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Kubacz M, Kusowska A, Winiarska M, Bobrowicz M. In Vitro Diffuse Large B-Cell Lymphoma Cell Line Models as Tools to Investigate Novel Immunotherapeutic Strategies. Cancers (Basel) 2022; 15:cancers15010235. [PMID: 36612228 PMCID: PMC9818372 DOI: 10.3390/cancers15010235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
Despite the high incidence of diffuse large B-cell lymphoma (DLBCL), its management constitutes an ongoing challenge. The most common DLBCL variants include activated B-cell (ABC) and germinal center B-cell-like (GCB) subtypes including DLBCL with MYC and BCL2/BCL6 rearrangements which vary among each other with sensitivity to standard rituximab (RTX)-based chemoimmunotherapy regimens and lead to distinct clinical outcomes. However, as first line therapies lead to resistance/relapse (r/r) in about half of treated patients, there is an unmet clinical need to identify novel therapeutic strategies tailored for these patients. In particular, immunotherapy constitutes an attractive option largely explored in preclinical and clinical studies. Patient-derived cell lines that model primary tumor are indispensable tools that facilitate preclinical research. The current review provides an overview of available DLBCL cell line models and their utility in designing novel immunotherapeutic strategies.
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Affiliation(s)
- Matylda Kubacz
- Department of Immunology, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Aleksandra Kusowska
- Department of Immunology, Medical University of Warsaw, 02-097 Warsaw, Poland
- Doctoral School, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Magdalena Winiarska
- Department of Immunology, Medical University of Warsaw, 02-097 Warsaw, Poland
- Laboratory of Immunology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Małgorzata Bobrowicz
- Department of Immunology, Medical University of Warsaw, 02-097 Warsaw, Poland
- Correspondence:
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Zibara V, Sen F, Scordo M, Falchi L. Successful brentuximab vedotin and nivolumab therapy of multiply refractory diffuse large B-cell lymphoma with Hodgkin features. Leuk Lymphoma 2022; 63:3241-3244. [PMID: 36120859 DOI: 10.1080/10428194.2022.2113528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Victor Zibara
- Department of Medicine, Mount Sinai Morningside West, New York, NY, USA.,Lymphoma, Hematopathology, and Bone Marrow Transplantation Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Filiz Sen
- Lymphoma, Hematopathology, and Bone Marrow Transplantation Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Michael Scordo
- Lymphoma, Hematopathology, and Bone Marrow Transplantation Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Lorenzo Falchi
- Lymphoma, Hematopathology, and Bone Marrow Transplantation Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Abstract
Purpose of Review Cancer remains a major cause of morbidity and mortality in HIV-infected individuals, with aggressive non-Hodgkin’s lymphoma as the most frequent one. However, the introduction of modern antiretroviral therapy (ART) drastically improved treatment options and prognosis in HIV-associated lymphomas. This review summarized the current treatment landscape and future challenges in HIV-positive patients with non-Hodgkin’s and Hodgkin’s lymphoma. Recent Findings Selecting the appropriate therapy for the individual patient, diffuse-large B cell lymphoma, Burkitt’s lymphoma, and Hodgkin’s disease may be curable diseases. In contrast, the prognosis of plasmablastic lymphoma and primary effusion lymphoma remain poor. New treatment approaches, as targeted therapies or CAR T cell therapy, may broaden the therapeutic armamentarium. Summary The continuous application of ART is mandatory for successful treatment. The choice of lymphoma therapy may follow the recommendations for HIV-negative patients, but prospective trials in HIV-lymphoma are needed.
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Cozzolino I, Vitagliano G, Caputo A, Montella M, Franco R, Ciancia G, Selleri C, Zeppa P. CD15, CD30, and PAX5 evaluation in Hodgkin's lymphoma on fine-needle aspiration cytology samples. Diagn Cytopathol 2019; 48:211-216. [PMID: 31825183 DOI: 10.1002/dc.24366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/16/2019] [Accepted: 12/02/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND The phenotypical identification of diagnostic cells is crucial for the diagnosis of Hodgkin's lymphoma (HL) on fine-needle aspiration cytology (FNAC). The aim of this study is to evaluate the immunocytochemical (ICC) expression of CD30, CD15, and PAX5 in Hodgkin's cells (HC) and Reed-Sternberg cells (RSC) on smears and cell-blocks (CB) of HL and to compare the performance of each antibody on smears and CB. METHODS In 21 FNAC cases of histologically confirmed classical HL, ICC identification of HC and RSC was performed using CD15, CD30, and PAX5 on smears and CB, respectively. RESULTS CD30 was positive in 19/21 cases (90.5%; 11/11 smears and 8/10 CB), CD15 was positive in 14/21 cases (66.7%; 5/11 smears and 9/10 CB), and PAX5 was positive in 13/21 cases (61.9%; 9/11 smears and 4/10CB). CONCLUSIONS CD15, CD30, and PAX5 are useful to the FNAC identification of HC and RSC. CD30 is the most sensitive, followed by CD15 and PAX5, which are more effective on CB and smears, respectively.
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Affiliation(s)
- Immacolata Cozzolino
- Department of Physical and Mental Health and Preventive Medicine School of Medicine and Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulio Vitagliano
- Department of Pathology, University of Salerno, University of Napoli "Federico II", Fisciano SA, Italy
| | - Alessandro Caputo
- Department of Medicine and Surgery, University of Salerno, Fisciano SA, Italy
| | - Marco Montella
- Department of Physical and Mental Health and Preventive Medicine School of Medicine and Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Renato Franco
- Department of Physical and Mental Health and Preventive Medicine School of Medicine and Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Ciancia
- Department of Medicine and Surgery, University of Salerno, Fisciano SA, Italy
| | - Carmine Selleri
- Department of Medicine and Surgery, University of Salerno, Fisciano SA, Italy
| | - Pio Zeppa
- Department of Medicine and Surgery, University of Salerno, Fisciano SA, Italy
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Li LR, Wang L, He YZ, Young KH. Current perspectives on the treatment of double hit lymphoma. Expert Rev Hematol 2019; 12:507-514. [PMID: 31117849 DOI: 10.1080/17474086.2019.1623020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Introduction: Double hit lymphoma (DHL) represents a new diagnostic category with genetic, immunohistochemical and clinical characteristics intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Patients with DHL usually experience poor survival after frontline R-CHOP treatment and require alternative therapies. However, the ideal therapeutic options remain undefined. Areas covered: Traditional therapies for the treatment of DHL are discussed, including intensive induction, hematopoietic stem cell transplantation (HSCT), methotrexate CNS-directed prophylaxis, and radiation therapy. The authors further introduce small-molecule inhibitors targeting myc or bcl-2 signaling pathways, chimeric antigen receptor T-cell therapy, programmed death-1 monoclonal antibody and immunomodulatory drugs as novel approaches. Expert opinion: No standard treatment exists for DHL. At present, DA-EPOCH-R exhibits an upfront induction option. Central nervous system prophylaxis with methotrexate is recommended as part of the induction therapy. For those who do not obtain complete remission, HSCT or clinical trials should be considered. Targeted approaches, especially chimeric antigen receptor T-cell therapies and small-molecule inhibitors targeting myc or bcl-2, exhibit the potential of improving outcomes for patients with DHL. High-throughput sequencing is a promising technique both at diagnosis and relapse, in order to predict outcomes and potential novel therapies.
