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Sarro R, Bisig B, Guey B, Missiaglia E, Cairoli A, Omoumi P, Letovanec I, Ferry JA, Hasserjian RP, de Leval L. Follicular Lymphoma Presenting With Symptomatic Bone Involvement: A Clinicopathologic and Molecular Analysis of 16 Cases. Mod Pathol 2024; 37:100440. [PMID: 38290600 DOI: 10.1016/j.modpat.2024.100440] [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: 11/24/2023] [Revised: 01/14/2024] [Accepted: 01/21/2024] [Indexed: 02/01/2024]
Abstract
Primary bone lymphoma (PBL) is rare and mostly represented by diffuse large B-cell lymphomas (DLBCL). Follicular lymphoma (FL), albeit commonly disseminating to the bone marrow, rarely presents primarily as bone lesions. Here, we studied 16 patients (12 men:4 women, median age 60 years) who presented with bone pain and/or skeletal radiologic abnormalities revealing bone FL. Lesions were multifocal in 11 patients (spine ± appendicular skeleton), and unifocal in 5 patients (femoral, tibial, or vertebral). An infiltrate of centrocytes and centroblasts (CD20+ CD5- CD10+ BCL2+ BCL6+) with abundant reactive T cells and an increased reticulin fibrosis massively replaced the marrow spaces between preserved bone trabeculae. The pattern was diffuse ± nodular, often with paratrabecular reinforcement and/or peripheral paratrabecular extension. Ki-67 was usually <15%. Two cases had necrosis. BCL2 rearrangement was demonstrated in 14 of 14 evaluable cases (with concomitant BCL6 rearrangement in one). High-throughput sequencing revealed BCL2, KMT2D, and TNFRSF14 to be the most frequently mutated genes. After staging, 5 qualified for PBL (3 limited stage) and 11 had stage IV systemic FL. All patients received rituximab ± polychemotherapy as firstline treatment, and 7 received local therapy (6 radiotherapy and 2 surgery). Three patients experienced transformation to DLBCL. At the last follow-up (15/16, median 48 months), 11 patients achieved complete remission, including all cases with PBL and most patients with limited extraosseous disease (3-year progression-free survival 71%). One patient died of unrelated cause (3-year overall survival 91%). FL may manifest as a localized or polyostotic bone disease. A minority represent PBL, whereas most reveal systemic disease.
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Affiliation(s)
- Rossella Sarro
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland; Institute of Pathology Ente Ospedaliero Cantonale (EOC), Locarno, Switzerland
| | - Bettina Bisig
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Baptiste Guey
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Edoardo Missiaglia
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Anne Cairoli
- Service of Haematology, Department of Oncology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Igor Letovanec
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland; Department of Pathology, Central Institute, Valais Hospital, Sion, Switzerland
| | - Judith A Ferry
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Robert P Hasserjian
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Laurence de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland.
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Ivanova VS, Davies J, Menter T, Wild D, Müller A, Krasniqi F, Stenner F, Papachristofilou A, Dirnhofer S, Tzankov A. Primary bone diffuse large B-cell lymphoma (PB-DLBCL): a distinct extranodal lymphoma of germinal centre origin, with a common EZB-like mutational profile and good prognosis. Histopathology 2024; 84:525-538. [PMID: 37965677 DOI: 10.1111/his.15096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/03/2023] [Accepted: 10/28/2023] [Indexed: 11/16/2023]
Abstract
AIMS Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is not recognized as a separate entity by the current classification systems. Here we define and highlight its distinctive clinical presentation, morphology, phenotype, gene expression profile (GEP), and molecular genetics. METHODS We collected 27 respective cases and investigated their phenotype, performed gDNA panel sequencing covering 172 genes, and carried out fluorescence in situ hybridization to evaluate MYC, BCL2, and BCL6 translocations. We attempted to genetically subclassify cases using the Two-step classifier and performed GEP for cell-of-origin subtyping and in silico comparison to uncover up- and downregulated genes as opposed to other DLBCL. RESULTS Most cases (n = 22) were germinal centre B-cell-like (GCB) by immunohistochemistry and all by GEP. Additionally, PB-DLBCL had a mutational profile similar to follicular lymphoma and nodal GCB-DLBCL, with the exception of more frequent TP53 and B2M mutations. The GEP of PB-DLBCL was unique, and the frequency of BCL2 rearrangements was lower compared to nodal GCB-DLBCL. The Two-step classifier categorized eight of the cases as EZB, three as ST2, and one as MCD. CONCLUSION This study comprehensively characterizes PB-DLBCL as a separate entity with distinct clinical and morpho-molecular features. These insights may aid in developing tailored therapeutic strategies and shed light on its pathogenesis.
