mantle-Cell/surgery
- Male
- Neprilysin/metabolism
- Translocation, Genetic
- Waldenstrom Macroglobulinemia/diagnosis
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37
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Gao J, Peterson L, Nelson B, Goolsby C, Chen YH. Immunophenotypic variations in mantle cell lymphoma. Am J Clin Pathol 2009; 132:699-706. [PMID: 19846810 DOI: 10.1309/ajcpv8ln5enmzovy] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Mantle cell lymphoma (MCL) expresses pan-B-cell antigens and is usually CD5+/CD10-/CD23-/FMC7+. In this study, we evaluated 52 patients with confirmed diagnoses of MCL and identified variant immunophenotypes in 21 patients (19/48 classical and 2/4 variant MCLs), including CD5- in 6 (12%) of 52, CD10+ in 4 (8%) of 50, CD23+ in 10 (21%) of 48, and FMC7- in 4 (11%) of 37 cases. Three cases showed variations in 2 antigens, including CD5-/CD23+, CD10+/FMC7-, and CD23+/FMC7-; they were all classical MCLs. One blastoid variant MCL was CD23+, and one was FMC7-. Evaluation for proliferation index by immunohistochemical analysis for Ki-67 demonstrated no significant difference between MCLs with variant immunophenotypes and MCLs with typical immunophenotypes. The high proliferation index (>60%) was exclusively seen in the blastoid and pleomorphic variants. Our results indicate that immunophenotypic variations are common in MCL, and recognizing the variability is important for accurate subclassification of B-cell lymphoma.
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38
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Chiu A, Frizzera G, Mathew S, Hyjek EM, Chadburn A, Tam W, Knowles DM, Orazi A. Diffuse blastoid B-cell lymphoma: a histologically aggressive variant of t(14;18)-negative follicular lymphoma. Mod Pathol 2009; 22:1507-17. [PMID: 19633642 DOI: 10.1038/modpathol.2009.106] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Among the diffuse lymphomas of B-cell origin, we have encountered one variant displaying blastoid features that morphologically mimic lymphoblastic lymphoma, the blastoid variant of mantle cell lymphoma, and the so-called blastoid transformation of follicular lymphoma. To better characterize this entity, we studied eight cases morphologically, immunohistochemically, and by fluorescence in situ hybridization (FISH) for cytogenetic abnormalities commonly associated with follicular lymphoma and B-cell lymphomas exhibiting high-grade histological features. All eight cases were presented as de novo neoplasms, and displayed an entirely diffuse (five cases) or only minimal follicular (three cases) growth pattern. The neoplastic lymphoid cells were of medium size with round nuclei, fine chromatin, inconspicuous nucleoli, and high mitotic rate; they expressed CD10, BCL6, and BCL2-a phenotype consistent with follicle center cell origin. A proportion of cases expressed MUM1. Their lack of TdT and CYCLIN D1 distinguished them from lymphoblastic lymphoma and the blastoid mantle cell lymphoma, respectively. The neoplastic lymphoid cells consistently expressed CD43 (seven of eight cases) and occasionally other T-cell-associated antigens, including CD5, CD7, CD8, and CD57. Although all cases overexpressed BCL2, t(14;18) was not detected in any of the five cases examined by FISH; instead, extra copies of chromosome 18 were found in four of five cases. Finally, other cytogenetic abnormalities, including structural abnormalities of BCL6 (allelic loss/gain, rearrangement), monosomy 7, del(13)(q14), and MYC allelic loss, were frequently detected. The combination of a B-cell CD10+ BCL6+ BCL2+ phenotype in the presence of structural abnormalities of BCL6 is consistent with a follicular center cell derivation for our cases. The lack of t(14;18) seen in our cases, although rare in most cases of follicular lymphoma, has been nevertheless reported in cases of follicular lymphoma with a predominantly diffuse growth pattern. The molecular pathogenesis, clinical manifestations, and prognostic significance of these lesions remain to be elucidated.