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Affiliation(s)
- Lin-Rong Li
- a Second Clinical Medical College , Southern Medical University , Guangzhou , China
| | - Liang Wang
- b Department of Hematology , Zhujiang Hospital of Southern Medical University , Guangzhou , China
| | - Ying-Zhi He
- b Department of Hematology , Zhujiang Hospital of Southern Medical University , Guangzhou , China
| | - Ken H Young
- c Department of Hematopathology , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
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Meister A, Hentrich M, Wyen C, Hübel K. Malignant lymphoma in the HIV-positive patient. Eur J Haematol 2018; 101:119-126. [PMID: 29663523 DOI: 10.1111/ejh.13082] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2018] [Indexed: 12/27/2022]
Abstract
The introduction of combination antiretroviral therapy (cART) drastically improved performance status, immune function, and life expectancy of HIV-infected individuals. In addition, incidence of opportunistic infections and of AIDS-defining malignancies declined. Nevertheless, aggressive non-Hodgkin's lymphoma still remains the leading cause of AIDS-related deaths. The availability of cART, however, significantly improved the therapeutic options for HIV-positive patients with lymphomas. Diffuse large B-cell lymphoma, Burkitt's lymphoma, or Hodgkin lymphoma has increasingly become curable diseases. In light of these favorable developments in the treatment of HIV and HIV-associated lymphomas, reduction in treatment-associated toxicities and further improvement of outcome of patients with advanced immune suppression are major requirements for future clinical trials. This review summarizes the current treatment landscape and gives an overview on future needs in HIV-positive patients with lymphoma.
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Affiliation(s)
- Anne Meister
- Department of Medicine I, University Hospital of Cologne, Cologne, Germany
| | - Marcus Hentrich
- Department of Medicine III, Red Cross Hospital Munich, Munich, Germany
| | - Christoph Wyen
- Department of Medicine I, University Hospital of Cologne, Cologne, Germany.,Praxis am Ebertplatz, Cologne, Germany
| | - Kai Hübel
- Department of Medicine I, University Hospital of Cologne, Cologne, Germany
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Link BK. Transformation of follicular lymphoma – Why does it happen and can it be prevented? Best Pract Res Clin Haematol 2018; 31:49-56. [DOI: 10.1016/j.beha.2017.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 10/23/2017] [Indexed: 02/02/2023]
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8
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Kunder C, Cascio MJ, Bakke A, Venkataraman G, O'Malley DP, Ohgami RS. Predominance of CD4+ T Cells in T-Cell/Histiocyte-Rich Large B-Cell Lymphoma and Identification of a Subset of Patients With Peripheral B-Cell Lymphopenia. Am J Clin Pathol 2017; 147:596-603. [PMID: 28575178 DOI: 10.1093/ajcp/aqx034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a morphologic variant of large B-cell lymphoma whose flow cytometry findings are not well characterized. METHODS Nineteen cases with flow cytometric immunophenotyping were identified from the case records of four institutions between 2001 and 2016. RESULTS In most cases, neoplastic B cells were not detected by flow cytometry. Overall, cases showed a predominance of CD4+ T cells, which in some cases was marked. Significant coexpression of CD57 was seen on CD4+ T cells where this marker was analyzed, which correlated with PD-1 expression. Two cases also showed a profound systemic B-cell lymphopenia, which was associated in one case with hypogammaglobulinemia. CONCLUSIONS Overall, our work challenges previous findings that cases of THRLBCL are rich in CD8+ T cells and highlights parallels between THRLBCL and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). Also, an association of THRLBCL with systemic B-cell lymphopenia has not been previously reported but may represent an underrecognized manifestation.
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MESH Headings
- Adolescent
- Adult
- Aged
- B-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/immunology
- Diagnosis, Differential
- Female
- Flow Cytometry
- Histiocytes/immunology
- Hodgkin Disease/classification
- Hodgkin Disease/diagnosis
- Hodgkin Disease/genetics
- Hodgkin Disease/immunology
- Hodgkin Disease/pathology
- Humans
- Immunophenotyping
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/classification
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Young Adult
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Abstract
Low-grade B-cell leukemias/lymphomas are a diverse group of indolent lymphoproliferative disorders that are typically characterized by good patient outcomes and long life expectancies. A subset of cases, however, undergo histologic transformation to a higher-grade neoplasm, a transition associated with a more aggressive clinical course and poor survival. Transformation of follicular lymphoma to diffuse large B-cell lymphoma and Richter transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma are best characterized in the literature. This article reviews clinical and pathologic characteristics of these most common forms of transformation, with an emphasis on salient histologic, immunophenotypic, and genetic features.
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Affiliation(s)
- Nathan D Montgomery
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, CB #7525, Chapel Hill, NC 27599-7525, USA
| | - Stephanie P Mathews
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, CB #7525, Chapel Hill, NC 27599-7525, USA.
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Cheng CL, O'Connor S. T cell-rich lymphoid infiltrates with large B cells: a review of key entities and diagnostic approach. J Clin Pathol 2016; 70:187-201. [PMID: 27895166 DOI: 10.1136/jclinpath-2016-204065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/01/2016] [Indexed: 12/18/2022]
Abstract
Accurate diagnostic interpretation of a lymphoid population composed predominantly of small T cells, together with smaller numbers of large B cells, with or without a nodular architecture, is a common problem faced by the histopathologist. The differential diagnosis of this histological pattern is wide, ranging from reactive conditions such as drug reactions and viral infections, through borderline entities such as immunodeficiency-related lymphoproliferative disorders to lymphomas. The latter includes entities where the large B cells are primarily neoplastic (classical and nodular lymphocyte-predominant Hodgkin lymphomas and T cell/histiocyte-rich large B cell lymphoma) as well as T cell lymphomas such as angioimmunoblastic T cell lymphoma where the large B cells represent an epiphenomenon and may or may not be neoplastic. Several rare variants of these conditions, and the fact that treatment can significantly modify appearances, add to the diagnostic difficulty of these pathological entities. Unlike monomorphic lymphoid infiltrates, the histological pattern of T cell-rich proliferation with large B cells requires close evaluation of the inter-relationship between B cells and T cells, follicular dendritic cells and sometimes other inflammatory cells. Epstein-Barr virus plays a key role in several of these scenarios, and interpreting not only its presence but also its distribution within cellular subgroups is essential to accurate diagnosis and the avoidance of some important diagnostic pitfalls. An understanding of normal immunoarchitecture and lymphoid maturational pathways is also fundamental to resolving these cases, as is a knowledge of their common patterns of spread, which facilitates correlation with clinical and radiological findings.