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Affiliation(s)
- Vanesa-Sindi Ivanova
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - John Davies
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Thomas Menter
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Damian Wild
- Divison of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Anne Müller
- Institute of Molecular Cancer Research, University of Zurich, Zurich, Switzerland
| | - Fatime Krasniqi
- Division of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Frank Stenner
- Division of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | | | - Stefan Dirnhofer
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Alexandar Tzankov
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
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Cao S, Fan B, Sun Q, Chen J, Song X, Yin W. Comparison of the Effect of Chemoradiotherapy and Chemotherapy on the Survival of Patients with Primary Diffuse Large B-Cell Lymphoma of the Spine: A SEER-Based Study. World Neurosurg 2023; 175:e940-e949. [PMID: 37075894 DOI: 10.1016/j.wneu.2023.04.045] [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: 10/12/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE The role of radiotherapy in primary spinal diffuse large B-cell lymphoma (PB-DLBCL) remains controversial. This study explored the effects of chemoradiotherapy and chemotherapy alone on the survival of patients with PB-DLBCL and established an instructive nomogram. METHODS Survival analysis using the Kaplan-Meier method and log-rank test was performed for patients diagnosed with PB-DLBCL from 1983 to 2016, identified in the Surveillance Epidemiology and End Results database. The Cox regression model was used to analyze the effects of each variable on the overall survival (OS) and construct a nomogram for predicting OS in patients. RESULTS Overall, 873 patients with PB-DLBCL were included. The patients were divided into the 1983-2001 (227 [26%]) and 2002-2016 (646 [74%]) groups. The 5-and 10-year OS rates of patients with PB-DLBCL in the 2002-2016 group were 62.8% and 49.9%, respectively. The results of the multivariate Cox regression analysis in the 2002-2016 group showed that age, stage, marriage, and treatment strategy were independent prognostic factors. Kaplan-Meier analysis showed that the OS of patients who underwent chemoradiotherapy from 2002 to 2016 was significantly better than that of patients treated with chemotherapy alone. Further subgroup analysis of patients with different stages of DLBCL and at different ages showed that chemoradiotherapy had a better prognosis than chemotherapy alone in stages I-II and age >60 years, whereas the advantages of chemoradiotherapy were not reflected in stages III-IV and age <60 years. CONCLUSIONS Chemoradiotherapy improves the OS of patients with PB-DLBCL who are aged >60 years or have stage I-II disease. The nomograms established in this study can help clinicians determine prognosis and select treatment strategies.
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Affiliation(s)
- Shuyan Cao
- Department of Orthopedic, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Bingjie Fan
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qifeng Sun
- Department of Orthopedic, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jianxing Chen
- Department of Orthopedic, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xin Song
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wenzhe Yin
- Department of Orthopedic, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
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Tazi I, Benmoussa A, Boufarissi FZ, RajaaTissir, Lahlimi FZ. [Adult non-Hodgkin bone lymphomas]. Bull Cancer 2021; 108:424-434. [PMID: 33722379 DOI: 10.1016/j.bulcan.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 10/21/2022]
Abstract
Two forms of bone lymphomas can be distinguished: the primary bone lymphoma (PBL) and the secondary bone lymphoma (SBL). PBL is a rare disease with a good prognosis. Clinical manifestations and imaging findings are usually non-specific. Patient can present with pain, swelling of affected bone or pathologic fracture. Positron emission tomography-CT scan is a sensitive imaging modality and very useful for staging, restaging, surveillance of recurrence, and monitoring of treatment response of lymphoma. The diagnosis of PBL is often difficult and made after biopsy examination. Most patients have diffuse large B-cell lymphoma. Patients have been treated with radiotherapy, chemotherapy or combination of both. Localized disease, low IPI (International Prognostic Index) and complete remission after initial treatment were associated with a better outcome. Management of late sequelae deserves particular attention. SBL is more common than PBL; this is a disseminated lymphoma with concomitant involvement of the skeleton. We review the clinical, imaging and pathologic features of bone lymphomas; and discuss therapeutic modalities as well as prognosis of these lymphomas in the era of immunochemotherapy.
