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Uczkowski D, Ashraf H, Cherry M, Dimov N. Gray zone lymphoma: A case report and comprehensive review of literature. Leuk Res Rep 2023; 19:100372. [PMID: 37287497 PMCID: PMC10242558 DOI: 10.1016/j.lrr.2023.100372] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 05/25/2023] [Indexed: 06/09/2023] Open
Abstract
Gray zone lymphoma is a very rare liquid malignancy that possesses intersecting features between primary mediastinal B-cell lymphoma and classic Hodgkin Lymphoma. In the case presented and accompanying literature review, we will discuss a patient with a chief complaint of shortness of breath and was found to have a mediastinal mass with biopsy consistent with mediastinal gray zone lymphoma. Herein, we explore the historical and recently updated diagnostic criteria of gray zone lymphoma from 2022 as well as the pathophysiology as it pertains to gene expression, while also reviewing the histological findings, epidemiology and treatment modalities.
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Affiliation(s)
- Dariusz Uczkowski
- Overlook Medical Center, 99 Beauvoir Ave, Summit, 07901, New Jersey, United States of America
| | - Hamza Ashraf
- Overlook Medical Center, 99 Beauvoir Ave, Summit, 07901, New Jersey, United States of America
| | - Mohamad Cherry
- Morristown Medical Center, 435 South St, Morristown, 07960, New Jersey, United States of America
| | - Nikolay Dimov
- Morristown Medical Center, 435 South St, Morristown, 07960, New Jersey, United States of America
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2
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Alhamss M, El Fakih R. Thinking Outside the Box in Mediastinal Lymphoma Management. Clin Hematol Int 2023:10.1007/s44228-023-00045-7. [PMID: 37195392 DOI: 10.1007/s44228-023-00045-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/29/2023] [Indexed: 05/18/2023] Open
Affiliation(s)
- Marwa Alhamss
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Riad El Fakih
- Section of Adult Hematology/HSCT, Oncology Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11471, Saudi Arabia.
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3
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Bosch-Schips J, Granai M, Quintanilla-Martinez L, Fend F. The Grey Zones of Classic Hodgkin Lymphoma. Cancers (Basel) 2022; 14:cancers14030742. [PMID: 35159009 PMCID: PMC8833496 DOI: 10.3390/cancers14030742] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 01/08/2023] Open
Abstract
Simple Summary Classic Hodgkin lymphoma (CHL) is a well-defined lymphoid neoplasm with a minority of characteristic neoplastic cells of B cell origin, namely Hodgkin and Reed–Sternberg cells immersed in a rich reactive inflammatory infiltrate in the background. Although CHL has always been set apart from non-Hodgkin lymphomas, cases with morphological and phenotypic features intermediate between CHL and other lymphomas have been described. Whereas some of these lymphomas only represent morphological mimics, others exhibit mutational and gene expression profiles which overlap with CHL, indicating that these cases, frequently termed grey zone lymphomas, reside on the biological boundary between CHL and large B-cell lymphomas. In the present review, we aim to describe the current knowledge of these rare lymphomas, address diagnostic issues and summarize today’s concepts on the classification of grey zone lymphomas and related tumors. Abstract Classic Hodgkin lymphoma (CHL) is a well-defined neoplasm characterized by the presence of a minority of pathognomonic Hodgkin and Reed–Sternberg (HRS) cells in a reactive inflammatory background. Although genotypically of B cell origin, HRS cells exhibit a downregulated B cell program and therefore are set apart from other B cell lymphomas in the current WHO classification. However, cases with morphological and phenotypic features overlapping with CHL have been recognized, and the category of B cell lymphoma—unclassifiable—with features intermediate between diffuse large B cell lymphoma (DLBCL) and CHL, also termed grey zone lymphoma, was first introduced into the WHO classification in 2008 as provisional entity. These cases, as well as others raising a differential diagnosis of CHL can present diagnostic problems, as well as therapeutic challenges. Whereas some of these lymphomas only represent biologically unrelated morphological mimics, others, especially mediastinal grey zone lymphoma, exhibit genetic and gene expression profiles which overlap with CHL, indicating a true biological relationship. In this review, we address areas of diagnostic difficulties between CHL and other lymphoma subtypes, discuss the biological basis of true grey zone lymphoma based on recent molecular studies and delineate current concepts for the classification of these rare tumors.