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Affiliation(s)
- Chee Leong Cheng
- Anatomical Pathology Department, Singapore General Hospital, Singapore, Singapore
| | - Simon O'Connor
- Haematological Malignancy Diagnostic Service, Centre for Molecular Pathology, The Royal Marsden Hospital, Sutton, London, UK
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Distinguishing Classical Hodgkin Lymphoma, Gray Zone Lymphoma, and Large B-cell Lymphoma: A Proposed Scoring System. Appl Immunohistochem Mol Morphol 2016; 24:535-40. [DOI: 10.1097/pai.0000000000000236] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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12
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Clinicopathological Analysis of B Cell Lymphomas, Unclassifiable; with Features Intermediate Between Diffuse Large B-Cell Lymphoma and Burkitt Lymphoma in a Tertiary Care Hospital in Southern India. Indian J Hematol Blood Transfus 2016; 32:168-75. [PMID: 27065578 DOI: 10.1007/s12288-015-0558-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 05/25/2015] [Indexed: 10/23/2022] Open
Abstract
B-cell lymphomas, unclassifiable; with features intermediate between large B-cell lymphoma and Burkitt lymphoma (BCLu-DLBCL/BL) is a new entity included in the recent World Health Organization (WHO) classification of Tumours of the Hematopoietic and Lymphoid Tissues (2008) to overcome the problems of difficulty in classifying certain lymphomas having overlapping morphological, immunophenotypical and genetic features. To study the clinicopathological profile of BCLu-DLBCL/BL. Cross-sectional study over 3 year period in the Haematology section of Department of Pathology in a large teaching hospital in Southern India from January 2011 to December 2013. All the cases reported as BCLu-DLBCL/BL were collected and the clinical, morphological and immunohistochemical parameters were analyzed. Descriptive statistics. There were seven cases, four males and three females, of age ranging from 20 to 70 years. Five cases had extranodal involvement. Four cases had Burkitt morphology with strong Bcl2 positivity and absent CD10 expression. One case had the morphology and immunophenotype that of typical BL, along with strong positivity to Bcl2 suggesting a double hit hypothesis. Two cases had morphology and immunophenotype of BL with low Ki 67. Three patients on follow up had adverse outcome. BCLu-DLBCL/BL, a provisional category in WHO 2008 is useful in classifying the cases not meeting the criteria for classical BL or DLBCL. Each of these cases was interesting with different sites of involvement, different morphological features and immunophenotype with most of the patients on follow up ending with a grave prognosis.
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Mandal PK, Baul S, Dolai TK. Primary bone lymphoma with multifocal osteolytic lesions: a rare case report with review of literature. Blood Res 2015; 50:256-60. [PMID: 26770955 PMCID: PMC4705053 DOI: 10.5045/br.2015.50.4.256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 01/28/2015] [Accepted: 11/12/2015] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Shuvraneel Baul
- Department of Hematology, NRS Medical College, Kolkata, India
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14
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Schiefer AI, Kornauth C, Simonitsch-Klupp I, Skrabs C, Masel EK, Streubel B, Vanura K, Walter K, Migschitz B, Stoiber D, Sexl V, Raderer M, Chott A, da Silva MG, Cabecadas J, Müllauer L, Jäger U, Porpaczy E. Impact of Single or Combined Genomic Alterations of TP53, MYC, and BCL2 on Survival of Patients With Diffuse Large B-Cell Lymphomas: A Retrospective Cohort Study. Medicine (Baltimore) 2015; 94:e2388. [PMID: 26717387 PMCID: PMC5291628 DOI: 10.1097/md.0000000000002388] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
MYC and BCL2 translocations as well as TP53 deletion/mutation are known risk factors in diffuse large B-cell lymphoma (DLBCL) but their interplay is not well understood.In this retrospective cohort study, we evaluated the combined prognostic impact of TP53 deletion and mutation status, MYC and BCL2 genomic breaks in tumor samples of 101 DLBCL patients. The cohort included 53 cases with MYC rearrangements (MYC+).TP53 deletions/mutations (TP53+) were found in 32 of 101 lymphomas and were equally distributed between MYC+ and MYC- cases (35.8% vs. 27.1%). TP53+ lymphomas had lower responses to treatment than TP53- (complete remission 34.4% vs. 60.9%; P = 0.01). TP53 alteration was the dominant independent prognostic factor in multivariate analysis (P = 0.01). Overall survival (OS) varied considerably between subgroups with different genomic alterations: Patients with sole MYC translocation, and interestingly, with triple MYC+/BCL2+/TP53+ aberration had favorable outcomes (median OS not reached) similar to patients without genomic alterations (median OS 65 months). In contrast, patients with MYC+/BCL2+/TP53- double-hit lymphomas (DHL) (28 months), MYC+/BCL2-/TP53+ lymphomas (10 months) or sole TP53 mutation/deletion (12 months) had a poor median OS. Our findings demonstrate differences in OS of DLBCL patients depending on absence or presence of single or combined genetic alterations of MYC, BCL2, and TP53. Cooccurrence of TP53 and BCL2 aberrations ameliorated the poor prognostic impact of single TP53+ or BCL2+ in MYC positive patients.This pilot study generates evidence for the complex interplay between the alterations of genetic pathways in DLBCL, which goes beyond the concept of DHL. The variable survival of DLBCL patients dependent on single or combined alterations in the TP53, MYC, and BCL2 genes indicates the need for comprehensive genomic diagnosis.
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Affiliation(s)
- Ana-Iris Schiefer
- From the Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria (A-IS, CK, IS-K, BS, KW, BM, LM); Division of Hematology and Hemostaseology, Department of Internal Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (CS, KV, UJ, EP); Division of Palliative Care, Department of Internal Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (EKM); Institute of Pharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria (DS); Ludwig Boltzmann Institute for Cancer Research, Vienna, Austria (DS); Institute of Pharmacology and Toxicology, Department of Biomedical Sciences, Veterinary University of Vienna, Vienna, Austria (VS); Division of Oncology, Department of Internal Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (MR); Institute of Pathology and Bacteriology, Wilhelminenspital, Vienna, Austria (AC); Portuguese Institute of Oncology, Haematology Unit, Lisbon, Portugal (MGdS); and Portuguese Institute of Anatomical Pathology, Lisbon, Portugal (JC)
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15
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Budiongo AN, Ngiyulu RM, Lebwaze BM, Gini-Ehungu JL, Mafuta EM, Ekulu PM, Kabongo-Mpolesha JM, Aloni MN. Pediatric non-Hodgkin lymphomas: first report from Central Africa. Pediatr Hematol Oncol 2015; 32:239-49. [PMID: 25871614 DOI: 10.3109/08880018.2015.1013231] [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] [Indexed: 02/06/2023]
Abstract
BACKGROUND Information on presentation and outcome of pediatric non-Hodgkin's lymphoma is limited from Africa. The demographic characteristics, distribution of different subtypes were noted and compared with published reports from other parts of the world. METHODS The study was conducted in Kinshasa, the Democratic Republic of Congo between January 2002 and December 2012. RESULTS A total of 63 cases of pediatric non-Hodgkin's lymphoma were retrospectively analyzed. This cohort represents the largest series of pediatric non-Hodgkin's lymphoma presented from sub-Saharan Africa. Median age was 8.7±3.6 years. There were 43 (68.3%) males. A mean of 82 ± 59 days passed from detection of the first sign to referral to oncology unit. Morphology distribution showed that 42 cases (66.7%) had a diagnosis of Burkitt lymphoma, 16 cases (25.4%) had diffuse large B-cell lymphoma and 5 cases (7.9%) had NHL-not otherwise specified. The majority of patients (82.5%) had advanced stage (stage III and IV). Immunohistochemistry findings were available for 32 biopsy samples. All (100%) cases were B-cell non-Hodgkin's lymphoma and immunohistochemistry had identified 18 (56.3%) cases of Burkitt lymphoma. In our cohort, 22 of 32 cases expressed positive bcl-2 and 12 (37.5%) were found to be positive for bcl-6. Thirty-one (96.7%) cases were positive for high Ki-67 antigen expression. Assuming that cases lost to follow-up worsened and died, the mortality would be 98.4%. CONCLUSION In comparison to western data, we observed higher proportion of B-cell non-Hodgkin's lymphoma, Burkitt Lymphoma and patients with bcl-2 expression.