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Affiliation(s)
- Illias Tazi
- CHU Mohamed VI, université Cadi Ayyad, faculté de médecine, service d'hématologie clinique, Marrakech, Maroc.
| | - Amine Benmoussa
- CHU Mohamed VI, université Cadi Ayyad, faculté de médecine, service d'hématologie clinique, Marrakech, Maroc
| | - Fatima Zahra Boufarissi
- CHU Mohamed VI, université Cadi Ayyad, faculté de médecine, service d'hématologie clinique, Marrakech, Maroc
| | - RajaaTissir
- CHU Mohamed VI, université Cadi Ayyad, faculté de médecine, service d'hématologie clinique, Marrakech, Maroc
| | - Fatima Zahara Lahlimi
- CHU Mohamed VI, université Cadi Ayyad, faculté de médecine, service d'hématologie clinique, Marrakech, Maroc
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Kiessling JW, Whitney E, Cathel A, Khan YR, Mahato D. Primary Cranial Vault Non-Hodgkin's Lymphoma Mimicking Meningioma With Positive Angiography. Cureus 2020; 12:e8856. [PMID: 32754397 PMCID: PMC7386091 DOI: 10.7759/cureus.8856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Primary non-Hodgkin’s lymphoma of the bone remains an uncommon presentation of non-Hodgkin’s lymphoma. Primary lymphoma of the cranial vault is exceptionally rare. Here, we present a 62-year-old immunocompetent male presenting with the rapid growth of a left parietal scalp lesion and new-onset seizure. In addition to his imaging, which showed an extracranial, cranial, and intracranial mass with bony destruction, sagittal sinus involvement, and parenchymal invasion, his diagnostic angiogram demonstrated extensive vascular supply from both the right and left external carotid branches. Intraoperatively, we confirmed a frank invasion of the posterior sagittal sinus. After subtotal resection followed by R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone therapy, the patient continues to be disease-free at the 10-month follow-up. We report here a case of primary cranial vault lymphoma that very closely mimicked meningioma in many ways, with positive angiography and intraoperatively confirmed venous sinus invasion.
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Affiliation(s)
| | - Eric Whitney
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | | | - Yasir R Khan
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
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Xu Y, Li J, Ouyang J, Li J, Xu J, Zhang Q, Yang Y, Zhou M, Wang J, Zhang C, Xu Y, Li P, Zhou R, Chen B. Prognostic relevance of protein expression, clinical factors, and MYD88 mutation in primary bone lymphoma. Oncotarget 2017; 8:65609-65619. [PMID: 29029457 PMCID: PMC5630357 DOI: 10.18632/oncotarget.19936] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 07/25/2017] [Indexed: 12/27/2022] Open
Abstract
Primary bone lymphomas (PBLs) are composed of malignant lymphoid cells presenting in osseous sites, without supra-regional lymph node or extranodal involvement. We systematically characterized the immunophenotype and the myeloid differentiation factor 88 (MYD88)-L265P gene mutation status in PBL. Clinical data from 19 patients with PBL treated at Nanjing Drum Tower Hospital between 2009 and 2015 were analyzed retrospectively. Protein expression patterns were identified immunohistochemically, and MYD88 mutation was assessed using polymerase chain reaction and direct DNA sequencing. Fifteen patients presented with diffuse large B-cell lymphoma. Clinical factors favoring a good prognosis were an age < 60 years and rituximab treatment. B-cell lymphoma 2 expression was detected in 5/15 diffuse large B-cell lymphoma patients, and was associated with a poor prognosis in a univariate model. Janus kinase/signal transducer and activator of transcription 3 (JAK/STAT3) signaling factors were upregulated in PBLs. All eighteen evaluable PBL samples harbored wild-type MYD88. These data thus suggest that age and rituximab treatment are independent prognostic factors determining overall survival, and that activation of JAK/STAT3 signaling may promote the pathogenesis of PBL. Moreover, the absence of MYD88-L265P mutation in PBL indicate there are distinct pathogenetic backgrounds among extranodal lymphomas.