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Affiliation(s)
- April Chiu
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY 10065, USA
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39
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Gujral S, Polampalli SN, Badrinath Y, Kumar A, P. G. S, Nair R, Gupta S, Sengar M, Nair C. Immunophenotyping of mature B-cell non Hodgkin lymphoma involving bone marrow and peripheral blood: critical analysis and insights gained at a tertiary care cancer hospital. Leuk Lymphoma 2009; 50:1290-300. [DOI: 10.1080/10428190903064824] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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40
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Lau SK, Weiss LM, Zhang Y, Huang Q. Prolymphocytoid transformation of follicular lymphoma with coexpression of CD5 and CD10. Leuk Lymphoma 2009; 47:541-7. [PMID: 16396778 DOI: 10.1080/10520290500305310] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Histologic transformation of follicular lymphoma is usually to a diffuse large B-cell lymphoma. We present a rare example of a histologic transformation of follicular lymphoma manifested by prolymphocytoid morphology and an unusual immunophenotype characterized by coexpression of CD5 and CD10. The transformed prolymphocytoid lymphoma was positive for CD5 and CD10 antigens by both flow cytometry and immunohistochemistry. The case also expressed bcl-2 and bcl-6 proteins, and exhibited t(14;18), consistent with derivation from a pre-existing follicular lymphoma. Polymerase chain reaction analysis of the immunoglobulin kappa light chain genes derived from the follicular lymphoma and prolymphocytoid lymphoma showed identical rearranged bands, suggesting clonal identity of the two neoplasms. The basis for coexpression of CD5 and CD10 remains unclear. Because the preceding low-grade follicular lymphoma was positive only for CD10 and did not express CD5, CD5 expression appears to be an acquired phenomenon accompanying the process of histologic transformation in this particular case. Prolymphocytoid transformation, similar to other histologic forms of transformation of follicular lymphoma, appears to accompany clinical progression of disease.
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MESH Headings
- Adult
- CD5 Antigens/biosynthesis
- CD5 Antigens/immunology
- Cell Transformation, Neoplastic/immunology
- Cell Transformation, Neoplastic/pathology
- Disease Progression
- Fatal Outcome
- Female
- Humans
- Immunophenotyping
- Leukemia, Prolymphocytic/immunology
- Leukemia, Prolymphocytic/pathology
- Lymphoma, Follicular/immunology
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/therapy
- Neoplasms, Second Primary/immunology
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/therapy
- Neprilysin/biosynthesis
- Neprilysin/immunology
- Remission Induction
- Treatment Failure
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Affiliation(s)
- Sean K Lau
- Department of Pathology, City of Hope National Medical Center, Duarte, CA 91010, USA.
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41
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Dong HY, Weisberger J, Liu Z, Tugulea S. Immunophenotypic analysis of CD103+ B-lymphoproliferative disorders: hairy cell leukemia and its mimics. Am J Clin Pathol 2009; 131:586-95. [PMID: 19289595 DOI: 10.1309/ajcpl13yduhfkpju] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
CD103 is characteristically expressed in hairy cell leukemia (HCL), a B-lymphoproliferative disorder highly responsive to treatment with purine analogs. Other CD103+ diseases are rare and do not respond well to the same therapy, including HCL variant (HCLv) and splenic marginal zone B-cell lymphoma (SMZL) variants. We analyzed 215 cases of CD103+ B-lymphoproliferative disorders to further delineate their immunophenotypic features. Flow cytometric analysis revealed that 78.6% of all cases expressed CD25 and CD103, characteristic of classical HCL. Cases analyzed immunohistochemically were also invariably positive for annexin-A1; a subset coexpressed CD10 (33/169 [19.5%]) or BCL1 (26/65 [36.9%]). In contrast, 21.4% of cases lacked CD25, a subset of which was analyzed and was invariably negative for annexin-A1, CD10, and BCL1. The CD25- cases had variable morphologic features ranging from HCLv and SMZL to prolymphocytic leukemia and diffuse large B-cell lymphoma. Clinically, patients with CD25- disease tended to be older (P= .001), typically had leukocytosis (P= .014), and did not respond well to cladribine or pentostatin. We suggest categorizing CD103+ B-lymphoproliferative disorders into 2 groups. While HCL coexpresses CD25 and annexin-A1, diseases lacking CD25 and annexin-A1 behave clinically differently and can be separated from HCL on diagnosis.
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Establishment of CD5 and CD10 double-positive mature B-cell line, WILL1, showing complex 8q24 translocation involving 14q32 and 6q27. Int J Hematol 2008; 88:536-542. [PMID: 18972186 DOI: 10.1007/s12185-008-0189-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Revised: 09/24/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022]
Abstract
We established a novel mature B-cell line from a CD5 and CD10 double-positive diffuse large B-cell lymphoma patient, designated as WILL1. WILL1 cells were positive for CD5, CD10, CD19, and CD20. Spectral karyotype (SKY) analysis revealed chromosome 8 signals on 6q27 as well as 14q32. Fluorescence in situ hybridization (FISH) analysis suggested that a translocation break occurred outside the immunoglobulin heavy chain (IGH) gene on 14q32. Moreover, fusion signals of IGH and C-MYC probes were detected on the derivative 6 and derivative 14 chromosomes. Southern blot analysis using a C-MYC exon II fragment failed to detect rearrangement, suggesting that the 8q24 breakpoints lay far up- or downstream of the C-MYC gene. WILL1 is a useful tool to analyze the pathogenesis of CD5 and CD10 double-positive diffuse large B-cell lymphoma, and for molecular cloning of the unique translocation breakpoints of 14q32 and 8q24 and a novel gene on 6q27.