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Affiliation(s)
- Aléine Nzazi Budiongo
- Division of Paediatric Hemato-Oncology and Nephrology, Department of Paediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa , Kinshasa , Democratic Republic of Congo
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Zhang S, Wilson D, Czader M. Pediatric B-cell lymphoma, unclassifiable, with intermediate features between those of diffuse large B-cell lymphoma and Burkitt lymphoma: a report of two cases. Ann Lab Med 2015; 35:254-6. [PMID: 25729731 PMCID: PMC4330179 DOI: 10.3343/alm.2015.35.2.254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 02/15/2014] [Accepted: 11/25/2014] [Indexed: 11/19/2022] Open
Affiliation(s)
- Shanxiang Zhang
- Department of Pathology and Laboratory Medicine, Indiana University, IN, USA
| | | | - Magdalena Czader
- Department of Pathology and Laboratory Medicine, Indiana University, IN, USA
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Treetipsatit J, Metcalf RA, Warnke RA, Natkunam Y. Large B-cell lymphoma with T-cell–rich background and nodules lacking follicular dendritic cell meshworks: description of an insufficiently recognized variant. Hum Pathol 2015; 46:74-83. [DOI: 10.1016/j.humpath.2014.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/01/2014] [Accepted: 09/25/2014] [Indexed: 01/12/2023]
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18
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Zhu J, Wang Y, Gong L, Huang G. Diagnosis of primary pulmonary T- cell/histiocyte-rich large B cell lymphoma with tissue eosinophilia via clinicopathological observation and molecular assay. Diagn Pathol 2014; 9:188. [PMID: 25273521 PMCID: PMC4207321 DOI: 10.1186/s13000-014-0188-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 09/20/2014] [Indexed: 11/10/2022] Open
Abstract
Background Primary pulmonary lymphoma (PPL) is rare and easily misdiagnosed because of the lack of typical clinical features. It most commonly involves elderly patients aged between 60 and 70 years, and pathological diagnosis depends mainly on chest surgery rather than bronchial mucosal biopsy. Via percutaneous needle aspiration biopsy of the lung of a 33-year-old woman, which had distinct tissue eosinophilia, we diagnosed a rare case of rapidly growing large B cell lymphoma. Methods Bronchial mucosal biopsy and computed tomography–guided percutaneous needle aspiration biopsy were performed to determine the nature of the lesion, and we identified its immunophenotype using immunohistochemistry. We used BIOMED-2 gene rearrangement PCR to determine lymphocyte clonality; laser microdissection was used to confirm the clonality of suspicious malignant lymphocytes. Results Morphologically, the lesion was composed of a large number of eosinophilic cells and a few lymphoid cells. Immunohistochemical staining revealed a few CD1α-positive cells, but they were S-100–negative. The small lymphoid cells predominantly expressed CD3; the large lymphoid cells expressed CD20 and some scattered large lymphoid cells expressed Pax5. However, molecular studies confirmed clonal immunoglobulin heavy chain (IGH)-D gene rearrangement in Pax5–positive large B lymphocytes. Conclusions This is the first recorded case of T- cell/histiocyte-rich large B cell lymphoma with tissue eosinophilia of the lung. It highlights the unusual morphological features of PPL that might be mistaken for eosinophilic granuloma or parasitic infection. In addition, IGH and T cell receptor gene rearrangement play important roles in differentiating rare B cell lymphoma from lung space–occupying lesions with abundant eosinophils or T cell infiltration. Virtual Slides The virtual slide(s) for this article can be found here: http://med.motic.com/MoticGallery/Slides/AC5C9A6F-46EC-4C71-A448-1312F6900C65?user=2C69F0D6-A478-4A2B-ABF0-BB36763E8025
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Abstract
Pediatric non-Hodgkin's lymphomas (NHLs) are a heterogeneous group of malignancies with distinct clinical, pathological, immunological and genetic characteristics. More than 90% of pediatric NHLs belong to one of three major histological subtypes: mature B-cell neoplasms, lymphoblastic lymphomas and anaplastic large-cell lymphomas. The recognition that different subtypes require different treatment regimens resulted in therapeutic strategies leading to over 80% of patients being cured. On the other hand, patients with resistant or relapsed disease have a poor prognosis. Prognostic biomarkers have not yet been identified for all pediatric NHLs and, although some are very important for diagnosis and prognosis, others may be of questionable value. Discovery of new biomarkers suitable for clinical application may aid the diagnosis and classification of lymphomas, which should, in turn, lead to better patient stratification. Consequent development of new treatment and follow-up approaches should lead to more efficient and less toxic treatment in children with NHL.
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Affiliation(s)
- Lidija Dokmanovic
- University Children's Hospital, Department of Hematology & Oncology, Faculty of Medicine, University of Belgrade, Dr Subotica 13, 11000 Belgrade, Serbia.
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Abstract
We report a case of a triple-hit lymphoma in a 72-year-old man. This lymphoma was diagnosed using morphology, flow cytometry, immunochemistry, and cytogenetics. Since many triple-hit lymphomas have not been documented in the literature, it is important to bring attention to this entity, as this lymphoma has different prognostic and therapeutic implications than other diffuse large B-cell lymphomas, thus making a correct and early diagnosis important.