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Affiliation(s)
- Yong Xu
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jian Li
- Department of Hematology Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jian Ouyang
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Juan Li
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jingyan Xu
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Qiguo Zhang
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yonggong Yang
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Min Zhou
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jing Wang
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Cuiling Zhang
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yueyi Xu
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Ping Li
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Rongfu Zhou
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Chen
- Department of Hematology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
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Surgical Outcomes and Prognostic Factors in Patients With Diffuse Large B-cell Lymphoma-associated Metastatic Spinal Cord Compression. Spine (Phila Pa 1976) 2016; 41:E943-E948. [PMID: 26890958 DOI: 10.1097/brs.0000000000001511] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective study. OBJECTIVE The aim of this study was to discuss the factors that may affect surgical outcomes of patient with diffuse large B-cell lymphoma (DLBCL)-associated metastatic spinal cord compression (MSCC). SUMMARY OF BACKGROUND DATA DLBCL in the spine is rare and minimal information has been published in the literature regarding this subject. Although DLBCL is highly sensitive to both chemotherapy and radiotherapy, surgical decompression is recommended in the treatment of DLBCL-associated MSCC. However, the prognostic factors affecting surgical outcomes of patients with DLBCL-associated MSCC remain unknown. METHODS We conducted a retrospective study to investigate the impact of surgical decompression on recovery from neurological deficit caused by DLBCL-associated MSCC. Univariate and multivariate analyses were performed to identify prognostic factors for overall survival of spinal DLBCL. The survival rate was estimated by the Kaplan-Meier method, and differences were analyzed by the log-rank test. Factors with P values of 0.1 or less were subjected to multivariate analysis for survival rate by multivariate Cox proportional hazards analysis. RESULTS A total of 37 patients with spinal DLBCL from 2003 to 2014 were included in the study. International Prognostic Index (IPI) (0-1/2-5), duration of preoperative symptoms (≤2m/>2m), and lactate dehydrogenase (normal/abnormal) were suggested as the potential prognostic factors through univariate analysis. However, as they were submitted to the multivariate Cox regression model, only IPI and duration of preoperative symptoms were found as independent prognostic factors. CONCLUSION Surgical decompression improves recovery from neurological deficit. Patient IPI score plays an important role in decision making for surgical intervention, as it affects the length of survival and functional outcome. Patients with duration of preoperative symptoms no more than 2 months confer a very poor prognosis. LEVEL OF EVIDENCE 4.
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Messina C, Christie D, Zucca E, Gospodarowicz M, Ferreri AJM. Primary and secondary bone lymphomas. Cancer Treat Rev 2015; 41:235-46. [PMID: 25698636 DOI: 10.1016/j.ctrv.2015.02.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 01/20/2015] [Accepted: 02/01/2015] [Indexed: 12/24/2022]
Abstract
Recent studies have contributed to the enhancement of clinical and molecular knowledge on bone lymphomas, a group of rare malignancies with particular characteristics. Nevertheless, several questions remain unanswered and the level of evidence supporting some diagnostic and therapeutic decisions remains low. Currently, three different forms of bone lymphomas can be distinguished: the primary bone lymphoma, consisting of a single bone lesion with or without regional lymphadenopathies; the polyostotic lymphoma, consisting of multifocal disease exclusively involving the skeleton; and the disseminated lymphoma with secondary infiltration of the skeleton. The first two forms exhibit a good prognosis, requiring treatments similar to those commonly used for nodal lymphomas of the same category, but several issues regarding the role of surgery and local control of the disease, the sequence of treatment, radiation volumes and doses, management of pathological fractures and prevention of late sequelae deserve particular attention. Due to its rarity, prospective trials exclusively focused on bone lymphomas appear unrealistic, thus, critical revision of our own experience and analyses of large cumulative series as well as molecular studies on archival cases remain valid alternatives to improve our knowledge on this obscure lymphoproliferative malignancy. The present review is based on the analysis of the largest available database of bone lymphomas established under the sponsorship of the International Extranodal Lymphoma Study Group (IELSG) as well as on the critical revision of related literature. We provide recommendations for diagnosis, staging, treatment, and response assessment of these patients in everyday practice as well as for the management of special conditions like pathological fractures, indolent forms and central nervous system prophylaxis.