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Affiliation(s)
- Jan Bosch-Schips
- Institute of Pathology and Neuropathology, Tübingen University Hospital and Comprehensive Cancer Center Tübingen-Stuttgart, 72076 Tübingen, Germany; (J.B.-S.); (M.G.); (L.Q.-M.)
- Department of Pathology, Hospital Universitari de Bellvitge—Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Massimo Granai
- Institute of Pathology and Neuropathology, Tübingen University Hospital and Comprehensive Cancer Center Tübingen-Stuttgart, 72076 Tübingen, Germany; (J.B.-S.); (M.G.); (L.Q.-M.)
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Tübingen University Hospital and Comprehensive Cancer Center Tübingen-Stuttgart, 72076 Tübingen, Germany; (J.B.-S.); (M.G.); (L.Q.-M.)
| | - Falko Fend
- Institute of Pathology and Neuropathology, Tübingen University Hospital and Comprehensive Cancer Center Tübingen-Stuttgart, 72076 Tübingen, Germany; (J.B.-S.); (M.G.); (L.Q.-M.)
- Correspondence: ; Tel.: +49-7071-2982266
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Maracaja DLV, Puthenpura V, Pels SG, O'Malley DP, Sklar JL, Finberg KE, Xu ML. EBV-Positive Primary Large B-Cell Lymphoma: The Role of Immunohistochemistry and XPO1 in the Diagnosis of Mediastinal Lymphomas. Appl Immunohistochem Mol Morphol 2021; 28:725-730. [PMID: 31789821 DOI: 10.1097/pai.0000000000000820] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Primary mediastinal (thymic) large B-cell lymphoma (PMBL) is described as almost always negative for Epstein-Barr virus (EBV). In the context of a mediastinal lymphoma, the distinction between PMBL, classical Hodgkin lymphoma, diffuse large B-cell lymphoma, and mediastinal gray-zone lymphoma can be very difficult; hence, EBV positivity often argues against PMBL. We present a 19-year-old man with mediastinal mass morphologically consistent with PMBL. The tumor expressed classic immunophenotype, including positivity for CD20, CD19, MAL, OCT2, BOB1, BCL6, CD79a, and subset positivity for CD30. However, the tumor was EBV-positive by in situ hybridization. Next-generation sequencing detected somatic mutations in XPO1 (E571K), SMARCB1 (L356fs), and MYCC (T73A). Although the immunophenotype and XPO1 mutation are characteristic of PMBL, EBV expression is uncommon. Since EBV positivity can occur in rare PMBLs, it should not be the deciding factor in the diagnosis. This is the first EBV-positive PMBL in which mutational profiling has been reported. Aside from providing diagnostic support, the finding of the XPO1 E571K mutation may suggest a targeted therapeutic option.