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Affiliation(s)
- Naresh Pemmaraju
- Department of Pathology, Baylor University Medical Center at Dallas
| | - Javed Gill
- Department of Pathology, Baylor University Medical Center at Dallas
| | - Saurabh Gupta
- Department of Pathology, Baylor University Medical Center at Dallas
| | - John R Krause
- Department of Pathology, Baylor University Medical Center at Dallas
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Tabata R, Yasumizu R, Tabata C, Kojima M. Double-hit lymphoma demonstrating t(6;14;18)(p25;q32;q21), suggesting two independent dual-hit translocations, MYC/BCL-2 and IRF4/BCL-2. J Clin Exp Hematop 2014; 53:141-50. [PMID: 23995111 DOI: 10.3960/jslrt.53.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Here, we report a rare case of double-hit lymphoma, demonstrating t(6;14;18)(p25;q32;q21), suggesting two independent dual-translocations, c-MYC/BCL-2 and IRF4/BCL-2. The present case had a rare abnormal chromosome, t(6;14;18)(p25;q32;q21), independently, in addition to known dual-hit chromosomal abnormalities, t(14;18)(q32;q21) and t(8;22)(q24;q11.2). Lymph node was characterized by a follicular and diffuse growth pattern with variously sized neoplastic follicles. The intrafollicular area was composed of centrocytes with a few centroblasts and the interfollicular area was occupied by uniformly spread medium- to large-sized lymphocytes. CD23 immunostaining demonstrated a disrupted follicular dendritic cell meshwork. The intrafollicular tumor cells had a germinal center phenotype with the expression of surface IgM, CD10, Bcl-2, Bcl-6, and MUM1/IRF4. However, the interfollicular larger cells showed plasmacytic differentiation with diminished CD20, Bcl-2, Bcl-6, and positive intracytoplasmic IgM, and co-expression of MUM1/IRF4 and CD138 with increased Ki-67-positive cells (> 90%). MUM1/IRF4 has been found to induce c-MYC expression, and in turn, MYC transactivates MUM1/IRF4, creating a positive autoregulatory feedback loop. On the other hand, MUM1/IRF4 functions as a tumor suppressor in c-MYC-induced B-cell leukemia. The present rare case arouses interest in view of the possible "dual" activation of both c-MYC and MUM1/IRF4 through two independent dual-translocations, c-MYC/BCL-2 and IRF4/BCL-2.
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Affiliation(s)
- Rie Tabata
- Department of Internal Medicine, Hyogo Prefectural Tsukaguchi Hospital, Hyogo, Japan.
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22
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Parekh P, Kamble S, Zhao N, Zeng Z, Wen J, Yuan B, Zu Y. Biostable ssDNA aptamers specific for Hodgkin lymphoma. SENSORS (BASEL, SWITZERLAND) 2013; 13:14543-57. [PMID: 24233078 PMCID: PMC3871109 DOI: 10.3390/s131114543] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/17/2013] [Accepted: 10/18/2013] [Indexed: 02/07/2023]
Abstract
As a "chemical antibody", oligonucleotide aptamers can specifically bind to their target molecules. However, clinical potential of aptamers in disease diagnosis is not yet fully explored. Using a tumor cell-based selection protocol, we developed single-stranded DNA aptamers for Hodgkin lymphoma (HL) tumor cells. The aptamers specifically bound to HL cells with a high affinity, reaching maximal cell binding at 10 nM final concentration. Importantly, the aptamers were able to selectively detect HL cells and did not react to other tumor or blood cells in mixed samples, indicating that the aptamers can be used as a specific probe for in vitro analysis of HL cells. Moreover, due to the inherent properties of DNA, the aptamers were stable in human serum, suggesting potential for in vivo detection of HL tumor cells.
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Affiliation(s)
- Parag Parekh
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Sanchit Kamble
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Nianxi Zhao
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Zihua Zeng
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Jianguo Wen
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Bin Yuan
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Youli Zu
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
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23
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Bürgesser MV, Gualco G, Diller A, Natkunam Y, Bacchi CE. Clinicopathological features of aggressive B-cell lymphomas including B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell and Burkitt lymphomas: a study of 44 patients from Argentina. Ann Diagn Pathol 2013; 17:250-5. [DOI: 10.1016/j.anndiagpath.2012.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 11/11/2012] [Accepted: 11/11/2012] [Indexed: 01/06/2023]
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24
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Perry AM, Crockett D, Dave BJ, Althof P, Winkler L, Smith LM, Aoun P, Chan WC, Fu K, Greiner TC, Bierman P, Gregory Bociek R, Vose JM, Armitage JO, Weisenburger DD. B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and burkitt lymphoma: study of 39 cases. Br J Haematol 2013; 162:40-9. [DOI: 10.1111/bjh.12343] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 03/04/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | - David Crockett
- Department of Internal Medicine; University of Nebraska Medical Center; Omaha; NE; USA
| | - Bhavana J. Dave
- Human Genetics Laboratory; Munroe-Meyer Institute; University of Nebraska Medical Center; Omaha; NE; USA
| | - Pamela Althof
- Human Genetics Laboratory; Munroe-Meyer Institute; University of Nebraska Medical Center; Omaha; NE; USA
| | - Lisa Winkler
- Human Genetics Laboratory; Munroe-Meyer Institute; University of Nebraska Medical Center; Omaha; NE; USA
| | - Lynette M. Smith
- Department of Biostatistics; University of Nebraska Medical Center; Omaha; NE; USA
| | - Patricia Aoun
- Department of Pathology; City of Hope National Medical Center; Duarte; CA; USA
| | - Wing C. Chan
- Department of Pathology and Microbiology; University of Nebraska Medical Center; Omaha; NE; USA
| | - Kai Fu
- Department of Pathology and Microbiology; University of Nebraska Medical Center; Omaha; NE; USA
| | - Timothy C. Greiner
- Department of Pathology and Microbiology; University of Nebraska Medical Center; Omaha; NE; USA
| | - Phillip Bierman
- Department of Internal Medicine; University of Nebraska Medical Center; Omaha; NE; USA
| | - Robert Gregory Bociek
- Department of Internal Medicine; University of Nebraska Medical Center; Omaha; NE; USA
| | - Julie M. Vose
- Department of Internal Medicine; University of Nebraska Medical Center; Omaha; NE; USA
| | - James O. Armitage
- Department of Internal Medicine; University of Nebraska Medical Center; Omaha; NE; USA
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25
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Sionov RV. MicroRNAs and Glucocorticoid-Induced Apoptosis in Lymphoid Malignancies. ISRN HEMATOLOGY 2013; 2013:348212. [PMID: 23431463 PMCID: PMC3569899 DOI: 10.1155/2013/348212] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 11/14/2012] [Indexed: 12/20/2022]
Abstract
The initial response of lymphoid malignancies to glucocorticoids (GCs) is a critical parameter predicting successful treatment. Although being known as a strong inducer of apoptosis in lymphoid cells for almost a century, the signaling pathways regulating the susceptibility of the cells to GCs are only partly revealed. There is still a need to develop clinical tests that can predict the outcome of GC therapy. In this paper, I discuss important parameters modulating the pro-apoptotic effects of GCs, with a specific emphasis on the microRNA world comprised of small players with big impacts. The journey through the multifaceted complexity of GC-induced apoptosis brings forth explanations for the differential treatment response and raises potential strategies for overcoming drug resistance.