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Affiliation(s)
- Carlo Messina
- Unit of Lymphoid Malignancies, Department of Onco-Haematology, San Raffaele Scientific Institute, Milan, Italy
| | - David Christie
- Genesiscare and Bond University, Inland Dr., Tugun, QLD, Australia
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Mary Gospodarowicz
- Department of Radiation Oncology, Princess Margaret Hospital, Ontario Cancer Institute, Toronto, ON, Canada
| | - Andrés J M Ferreri
- Unit of Lymphoid Malignancies, Department of Onco-Haematology, San Raffaele Scientific Institute, Milan, Italy.
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Clinical characteristics and prognostic factors of bone lymphomas: focus on the clinical significance of multifocal bone involvement by primary bone large B-cell lymphomas. BMC Cancer 2014; 14:900. [PMID: 25465716 PMCID: PMC4265495 DOI: 10.1186/1471-2407-14-900] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 11/27/2014] [Indexed: 12/25/2022] Open
Abstract
Background Malignant bone lymphoma can be classified as primary (PBL) or secondary (SBL) bone lymphoma. However, the clinico-pathological characteristics and prognostic factors of PBL versus SBL have not yet been well defined. Whether lymphoma with multifocal bone involvement should be considered as stage IV PBL or SBL still remain controversial throughout the literature. Methods In this study, we retrospectively reviewed 127 patients with bone lymphoma diagnosed from1998 to 2013 at the Moffitt Cancer Center. Patients were classified as PBL (81 cases) and SBL (46 cases) using the 2013 WHO Classification of Bone/Soft Tissue Tumors and PBL patients were further subdivided into: 1) PBL with unifocal bone disease (uPBL, 46 cases), 2) PBL with multifocal bone involvement (mPBL, 35 cases). Patient characteristics, survival, and prognostic factors were analyzed. Results Diffuse large B-cell lymphoma (DLBCL) was the most common histological subtype in all three groups (37/46 of uPBL, 23/35 of mPBL, 23/46 of SBL). B symptoms, lymph node involvement, and bone marrow involvement were found to be more common in mPB-DLBCL and SB-DLBCL groups than in the uPB-DLBCL group. Femur was found to be the most common affected site in uPB-DLBCL patients, while spine was most commonly involved in the other two groups. Survival analysis indicated that uPBL-DLBCL patients had a significantly better progression-free survival (PFS) and overall survival (OS) than those in the other two groups (P < 0.05). We also found by univariate analysis that multifocality, and stage IV were significantly poor prognostic factors for both PFS and OS in PBL patients. Using multivariate analysis, multifocality remained an independent prognostic factor for both PFS and OS (P = 0.0117, RR: 3.789, 95% CI: 1.275-11.256). Conclusion Overall, our results suggest that mPBL is more similar to SBL in characteristics and survival rather than uPBL, and thus should be better classified and treated as SBL. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-900) contains supplementary material, which is available to authorized users.
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Székely E, Hagberg O, Arnljots K, Jerkeman M. Improvement in survival of diffuse large B-cell lymphoma in relation to age, gender, International Prognostic Index and extranodal presentation: a population based Swedish Lymphoma Registry study. Leuk Lymphoma 2014; 55:1838-43. [DOI: 10.3109/10428194.2013.853297] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Messina C, Ferreri AJM, Govi S, Bruno-Ventre M, Gracia Medina EA, Porter D, Radford J, Heo DS, Park HY, Pro B, Jayamohan J, Visco C, Scarfò L, Zucca E, Gospodarowicz M, Christie D. Clinical features, management and prognosis of multifocal primary bone lymphoma: a retrospective study of the international extranodal lymphoma study group (the IELSG 14 study). Br J Haematol 2014; 164:834-40. [DOI: 10.1111/bjh.12714] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 11/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Carlo Messina
- Unit of Lymphoid Malignancies; Department of Onco-Haematology; San Raffaele Scientific Institute; Milan Italy
| | - Andrés J. M. Ferreri
- Unit of Lymphoid Malignancies; Department of Onco-Haematology; San Raffaele Scientific Institute; Milan Italy
| | - Silvia Govi
- Unit of Lymphoid Malignancies; Department of Onco-Haematology; San Raffaele Scientific Institute; Milan Italy
| | - Marta Bruno-Ventre
- Unit of Lymphoid Malignancies; Department of Onco-Haematology; San Raffaele Scientific Institute; Milan Italy
| | - Elías A. Gracia Medina