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43
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Dong HY, Browne P, Liu Z, Gangi M. PAX-5 is invariably expressed in B-cell lymphomas without plasma cell differentiation. Histopathology 2008; 53:278-87. [DOI: 10.1111/j.1365-2559.2008.03091.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Aggressive CD5-positive B-cell lymphoma after remission of CD5-negative follicular lymphoma with distinct immunoglobulin heavy chain rearrangement and translocation. Int J Hematol 2008; 88:299-303. [PMID: 18758895 DOI: 10.1007/s12185-008-0160-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Revised: 08/04/2008] [Accepted: 08/04/2008] [Indexed: 10/21/2022]
Abstract
We report a unique, aggressive B-cell lymphoma that developed after the long-term remission of follicular lymphoma (FL). FL cells were negative for CD5, whereas aggressive lymphoma cells were positive for CD5. In FL, one immunoglobulin heavy chain gene (IGH) allele underwent V/D/J recombination and another t(14;18)(q32;q21). In aggressive lymphoma, one IGH allele underwent D/J recombination and another translocation, but not t(14;18)(q32;q21). An aggressive lymphoma-specific D/J sequence was detected in FL tissue. Our results indicated that the two tumors arose from distinct B cells and that they existed concurrently in the same lymph node.
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Sriganeshan V, Blom TR, Weissmann DJ. A unique case of mantle cell lymphoma with an aberrant CD5-/CD10+ immunophenotype and typical morphology. Arch Pathol Lab Med 2008; 132:1346-9. [PMID: 18684040 DOI: 10.5858/2008-132-1346-aucomc] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2008] [Indexed: 11/06/2022]
Abstract
Mantle cell lymphoma (MCL) is a non-Hodgkin lymphoma with a poor prognosis that may be confused with less aggressive diseases, such as small lymphocytic lymphoma and follicular lymphoma. In many cases immunophenotyping, particularly analysis of reactivity for CD5 and CD10, is an important adjunct to morphology that usually distinguishes MCL from follicular lymphoma; the former is CD5(+)/CD10(-), whereas follicular lymphoma is the reverse. We report a case of MCL, initially diagnosed as follicular lymphoma, that at presentation expressed neither CD5 nor CD10. At relapse, it was still CD5(-), but CD10 was now detected. Studies for a t(11;14) translocation and CYCLIN D1 protein expression, however, permitted a revised diagnosis of MCL. An MCL with this immunophenotype and classical morphology has not been previously reported.
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Affiliation(s)
- Vathany Sriganeshan
- Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL 33140, USA.
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Lin P, Jetly R, Lennon PA, Abruzzo LV, Prajapati S, Medeiros LJ. Translocation (18;22)(q21;q11) in B-cell lymphomas: a report of 4 cases and review of the literature. Hum Pathol 2008; 39:1664-72. [PMID: 18656237 DOI: 10.1016/j.humpath.2008.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 04/15/2008] [Accepted: 04/16/2008] [Indexed: 11/18/2022]
Abstract
Follicular lymphomas characteristically carry t(14;18)(q32;q21) which results in IGH-BCL-2 fusion. Variant translocations that juxtapose the BCL-2 gene with the immunoglobulin kappa (2p11) and lambda (22q11) light chain genes are rare. We report 4 cases of B-cell lymphoma/leukemia associated with t(18;22)(q21;q11). The t(18;22)(q21;q11) was the sole aberration identified by conventional cytogenetics in 2 cases. Three cases were classified as chronic lymphocytic leukemia, and one as follicular lymphoma based on morphology and immunophenotype. Fluorescence in situ hybridization analysis was performed on all 4 cases using a BCL-2 breakapart probe. The BCL-2 gene was rearranged in all cases. Immunoglobulin lambda light chain gene rearrangement was shown in 3 cases using bacterial artificial chromosome probes spanning the variable and constant clusters of the IGlambda gene. Each case was negative for MALT-1 rearrangement using a MALT-1 breakapart probe. These cases illustrate that t(18;22)(q21;q11) is more commonly observed in chronic lymphocytic leukemia and may represent either an initial or secondary genetic event.