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Affiliation(s)
- Ronit Vogt Sionov
- The Department of Biochemistry and Molecular Biology, The Institute for Medical Research-Israel-Canada, Hadassah Medical School, The Hebrew University of Jerusalem, Ein-Kerem, 91120 Jerusalem, Israel
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26
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Robledo C, García JL, Hernández JM. Clinical applications of BAC array-CGH to the study of diffuse large B-cell lymphomas. Methods Mol Biol 2013; 973:121-145. [PMID: 23412787 DOI: 10.1007/978-1-62703-281-0_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BAC array-CGH is a powerful method to identify DNA copy number changes (gains, amplifications and deletions) on a genome-wide scale, and to map these changes to genomic sequence. It is based on the analysis of genomic DNA isolated from test and reference cell populations, the differential labelling with fluorescent dyes and the co-hybridization with a genomic array. BAC array-CGH has proven to be a specific, sensitive, and reliable technique, with considerable advantages compared to other methods used for the analysis of DNA copy number changes. The application of genome scanning technologies and the recent advances in bioinformatics tools that enable us to perform a robust and highly sensitive analysis of array-CGH data, useful not only for genome scanning of tumor cells but also in the identification of novel cancer related genes, oncogenes and suppressor genes. Cytogenetic analysis provides essential information for diagnosis and prognosis in patients with hematologic malignancies such as lymphomas. However, the chromosomal interpretation in non-Hodgkin lymphoma (NHL) is sometimes inconclusive. Copy number aberrations identified by BAC array-CGH analyses could be a complementary methodology to chromosomal analysis. In NHL the genomic imbalances might have a prognostic rather than a diagnostic value. In fact, the diagnosis of NHL is based on pathological and molecular cytogenetics data. Furthermore genetic variations and their association with specific types of lymphoma development, and elucidation of the variable genetic pathways leading to lymphoma development, are important directions for future cancer research. Array-CGH, along with FISH and PCR, will be used for routine diagnostic purposes in near future.
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Affiliation(s)
- Cristina Robledo
- Unidad de Diagnóstico Molecular y Celular del Cáncer, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
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27
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Abstract
Aggressive B-cell lymphomas are diverse group of neoplasms that arise at different stages of B-cell development and by various mechanisms of neoplastic transformation. The aggressive B-cell lymphomas include many types, subtypes and variants of diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), mantle cell lymphoma and its blastoid variant, and B lymphoblastic lymphoma. Differences in histology, cytogenetic and molecular abnormalities, as well as the relationship with the tumor microenvironment, help define characteristic signatures for these neoplasms, and in turn dictate potential therapeutic targets. Rather than survey the entire spectrum of aggressive B-cell lymphomas, this report aims to identify and characterize important clinically aggressive subtypes of DLBCL, and explore the relationship of DLBCL to BL and the gray zone between them (B-cell lymphoma unclassifiable with features intermediate between DLBCL and BL).
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28
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Munoz J, Vekaria M, Hanbali A, Janakiraman N. Progression of double-hit lymphoma in the midst of R-hyper CVAD. Am J Hematol 2013; 88:87-8. [PMID: 22488177 DOI: 10.1002/ajh.23206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 03/07/2012] [Accepted: 03/12/2012] [Indexed: 11/11/2022]
Affiliation(s)
- Javier Munoz
- Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
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29
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Mann KP. Molecular Pathology of Malignant Lymphoma. Surg Pathol Clin 2012; 5:879-902. [PMID: 26838507 DOI: 10.1016/j.path.2012.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This review focuses on practical uses of molecular testing in mature B-cell and T-cell lymphomas with a focus on those lymphomas in which molecular testing is common. Clinical findings, histology, and biomarkers, as well as diagnostic and prognostic predictive value and practical applications of molecular testing for mature B- and T-cell lymphomas are presented.
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Affiliation(s)
- Karen P Mann
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Emory University Hospital, Emory University, 1364 Clifton Road, Northeast, Atlanta, GA 30322, USA.
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30
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Gualco G, Natkunam Y, Bacchi CE. The spectrum of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma: a description of 10 cases. Mod Pathol 2012; 25:661-74. [PMID: 22222636 DOI: 10.1038/modpathol.2011.200] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, is a diagnostic provisional category in the World Health Organization (WHO) 2008 classification of lymphomas. This category was designed as a measure to accommodate borderline cases that cannot be reliably classified into a single distinct disease entity after all available morphological, immunophenotypical and molecular studies have been performed. Typically, these cases share features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, or include characteristics of both lymphomas. The rarity of such cases poses a tremendous challenge to both pathologists and oncologists because its differential diagnosis has direct implications for management strategies. In this study, we present 10 cases of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma and have organized the criteria described by the WHO into four patterns along with detailed clinical, morphological and immunophenotypic characterization and outcome data. Our findings show a male preponderance, median age of 37 years and a mediastinal presentation in 80% of cases. All cases expressed at least two markers associated with B-cell lineage and good response to combination chemotherapy currently employed for non-Hodgkin lymphomas.
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31
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Ahn JY, Seo YH, Park PW, Kim KH, Park MJ, Jeong JH, Park SH, Song YH. A case of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma in a Korean child. Ann Lab Med 2012; 32:162-6. [PMID: 22389885 PMCID: PMC3289783 DOI: 10.3343/alm.2012.32.2.162] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 11/04/2011] [Accepted: 12/28/2011] [Indexed: 11/19/2022] Open
Abstract
B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL) (intermediate DLBCL/BL), is a heterogeneous group with some features resembling DLBCL and others resembling BL. Here, we report a case of intermediate DLBCL/BL in a Korean child. A 2-yr-old male was admitted for evaluation and management of left hip pain. Immunohistochemistry of a biopsy of the femur neck revealed tumor cells positive for CD20, CD10, BCL2, BCL6, and Ki67. A bone marrow (BM) aspirate smear revealed that 49.3% of all nucleated cells were abnormal lymphoid cells, composed of large- and medium-sized cells. Immunophenotyping of the neoplastic cells revealed positivity for CD19, CD10, CD20, and sIg lambda and negativity for CD34, Tdt, and myeloperoxidase (MPO). Cytogenetic and FISH analyses showed a complex karyotype, including t(8;14)(q24.1;q32) and IGH-MYC fusion. Intensive chemotherapy was initiated, including prednisone, vincristine, L-asparaginase, daunorubicin, and central nervous system prophylaxis with intrathecal methotrexate (MTX) and cytarabine. One month after the initial diagnosis, BM examination revealed the persistent of abnormal lymphoid cells; cerebrospinal fluid cytology, including cytospin, showed atypical lymphoid cells. The patient was treated again with cyclophosphamide, vincristine, prednisone, adriamycin, MTX, and intrathecal MTX and cytarabine. The patient died of sepsis 5 months after the second round of chemotherapy.
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Affiliation(s)
- Jeong Yeal Ahn
- Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea.