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MESH Headings
- Adult
- Biomarkers, Tumor/metabolism
- Diagnosis, Differential
- Epstein-Barr Virus Infections/diagnosis
- Epstein-Barr Virus Infections/genetics
- Epstein-Barr Virus Infections/pathology
- Herpesvirus 4, Human/physiology
- High-Throughput Nucleotide Sequencing
- Humans
- Immunohistochemistry
- Immunophenotyping
- Karyopherins/genetics
- Karyopherins/immunology
- Karyopherins/metabolism
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Mediastinal Neoplasms/diagnosis
- Mutation/genetics
- Receptors, Cytoplasmic and Nuclear/genetics
- Receptors, Cytoplasmic and Nuclear/immunology
- Receptors, Cytoplasmic and Nuclear/metabolism
- Thymus Neoplasms/diagnosis
- Thymus Neoplasms/genetics
- Thymus Neoplasms/pathology
- Young Adult
- Exportin 1 Protein
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Affiliation(s)
| | - Vidya Puthenpura
- Section of Pediatric Hematology/Oncology, Department of Pediatrics, Yale School of Medicine, New Haven, CT
| | - Salley G Pels
- Section of Pediatric Hematology/Oncology, Department of Pediatrics, Yale School of Medicine, New Haven, CT
| | | | | | | | - Mina L Xu
- Departments of Pathology and Laboratory Medicine
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5
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Onaindia A, Santiago-Quispe N, Iglesias-Martinez E, Romero-Abrio C. Molecular Update and Evolving Classification of Large B-Cell Lymphoma. Cancers (Basel) 2021; 13:cancers13133352. [PMID: 34283060 PMCID: PMC8269067 DOI: 10.3390/cancers13133352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/21/2021] [Accepted: 06/25/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary The development of high-throughput technologies in recent years has increased our understanding of the molecular complexity of lymphomas, providing new insights into the pathogenesis of large B-cell neoplasms and identifying different molecular biomarkers with prognostic impact, that lead to the revision of the World Health Organization consensus classification of lymphomas. This review addresses the main histopathological and molecular features of large B-cells lymphomas, providing an overview of the main recent novelties introduced by the last update of the consensus classification. Abstract Diffuse large B-cell lymphomas (DLBCLs) are aggressive B-cell neoplasms with considerable clinical, biologic, and pathologic diversity. The application of high throughput technologies to the study of lymphomas has yielded abundant molecular data leading to the identification of distinct molecular identities and novel pathogenetic pathways. In light of this new information, newly refined diagnostic criteria have been established in the fourth edition of the World Health Organization (WHO) consensus classification of lymphomas, which was revised in 2016. This article reviews the histopathological and molecular features of the various aggressive B-cell lymphoma subtypes included in the updated classification.
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Affiliation(s)
- Arantza Onaindia
- Bioaraba Health Research Institute, Oncohaematology Research Group, 01070 Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, 01070 Vitoria-Gasteiz, Spain; (N.S.-Q.); (E.I.-M.); (C.R.-A.)
- Correspondence: ; Tel.: +34-699-639-645
| | - Nancy Santiago-Quispe
- Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, 01070 Vitoria-Gasteiz, Spain; (N.S.-Q.); (E.I.-M.); (C.R.-A.)
| | - Erika Iglesias-Martinez
- Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, 01070 Vitoria-Gasteiz, Spain; (N.S.-Q.); (E.I.-M.); (C.R.-A.)
| | - Cristina Romero-Abrio
- Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, 01070 Vitoria-Gasteiz, Spain; (N.S.-Q.); (E.I.-M.); (C.R.-A.)
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6
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Affiliation(s)
- Caoimhe Egan
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda, MD, USA
| | - Stefania Pittaluga
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda, MD, USA
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7
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Innao V, Allegra A, Bacci F, Allegra AG, Vaddinelli D, Musolino C. A rare spinal localization of gray zone lymphoma without mediastinal involvement: a case report and review of literature. Gazz Med Ital - Arch Sci Med 2019. [DOI: 10.23736/s0393-3660.18.03795-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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8