- Servicio de Oncología Médica; Instituto Nacional de Oncología y Radiobiología; La Habana Cuba
| | | | | | - Dae S. Heo
- Seoul National University Hospital; Seoul Korea
| | | | - Barbara Pro
- Division of Hematology; M.D. Anderson Cancer Centre; Houston TX USA
| | | | - Carlo Visco
- Department of Haematology; San Bortolo Hospital; Vicenza Italy
| | - Lydia Scarfò
- Unit of Lymphoid Malignancies; Department of Onco-Haematology; San Raffaele Scientific Institute; Milan Italy
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - Mary Gospodarowicz
- Department of Radiation Oncology; Princess Margaret Hospital; Ontario Cancer Institute; Toronto ON Canada
| | - David Christie
- Premion and Bond University; Inland Dr.; Tugun QLD Australia
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Rajnai H, Heyning FH, Koens L, Sebestyén A, Andrikovics H, Hogendoorn PCW, Matolcsy A, Szepesi Á. The density of CD8+ T-cell infiltration and expression of BCL2 predicts outcome of primary diffuse large B-cell lymphoma of bone. Virchows Arch 2013; 464:229-39. [DOI: 10.1007/s00428-013-1519-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 10/28/2013] [Accepted: 11/18/2013] [Indexed: 10/26/2022]
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13
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Menter T, Ernst M, Drachneris J, Dirnhofer S, Barghorn A, Went P, Tzankov A. Phenotype profiling of primary testicular diffuse large B-cell lymphomas. Hematol Oncol 2013; 32:72-81. [DOI: 10.1002/hon.2090] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/15/2013] [Accepted: 07/15/2013] [Indexed: 12/13/2022]
Affiliation(s)
- Thomas Menter
- Institute of Pathology; University Hospital Basel; Basel Switzerland
| | - Martina Ernst
- Institute of Pathology; University Hospital Basel; Basel Switzerland
| | - Julius Drachneris
- National Centre of Pathology; Vilnius University Hospital Santariskiu Klinikos; Vilnius Lithuania
| | - Stephan Dirnhofer
- Institute of Pathology; University Hospital Basel; Basel Switzerland
| | | | - Philip Went
- Institute of Pathology; University Hospital Basel; Basel Switzerland
| | - Alexandar Tzankov
- Institute of Pathology; University Hospital Basel; Basel Switzerland
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Tang Y, Yang X, Xiao J, Liu K, Yan W, Song D, Qu J, Ma J, Wan W. Clinical outcomes of treatment for spinal cord compression due to primary non-Hodgkin lymphoma. Spine J 2013; 13:641-50. [PMID: 23337542 DOI: 10.1016/j.spinee.2012.11.054] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 08/01/2012] [Accepted: 11/17/2012] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Primary non-Hodgkin lymphoma of the spine (PNHLS) with spinal cord compression is an extremely rare disease in clinical practice. The optimal treatment options for this disease have been controversial and pose a challenge for the clinicians. PURPOSE To provide some useful insight into the treatments, outcomes, and prognostic factors of PNHLS. STUDY DESIGN Retrospective analysis. PATIENT SAMPLE The authors collected 40 patients' data with primary non-Hodgkin lymphoma at the mobile spine, and these patients presented with spinal cord compression as a first symptom between 1998 and 2010. OUTCOME MEASURES The posttreatment neurologic status, general status, local recurrence, and survival were noted according to the telephone calls, letters, or follow-up visits in the outpatient department. METHODS Multidisciplinary treatments, including surgical intervention, chemotherapy, and radiotherapy, were performed in this series. Follow-ups regarding treatment outcomes, local recurrence, and survival rates were carried out and analyzed. The prognostic factors including age, neurologic status, general status, vertebrae involvement, and treatment outcomes were determined. RESULTS The median age of the patients was 52 years (range, 13-79 years). After treatments, 30 patients (75%) reached a complete remission (CR). The 5-year overall survival (OS) of all patients was 72.9%. Patients who were younger than 60 years, with single vertebra involvement, or had CR after treatment had higher 5-year OS (p<.05). In multivariate analysis, CR after treatment and involvement of a single vertebra were identified as favorable prognostic factors for OS. CONCLUSIONS Patients with PNHLS with neurologic compression had distinct clinical features. Regarding treatment, the authors emphasized the importance of multidisciplinary management and the optimal operating juncture. Patients with excellent response to the treatment and single vertebra involvement had better survival.