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MESH Headings
- Aged
- Chromosomes, Human, Pair 18
- Chromosomes, Human, Pair 22
- Fatal Outcome
- Female
- Gene Rearrangement, B-Lymphocyte
- Genes, bcl-2
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/genetics
- Male
- Middle Aged
- Translocation, Genetic
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Affiliation(s)
- Pei Lin
- Department of Hematopathology, The University of Texas, M D Anderson Cancer Center, Houston, TX 77030, USA.
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Zanetto U, Dong H, Huang Y, Zhang K, Narbaitz M, Sapia S, Kostopoulos I, Liu H, Du MQ, Bacon CM. Mantle cell lymphoma with aberrant expression of CD10. Histopathology 2008; 53:20-9. [DOI: 10.1111/j.1365-2559.2008.03060.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Higgins RA, Blankenship JE, Kinney MC. Application of Immunohistochemistry in the Diagnosis of Non-Hodgkin and Hodgkin Lymphoma. Arch Pathol Lab Med 2008; 132:441-61. [DOI: 10.5858/2008-132-441-aoiitd] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2007] [Indexed: 11/06/2022]
Abstract
AbstractContext.—Beginning with the immunologic classifications of Lukes and Collins and Kiel and culminating in the Revised European-American Lymphoma and World Health Organization classifications, the diagnosis of lymphoid tumors relies heavily on the determination of cell lineage, maturation, and function, based on antigen expression in addition to morphology and clinical features. Technologic advances in immunology, antibody production, genetic analysis, cloning, and the identification of new genes and proteins by microarray and proteomics have provided pathologists with many antibodies to use in routine diagnosis.Objective.—To provide guidance to the practicing pathologist in the appropriate selection of an antibody panel for the diagnosis of lymphoma based on morphology and relevant clinical data and to avoid pitfalls in the interpretation of immunohistochemical data. Attention is given to some of the newer antibodies, particularly against transcription factors, that are diagnostically and prognostically useful.Data Sources.—The information presented in this article is based on review of the literature using the OVID database (Ovid MEDLINE 1950 to present with daily update) and 20 years of experience in diagnostic hematopathology.Conclusions.—Immunophenotyping is required for the diagnosis and classification of lymphoid malignancies. Many paraffin-reactive antibodies are available to the pathologist but most are not specific. To avoid diagnostic pitfalls, interpretation of marker studies must be based on a panel and knowledge of a particular antigen's expression in normal, reactive, and neoplastic conditions.
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Affiliation(s)
- Russell A. Higgins
- From the Department of Pathology, The University of Texas Health Science Center at San Antonio
| | - Jennifer E. Blankenship
- From the Department of Pathology, The University of Texas Health Science Center at San Antonio
| | - Marsha C. Kinney
- From the Department of Pathology, The University of Texas Health Science Center at San Antonio
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Abstract
Flow cytometric immunophenotyping remains an indispensable tool for the diagnosis, classification, staging, and monitoring of hematologic neoplasms. The last 10 years have seen advances in flow cytometry instrumentation and availability of an expanded range of antibodies and fluorochromes that have improved our ability to identify different normal cell populations and recognize phenotypic aberrancies, even when present in a small proportion of the cells analyzed. Phenotypically abnormal populations have been documented in many hematologic neoplasms, including lymphoma, chronic lymphoid leukemias, plasma cell neoplasms, acute leukemia, paroxysmal nocturnal hemoglobinuria, mast cell disease, myelodysplastic syndromes, and myeloproliferative disorders. The past decade has also seen refinement of the criteria used to identify distinct disease entities with widespread adoption of the 2001 World Health Organization (WHO) classification. This classification endorses a multiparametric approach to diagnosis and outlines the morphologic, immunophenotypic, and genotypic features characteristic of each disease entity. When should flow cytometric immunophenotyping be applied? The recent Bethesda International Consensus Conference on flow cytometric immunophenotypic analysis of hematolymphoid neoplasms made recommendations on the medical indications for flow cytometric testing. This review discusses how flow cytometric testing is currently applied in these clinical situations and how the information obtained can be used to direct other testing.
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The critical role of histology in an era of genomics and proteomics: a commentary and reflection. Adv Anat Pathol 2007; 14:375-400. [PMID: 18049128 DOI: 10.1097/pap.0b013e318159479d] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The role of histologic examination in lymphoma diagnosis has been called into question by proponents of new technologies, such as genomics and proteomics. We review the history and salient features of morphologic evaluation in lymphoid diseases, and discuss the general and specific limitations of mature ancillary techniques, such as immunohistochemistry, flow cytometry, and molecular studies. We then speculate on the future relationship between morphology and the new genomic and proteomic technologies as they become integrated into clinical practice.
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