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Lin P, Dickason TJ, Fayad LE, Lennon PA, Hu P, Garcia M, Routbort MJ, Miranda R, Wang X, Qiao W, Medeiros LJ. Prognostic value of MYC rearrangement in cases of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Cancer 2011; 118:1566-73. [DOI: 10.1002/cncr.26433] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 05/31/2011] [Accepted: 06/20/2011] [Indexed: 11/11/2022]
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Abstract
For the past 20 years most malignant lymphomas have been classified as clinicopathological entities, each with its own combination of clinical, morphological, immunophenotypic and molecular genetic characteristics. Molecular and cytogenetic abnormalities can be detected by a wide range of techniques, ranging from conventional karyotyping to single nucleotide polymorphism analysis. In this review, we consider the common genetic abnormalities found in lymphoma and discuss the advantages and disadvantages of individual techniques used in their detection. Finally, we discuss briefly possible novel developments in the field of lymphoma diagnostics.
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Affiliation(s)
- Philip Kluin
- Department of Pathology and Medical Biology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
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Valera ET, Queiroz RG, Brassesco MS, Scrideli CA, Neves F, Tone LG. Anti-CD20 monoclonal antibody therapy and minimal residual disease status of T-cell/histiocyte-rich large B cell non-Hodgkin lymphoma. Pediatr Blood Cancer 2011; 57:348-9. [PMID: 21480472 DOI: 10.1002/pbc.23127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 02/23/2011] [Indexed: 01/16/2023]
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García-Callejo FJ, Montoro-Elena MJ, Llópez-Carratalá I, Monroy-Parada V, Pla-Gil I, Marco-Algarra J. Hodgkin's Lymphoma in Otorhinolaryngology. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2011. [DOI: 10.1016/j.otoeng.2011.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Histological transformation of follicular lymphoma (FL) to a more aggressive non-Hodgkin's lymphomas is a pivotal event in the natural history of FL and is associated with poor outcome. While commonly observed in clinical practice and despite multiple studies designed to address its pathogenesis, the biology of this process represents an enigma. In this chapter we present a state of the art review summarizing the definition of histologic transformation, its incidence, pathogenesis, clinical manifestations, treatment and outcome. Furthermore, we specifically emphasize gaps in our knowledge that should be addressed in future studies.
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MESH Headings
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/biosynthesis
- Biopsy
- Burkitt Lymphoma/etiology
- Burkitt Lymphoma/genetics
- Burkitt Lymphoma/mortality
- Burkitt Lymphoma/pathology
- Burkitt Lymphoma/therapy
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/pathology
- Chromosome Aberrations
- Disease Progression
- Disease-Free Survival
- Humans
- Lymphoma, Follicular/complications
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/therapy
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Mutation
- Prognosis
- Salvage Therapy
- Stem Cell Transplantation
- Transplantation, Autologous
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Affiliation(s)
- Izidore S Lossos
- Department of Medicine & Division of Hematology/Oncology, Sylvester Comprehensive Cancer Center, University of Miami, 1475NW 12th Ave, D8-4, Miami, FL 33136, USA.
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Sasaki N, Kuroda J, Nagoshi H, Yamamoto M, Kobayashi S, Tsutsumi Y, Kobayashi T, Shimura Y, Matsumoto Y, Taki T, Nishida K, Horiike S, Akao Y, Taniwaki M. Bcl-2 is a better therapeutic target than c-Myc, but attacking both could be a more effective treatment strategy for B-cell lymphoma with concurrent Bcl-2 and c-Myc overexpression. Exp Hematol 2011; 39:817-28.e1. [PMID: 21640157 DOI: 10.1016/j.exphem.2011.05.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 04/30/2011] [Accepted: 05/02/2011] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The prognosis for diffuse large B-cell lymphomas with concomitant overexpression of c-Myc and Bcl-2 remains dismal; there is an urgent need to clarify the significance of these two oncogenes as therapeutic targets for a more effective treatment strategy. MATERIALS AND METHODS We established two novel cell lines, KPUM-MS3 and KPUM-UH1, from two chemoresistant patients with diffuse large B-cell lymphomas with concomitant overexpression of c-Myc and Bcl-2, and investigated the significance of c-Myc and Bcl-2 as therapeutic targets. RESULTS KPUM-MS3 possesses t(14;18)(q32;q21) chromosomal translocation and KPUM-UH1 bcl-2 gene amplification, both of which account for Bcl-2 overexpression. Chromosomal translocation t(8;14)(q24;q34) was found to coexist only in KPUM-UH1, overexpression of pvt-1 messenger RNA was detected only in KPUM-MS3, and reduced expression of miR-143 and miR-145 was identified in both. Working together, these abnormalities can contribute to c-Myc overexpression. Using ABT-263, an inhibitor for Bcl-2, and 10058-F4, an inhibitor for c-Myc, we found that both cell lines were more highly sensitive to cell death as a result of Bcl-2 inhibition than of c-Myc inhibition. When combined with genotoxic agents, ABT-263 exerted additive and/or synergistic cell-killing effects, while 10058-F4 showed, at most, a modest combinatory effect. Importantly, the combination of ABT-263 and 10058-F4 had a synergistic cell-killing effect on both cell lines. CONCLUSIONS Our data suggest that Bcl-2 is a better therapeutic target than c-Myc, but attacking both Bcl-2 and c-Myc would be an even more effective treatment strategy for diffuse large B-cell lymphomas with concurrent Bcl-2 and c-Myc overexpression.
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MESH Headings
- Aniline Compounds/pharmacology
- Antineoplastic Agents/pharmacology
- Blotting, Western
- Cell Line, Tumor
- Cell Survival/drug effects
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 18/genetics
- Cytarabine/pharmacology
- Dose-Response Relationship, Drug
- Doxorubicin/pharmacology
- Drug Synergism
- Etoposide/pharmacology
- Gene Expression Regulation, Neoplastic
- Humans
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- MicroRNAs/genetics
- Proto-Oncogene Proteins c-bcl-2/antagonists & inhibitors
- Proto-Oncogene Proteins c-bcl-2/genetics
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Proto-Oncogene Proteins c-myc/antagonists & inhibitors
- Proto-Oncogene Proteins c-myc/genetics
- Proto-Oncogene Proteins c-myc/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Spectral Karyotyping
- Sulfonamides/pharmacology
- Thiazoles/pharmacology
- Translocation, Genetic
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Affiliation(s)
- Nana Sasaki
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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38
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Geiersbach K, Salama M, Sennett MD, Shetty S. Multi-hit lymphoma with intermediate features and novel t(3;8)(q27;q24) not involving MYC. Leuk Lymphoma 2011; 52:922-9. [PMID: 21463122 DOI: 10.3109/10428194.2011.555894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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39
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Micro-RNA Expression and Function in Lymphomas. Adv Hematol 2011; 2011:347137. [PMID: 21461378 PMCID: PMC3063410 DOI: 10.1155/2011/347137] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 12/27/2010] [Accepted: 01/14/2011] [Indexed: 12/19/2022] Open
Abstract
The recent discovery of microRNAs (miRNAs) has introduced a new layer of complexity to the process of gene regulation. MiRNAs are essential for cellular function, and their dysregulation often results in disease. Study of miRNA expression and function in animal models and human lymphomas has improved our knowledge of the pathogenesis of this heterogeneous disease. In this paper, we attempt to describe the expression of miRNAs and their function in lymphomas and discuss potential miRNA-based therapies in the diagnosis and treatment of lymphomas.