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Affiliation(s)
- Yu Tang
- Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, No. 415 Feng Yang Rd, Huang Pu District, Shanghai 200003, China
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Koens L, Heyning FH, Szepesi Á, Matolcsy A, Hogendoorn PCW, Jansen PM. Nuclear factor-κB activation in primary lymphoma of bone. Virchows Arch 2013; 462:349-54. [DOI: 10.1007/s00428-013-1372-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 12/16/2012] [Accepted: 01/08/2013] [Indexed: 01/24/2023]
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Development of multigene expression signature maps at the protein level from digitized immunohistochemistry slides. PLoS One 2012; 7:e33520. [PMID: 22438942 PMCID: PMC3305321 DOI: 10.1371/journal.pone.0033520] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Accepted: 02/15/2012] [Indexed: 12/03/2022] Open
Abstract
Molecular classification of diseases based on multigene expression signatures is increasingly used for diagnosis, prognosis, and prediction of response to therapy. Immunohistochemistry (IHC) is an optimal method for validating expression signatures obtained using high-throughput genomics techniques since IHC allows a pathologist to examine gene expression at the protein level within the context of histologically interpretable tissue sections. Additionally, validated IHC assays may be readily implemented as clinical tests since IHC is performed on routinely processed clinical tissue samples. However, methods have not been available for automated n-gene expression profiling at the protein level using IHC data. We have developed methods to compute expression level maps (signature maps) of multiple genes from IHC data digitized on a commercial whole slide imaging system. Areas of cancer for these expression level maps are defined by a pathologist on adjacent, co-registered H&E slides, allowing assessment of IHC statistics and heterogeneity within the diseased tissue. This novel way of representing multiple IHC assays as signature maps will allow the development of n-gene expression profiling databases in three dimensions throughout virtual whole organ reconstructions.
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Primary lymphoma of the cranial vault: case report and a systematic review of the literature. Acta Neurochir (Wien) 2012; 154:257-65; discussion 265. [PMID: 21842209 DOI: 10.1007/s00701-011-1124-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Accepted: 07/29/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Bone involvement is a common finding in many types of lymphoma. Cranial vault involvement is extremely rare, and the majority of patients are found at staging to have concurrent disease in lymph nodes. Thirty-eight cases of primary lymphoma of the cranial vault have been reported to date. METHODS This article presents a rare case of primary cranial vault lymphoma and conducts a systematic review of the current literature. A total of 36 articles comprising 38 cases were included for analysis. The relevant demographic, clinical, and imaging characteristics, as well as the treatment and outcomes of this unique disease presentation were studied. RESULTS The average patient age was 60 years. There was no significant difference in patient gender. The predominant patient complaint was a subcutaneous scalp mass. Of the patients, 11.7% were immunocompromised. CT scans showed signs of osteolysis in 74% of lesions and hyperostosis in 5%, and the cranial vault was observed as normal in 18% of cases. MRI was performed in 23 cases. There was a wide range of histological subtypes, with a slight predominance of diffuse large B-cell lymphoma. Treatment consisted of surgery alone, surgery followed by radiotherapy, and surgery followed by radiotherapy and chemotherapy. The follow-up periods ranged from 5 months to 6 years, with a median value of 7 months. Sixteen patients were followed up to 12 months; 13 of them were alive at 1 year from diagnosis. CONCLUSION Primary cranial vault lymphoma is an extremely rare finding. It should be considered in the differential diagnosis of scalp masses. Although the analysis of outcome of the reported cases is difficult because of the small number of occurrences of this entity and the variability of follow-up, a combination of surgery, radiotherapy, and chemotherapy seems to offer better outcomes.