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Sarkozy C, Molina T, Ghesquières H, Michallet AS, Dupuis J, Damotte D, Morsschauser F, Parrens M, Martin L, Dartigues P, Stamatoullas A, Hirsch P, Fabiani B, Bouabdallah K, da Silva MG, Maerevoet M, Laurent C, Coiffier B, Salles G, Traverse-Glehen A. Mediastinal gray zone lymphoma: clinico-pathological characteristics and outcomes of 99 patients from the Lymphoma Study Association. Haematologica 2016; 102:150-159. [PMID: 27758822 DOI: 10.3324/haematol.2016.152256] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 09/30/2016] [Indexed: 01/02/2023] Open
Abstract
Mediastinal gray zone lymphoma, B-cell lymphomas with intermediate features between classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma, have not been well described in the literature. We report the clinical characteristics and outcomes of a large retrospective series of 99 cases centrally reviewed by a panel of hematopathologists, with a consensus established for the diagnosis. Cases were defined as classical Hodgkin lymphoma-like morphology (64.6%) with primary mediastinal B-cell lymphoma immunophenotype, primary mediastinal B-cell lymphoma-like morphology (30.3%) with classical Hodgkin lymphoma or composite (5.1%) (synchronous occurrence of classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma). The median age was 32 years (13-83 years); 55% were women. Thirteen of 81 evaluable cases (16%) were Epstein-Barr virus-positive. Twenty-eight percent of patients presented primary refractory disease (progression under first-line treatment or relapse within one year). The 3-year event-free and overall survival rates were 63% and 80%, respectively. Patients treated with a standard regimen (RCHOP/ABVD) had worse event-free survival (P=0.003) and overall survival (P=0.02) than those treated with a dose-intensive chemotherapy (high-dose RCHOP/escalated BEACOPP). Rituximab added to chemotherapy was not associated with better event-free survival (P=0.55) or overall survival (P=0.88). Radiotherapy for patients in complete remission had no impact on event-free survival. In multivariate prognostic analysis, ECOG-PS and anemia were the strongest factors associated with a shorter event-free survival and overall survival, respectively. In conclusion, this report describes the largest series of mediastinal gray zone lymphoma. Our data suggest that a dose-intensive treatment might improve the outcome of this rare and aggressive disease.
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Affiliation(s)
- Clémentine Sarkozy
- Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Department of Hematology, Pierre Bénite cedex, France .,INSERM1052, CNRS 5286, Université Claude Bernard, Faculté de Médecine Lyon-Sud Charles Mérieux Lyon-1, Pierre Bénite cedex, France
| | - Thierry Molina
- Department of Pathology, Hôpital Universitaire Necker Enfants Malades, AP-HP, Université Paris Descartes, Paris, France
| | - Hervé Ghesquières
- Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Department of Hematology, Pierre Bénite cedex, France.,INSERM1052, CNRS 5286, Université Claude Bernard, Faculté de Médecine Lyon-Sud Charles Mérieux Lyon-1, Pierre Bénite cedex, France
| | | | - Jehan Dupuis
- Department of Lymphoid Malignancies, Henri Mondor University Hospital, Créteil, France
| | - Diane Damotte
- Department of Pathology, Hôpitaux Universitaire Paris Centre, Inserm U1138, Cordelier Research Center, Paris, France
| | - Franck Morsschauser
- Department of Hematology, Centre Hospitalier Régional Universitaire de Lilles, France
| | - Marie Parrens
- Department of Pathology, INSERM U1053, CHU de Bordeaux, France
| | | | - Peggy Dartigues
- Department of Pathology, Institut Gustave Roussy, Villejuif, France
| | | | - Pierre Hirsch
- AP-HP, Hôpital Saint Antoine, Hematology Department, 75012, Paris, France.,Sorbonne Universités, UPMC Université Paris 06, UMR_S 938, CDR Saint-Antoine, France
| | - Bettina Fabiani
- Department of Pathology, Hôpital Saint Antoine, AP-HP, Paris, France
| | - Krimo Bouabdallah
- Department of Hematology and Cellular Therapy, CHU Hau-Lévèque, Bordeaux, France
| | | | | | | | - Bertrand Coiffier
- Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Department of Hematology, Pierre Bénite cedex, France.,INSERM1052, CNRS 5286, Université Claude Bernard, Faculté de Médecine Lyon-Sud Charles Mérieux Lyon-1, Pierre Bénite cedex, France
| | - Gilles Salles
- Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Department of Hematology, Pierre Bénite cedex, France.,INSERM1052, CNRS 5286, Université Claude Bernard, Faculté de Médecine Lyon-Sud Charles Mérieux Lyon-1, Pierre Bénite cedex, France
| | - Alexandra Traverse-Glehen
- INSERM1052, CNRS 5286, Université Claude Bernard, Faculté de Médecine Lyon-Sud Charles Mérieux Lyon-1, Pierre Bénite cedex, France.,Hospices Civiles de Lyon, Centre Hospitalier Lyon-Sud, Pathology Department, 69495 Pierre Bénite cedex, France
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9
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Chihara D, Westin JR, Miranda RN, Cheah CY, Oki Y, Turturro F, Romaguera JE, Neelapu SS, Nastoupil LJ, Fayad LE, Rodriguez MA, Fowler NH, Orlowski RZ, Wang M, Hagemeister FB, Medeiros LJ, Fanale MA. Dose adjusted-EPOCH-R and mediastinal disease may improve outcomes for patients with gray-zone lymphoma. Br J Haematol 2016; 179:503-506. [PMID: 27378601 DOI: 10.1111/bjh.14226] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Dai Chihara
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jason R Westin
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chan Y Cheah
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yasuhiro Oki
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Francesco Turturro
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jorge E Romaguera
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sattva S Neelapu
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorreta J Nastoupil
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Luis E Fayad
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Alma Rodriguez
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nathan H Fowler
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robert Z Orlowski
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Wang
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fredrick B Hagemeister
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michelle A Fanale
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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10
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Zhu JF, Gao GY, Zeng WQ, Li Q, Wu ZD, Xu W, Li JY. [Mediastinal gray zone lymphoma: a case report and literature review]. Zhonghua Xue Ye Xue Za Zhi 2016; 37:532-4. [PMID: 27431084 DOI: 10.3760/cma.j.issn.0253-2727.2016.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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11
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Verma A, Shet T, Epari S, Gupta M, Gujral S, Khanna N, Laskar S, Sengar M, Arora B, Menon H, Banavali S. Mediastinal Gray Zone Lymphoma. Int J Surg Pathol 2016; 24:382-93. [DOI: 10.1177/1066896916635816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Aim. To identify aggressively behaving classical Hodgkin lymphoma (CHL) of mediastinum and primary mediastinal B-cell lymphoma (PMBCL) and to classify them as mediastinal gray zone lymphoma(MGZL) and to define a minimum immunopanel for the diagnosis of MGZL. Materials and Methods. Ninety-two mediastinal B-cell lymphomas were reviewed with a wide immunopanel and were classified as CHL, PMBCL, or MGZL. CHL with an expression of 3 or 4 transcription factors performed worse, and hence the CHL with ≥3 transcription factors were classified as MGZL-CHL. In PMBCL, the cases with a weak or negative CD20 and positive CD15 as well as those cases showing cyclin E positivity with a negative or focal LCA and any one of the transcription factors were classified as MGZL-PMBCL. Results. The MGZL cases expanded from 9 to 28 cases after using an extended immunopanel. CHL and PMBCL had a disease-free survival rate of 86.8% and 69.2% and an overall survival rate of 97.4% and 80.8%, respectively. MGZL-CHL and MGZL-PMBCL had a disease-free survival rate of 33% and 40% and an overall survival rate of 66.7% and 60%, respectively. Conclusion. Thus, the MGZL may be a wider category than we think and hence the use of a wide immunopanel is recommended to identify the aggressively behaving mediastinal B-cell lymphomas.