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40
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Thomas DA, O'Brien S, Faderl S, Manning JT, Romaguera J, Fayad L, Hagemeister F, Medeiros J, Cortes J, Kantarjian H. Burkitt lymphoma and atypical Burkitt or Burkitt-like lymphoma: should these be treated as different diseases? Curr Hematol Malig Rep 2011; 6:58-66. [PMID: 21191675 PMCID: PMC4394740 DOI: 10.1007/s11899-010-0076-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Burkitt lymphoma (BL) is a mature B-cell non-Hodgkin lymphoma with an aggressive clinical course. Since the advent of short, intensive, multiagent chemoimmunotherapy regimens, it has carried a favorable prognosis. BL has been rather well characterized, whereas the other lymphomas morphologically resembling it are more heterogeneous. The cases classified as atypical BL/Burkitt-like lymphoma by the 2001 World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissue were thought to represent a continuum between BL and diffuse large B-cell lymphoma (DLBCL). The optimal therapeutic strategy for this provisional entity was not definitively established. However, recent incorporation of molecular genetic data into the 2008 WHO Classification has allowed further refinements with significant therapeutic implications, including the designation of a new provisional entity, "B-cell lymphoma, unclassifiable, with features intermediate between BL and DLBCL." This review presents a comprehensive overview of the previously designated provisional entity of atypical BL/BLL in conjunction with a detailed comparison with BL and DLBCL.
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Affiliation(s)
- Deborah A Thomas
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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41
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Wilkins BS. Pitfalls in lymphoma pathology: avoiding errors in diagnosis of lymphoid tissues. J Clin Pathol 2011; 64:466-76. [PMID: 21325143 DOI: 10.1136/jcp.2010.080846] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The complexity involved in the histological interpretation of lymph nodes and other lymphoid tissue specimens suspected of harbouring lymphoma is underappreciated. As with other histology specimens, the quality of sections and background information are crucial but so, increasingly, is the appropriate use of immunocytochemistry and a variety of molecular analyses. Within the UK National Health Service, progressive regional centralisation is ongoing, to ensure access to specialist expertise and a full range of testing beyond traditional stains. This is to be welcomed but there remains a need to maintain skills in smaller district hospitals, to ensure lymphoma recognition in unexpected circumstances, to permit clinically useful interim diagnoses when needed urgently and to sustain training in haematopathology among junior pathologists. In this review a range of potential pitfalls in lymphoid tissue pathology is outlined, arising at all stages from specimen preparation to reporting. Knowledge of such pitfalls, some of which are common while others are rare but of vital clinical importance, should help increase confidence in lymphoma diagnosis among histopathologists.
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Affiliation(s)
- Bridget S Wilkins
- Histopathology Department, Second Floor, North Wing, St Thomas' Hospital and King's College, London SE1 7EH, UK.
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42
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Carbone A, Spina M, Gloghini A, Tirelli U. Classical Hodgkin's lymphoma arising in different host's conditions: pathobiology parameters, therapeutic options, and outcome. Am J Hematol 2011; 86:170-9. [PMID: 21264899 DOI: 10.1002/ajh.21910] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Epidemiologic and molecular findings suggest that classical Hodgkin's lymphoma (CHL) is not a single disease but consists of more than one entity and may occur in different clinical settings. This review analyzes similarities and disparities among CHL entities arising in different host's conditions with respect to pathobiology parameters, therapeutic options, and outcome. For the purpose of this analysis, CHL entities have been subdivided according to the immune status of the host. In nonimmunosuppressed hosts, according to the age, CHL include pediatric, adult, and elderly forms, whereas, in immunosuppressed hosts, according to the type of immunosuppression, CHL include human immunodeficiency virus (HIV)-associated, iatrogenic, and post-transplant types. CHL entities in different settings are similar in morphology of neoplastic cells, expression of activation markers, and aberrations/activation of NFKB, JAK/STAT, and P13K/AKT pathways, but differ in the association with Epstein-Barr virus (EBV) infection, persistent B-cell phenotype, and cellular background composition. Large B-cell lymphomas resembling CHL may also be observed in the same clinical settings. These lesions, however, do not fulfill the diagnostic criteria of CHL and clinically display a very aggressive behavior. In this article, current treatment options for the CHL entities, especially for elderly CHL and HIV-associated CHL, are specifically reviewed. ABVD remains the gold standard both in nonimmunosuppressed or immunosuppressed hosts even if there are several data suggesting a possible improvement in outcome using the aggressive BEACOPP regimen in advanced stages. Refractory CHL, a clinical condition that may occur throughout the entire spectrum of CHL, is discussed separately.
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Affiliation(s)
- Antonino Carbone
- Division of Pathology, Centro di Riferimento Oncologico Aviano, Istituto Nazionale Tumori, Aviano, Italy
| | - Michele Spina
- Department of Medical Oncology, Centro di Riferimento Oncologico Aviano, Istituto Nazionale Tumori, Aviano, Italy
| | - Annunziata Gloghini
- Department of Diagnostic Pathology and Laboratory Medicine, Istituto Nazionale Tumori, Milano, Italy
| | - Umberto Tirelli
- Department of Medical Oncology, Centro di Riferimento Oncologico Aviano, Istituto Nazionale Tumori, Aviano, Italy
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43
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Banerjee D. Recent Advances in the Pathobiology of Hodgkin's Lymphoma: Potential Impact on Diagnostic, Predictive, and Therapeutic Strategies. Adv Hematol 2011; 2011:439456. [PMID: 21318045 PMCID: PMC3034907 DOI: 10.1155/2011/439456] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 10/04/2010] [Accepted: 11/12/2010] [Indexed: 12/20/2022] Open
Abstract
From its first description by Thomas Hodgkin in 1832, Hodgkin's disease, now called Hodgkin's lymphoma, has continued to be a fascinating neoplasm even to this day. In this review, historical aspects, epidemiology, diagnosis, tumor biology, new observations related to host-microenvironment interactions, gene copy number variation, and gene expression profiling in this complex neoplasm are described, with an exploration of chemoresistance mechanisms and potential novel therapies for refractory disease.
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Affiliation(s)
- Diponkar Banerjee
- Centre for Translational and Applied Genomics (CTAG), Department of Pathology, British Columbia Cancer Agency (BCCA), 600 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 4E6
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada V6T 2B5
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44
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Jack A. Changing Practice in Haematopathology: the impact of new technologies and better understanding of pathogenesis. Histopathology 2011; 58:1-3. [DOI: 10.1111/j.1365-2559.2010.03701.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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