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Xie L, Moroi Y, Tsuji G, Liu M, Hayashida S, Takahara M, Fukagawa S, Takeuchi S, Shan B, Nakahara T, Uchi H, Yokomizo T, Furue M. CD10-bearing fibroblast inhibits matrigel invasive potency of interleukin-1α-producing squamous cell carcinoma by diminishing substance P levels in the tumor microenvironment. Cancer Sci 2010; 101:2570-8. [PMID: 20874839 PMCID: PMC11158981 DOI: 10.1111/j.1349-7006.2010.01735.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
CD10 is a neutral endopeptidase, which cleaves various peptide substrates including substance P. CD10 expression has been detected in peritumoral fibroblasts (Fb) within the invasive area of various cancers such as squamous cell carcinoma (SCC). However, the biological significance of CD10-bearing Fb remains largely unknown. We examined dynamic interactions of Fb with tumorigenic A431 SCC cells or non-tumorigenic HaCaT squamous cells. The SCC and HaCaT cells did not synthesize CD10, while Fb constitutively expressed CD10. When co-cultured, SCC markedly upregulated fibroblastic CD10 expression compared with HaCaT, which was mainly attributable to SCC-derived interleukin-1α (IL-1α). Both SCC and Fb autonomously secreted substance P, which eventually enhanced the invasive capacity of SCC in a matrigel invasion assay by upregulating matrix metalloproteinase (MMP)-1 and MMP-2, but not MMP-9. Transfection of siRNA for CD10 successfully knocked down the CD10 expression in Fb (CD10ND-Fb). In the presence of CD10ND-Fb, substance P levels in supernatants as well as MMP production and the invasive potency of SCC were significantly augmented compared with control scramble RNA-transfected Fb. We also transfected CD10 vector to Fb and found that the matrigel invasive ability of SCC cells was downregulated co-cultured with CD10 vector-transfected Fb rather than empty vector-transfected Fb. In conclusion, the CD10-bearing Fb generated by SCC-derived IL-1 inhibited the invasive capacity of SCC by diminishing the microenvironmental concentration of substance P.
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Affiliation(s)
- Lining Xie
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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TASHIRO A, TAKEUCHI S, NAKAHARA T, OBA J, TSUJITA J, FUKUSHI JI, KIRYU H, ODA Y, XIE L, YAN X, TAKAHARA M, MOROI Y, FURUE M. Aberrant expression of CD10 in ground-glass-like multinucleated giant cells of multicentric reticulohistiocytosis. J Dermatol 2010; 37:995-7. [DOI: 10.1111/j.1346-8138.2010.00930.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tzankov A, Zlobec I, Went P, Robl H, Hoeller S, Dirnhofer S. Prognostic immunophenotypic biomarker studies in diffuse large B cell lymphoma with special emphasis on rational determination of cut-off scores. Leuk Lymphoma 2010; 51:199-212. [PMID: 19925052 DOI: 10.3109/10428190903370338] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A number of biomarkers, particularly proteins that contribute to prognosis in diffuse large B cell lymphoma (DLBCL), have been identified. However, translation into accepted standards to predict survival has not yet been accomplished, primarily due to contradictory reports in the literature resulting from, among other factors, arbitrary methodologies used to set cut-off values for determining positivity. Some of these problems might be resolved by application of rational statistical methods for determination of cut-off scores. Herein, we critically address issues on in situ phenotypic prognostic tumor-related biomarkers in DLBCL with a particular and practical emphasis on tools for cut-off level determination, especially receiver operating characteristic curve analysis. Moreover, we candidly illustrate the application of these tools for efficient disease-specific survival prognostication on a tissue microarray collective of 240 primary DLBCL using the common prognostic biomarkers Bcl-2, Bcl-6, CD10, FOXP1, MUM1, and Cyclin E. Comparison of the results relative to disease-specific survival unequivocally showed the superior discriminatory power of the cut-off levels calculated by receiver operating curves and the Youden's index, compared to arbitrary cut-off values from the literature, advocating fundamental application of rational methods for determination of clinically relevant prognostic biomarkers' cut-off scores.
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Zareifar S, Bordbar MR, Karimi M, Karim M, Geramizadeh B, Rasekhi AR. T-cell lymphoblastic lymphoma of the sternum. J Clin Oncol 2010; 28:e51-3. [PMID: 19917834 DOI: 10.1200/jco.2009.23.4898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Soheila Zareifar
- Hematology Research Center, Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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