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Affiliation(s)
- Anuj Verma
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - Tanuja Shet
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - Sridhar Epari
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - Manjudevi Gupta
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - Sumeet Gujral
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - Nehal Khanna
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India
| | - Siddhartha Laskar
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India
| | - Manju Sengar
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Brijesh Arora
- Department of Pediatric Oncology, Tata Memorial Hospital, Mumbai, India
| | - Hari Menon
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Shripad Banavali
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
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13
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Bogusz AM, Joyce R, Kolodny G, Buck T, Pihan G, Bhargava P. An unusual patient with shortness of breath--clinical, radiologic, and pathologic pitfalls. Am J Hematol 2014; 89:558-63. [PMID: 24496963 DOI: 10.1002/ajh.23689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 01/29/2014] [Accepted: 01/30/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Agata M. Bogusz
- Department of Pathology and Laboratory Medicine; University of Pennsylvania; Philadelphia Pennsylvania
| | - Robin Joyce
- Department of Medicine; Beth Israel Deaconess Medical Center; Boston Massachusetts
| | - Gerald Kolodny
- Department of Radiology; Beth Israel Deaconess Medical Center; Boston Massachusetts
| | - Thomas Buck
- Department of Pathology; Beth Israel Deaconess Medical Center; Boston Massachusetts
| | - German Pihan
- Department of Pathology; Beth Israel Deaconess Medical Center; Boston Massachusetts
| | - Parul Bhargava
- Department of Pathology; Beth Israel Deaconess Medical Center; Boston Massachusetts
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14
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15
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Campo E. Whole genome profiling and other high throughput technologies in lymphoid neoplasms--current contributions and future hopes. Mod Pathol 2013; 26 Suppl 1:S97-S110. [PMID: 23281439 DOI: 10.1038/modpathol.2012.179] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The development of high throughput technologies based on the knowledge of the human genome has opened the possibility to search for global genomic alterations in tumors responsible for their development and progression that may have important clinical implications. One of the major applications of this genomic knowledge has been the design of different types of microarray platforms for the analysis of DNA alterations and gene expression profiling (GEP). The main contributions of the DNA studies in lymphoid neoplasms include the definition of relatively characteristic genomic profiles for specific disease entities, the demonstration of common chromosomal alterations across entities, the identification of genes and pathways targeted by the altered chromosomal regions, and the identification of chromosomal alterations with prognostic implications. RNA GEP studies in these tumors have enhanced the molecular characterization of known entities and facilitated the recognition of new subtypes and categories of lymphoid neoplasms, the identification of new biomarkers and prognostic models, and the detection of oncogenic pathways with potential implications for targeted therapies. The recent development of the next generation sequencing (NGS) technologies and its application in lymphoid neoplasms already have provided an initial view of the complex landscape of somatic mutations in these tumors and some findings with important functional and clinical implications. This review addresses the major contributions and limitations of the microarray technologies in the understanding of lymphoid neoplasms and discusses how this knowledge may be transferred into the clinics. The initial results of the NGS studies are also presented.
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Affiliation(s)
- Elías Campo
- Haematopathology Section, Department of Anatomic Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
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Abstract
We report a case of CD20+ grey zone lymphoma (GZL) with Reed Sternberg cells as an unexpected pathological diagnosis of a destroyed right lower lobe after necrotizing pneumonia. These GZLs show overlapping features of classical Hodgkin's lymphoma and diffuse large B-cell lymphoma. GZLs are a rare specific entity of lymphomas, and the aetiology is unknown. The diagnosis is confirmed by pathological, immunohistochemical and molecular analyses. The optimal treatment is unknown. The prognosis of these patients is poor.
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Affiliation(s)
- Anouschka Cogen
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem (Antwerp), Belgium
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Hoeller S, Copie-Bergman C. Grey zone lymphomas: lymphomas with intermediate features. Adv Hematol 2012; 2012:460801. [PMID: 22548066 DOI: 10.1155/2012/460801] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 01/10/2012] [Accepted: 01/20/2012] [Indexed: 01/24/2023] Open
Abstract
The current classification of lymphoid neoplasms is based on clinical information, morphology, immunophenotype, and molecular genetic characteristics. Despite technical and scientific progress, some aggressive B-cell lymphomas with features overlapping between two different types of lymphomas remain difficult to classify. The updated 2008 World Health Organization (WHO) classification of Tumours of the Hematopoietic and Lymphoid Tissues has addressed this problem by creation of two new provisional categories of B-cell lymphomas, unclassifiable; one with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma and the second with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. We review here the diagnostic criteria of these two provisional entities and discuss new scientific findings in light of the 2008 WHO classification.
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