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Kamat M, Datar U, Kanitkar S, Byakodi S. Intraoral HIV-associated Burkitt's lymphoma: a rare case report with special emphasis on differential diagnosis. J Korean Assoc Oral Maxillofac Surg 2019; 45:225-229. [PMID: 31508356 PMCID: PMC6728624 DOI: 10.5125/jkaoms.2019.45.4.225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 03/16/2018] [Accepted: 03/22/2018] [Indexed: 12/02/2022] Open
Abstract
Individuals with human immunodeficiency virus (HIV) infection present with unique intraoral manifestations of various neoplasms. Intraoral HIV-associated Burkitt's lymphoma is a rare presentation, especially in patients of Indian origin and may present as an initial sign of HIV. The objective of this paper is to report a rare case of Burkitt's lymphoma in an HIV-positive Indian patient along with a special emphasis on differential diagnosis. A 30-year-old Indian female presented with a solitary, well-defined, exophytic mass extending anteroposteriorly and buccolingually from the 35th to 38th regions with no evidence of intraosseous extension. An incisional biopsy was performed, and histopathology showed sheets of neoplastic lymphoid cells with numerous tingible body macrophages with clear cytoplasm, presenting a starry sky appearance, suggesting a diagnosis of BL. The tumor cells were positive for CD10, CD20, c-myc, and Epstein-Barr virus, with a nearly 100% Ki-67 proliferative index. The patient tested positive for HIV. This report indicates the importance of immunohistochemical analysis to differentiate Burkitt's lymphoma from other similar lesions like diffuse large B-cell lymphoma. Thorough knowledge of the clinical presentation, etiopathogenesis, histopathology, and immunoprofile of intraoral HIV-associated Burkitt's lymphoma is essential among clinicians and pathologists.
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Affiliation(s)
- Mamata Kamat
- Department of Oral Pathology & Microbiology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, India
| | - Uma Datar
- Department of Oral Pathology & Microbiology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, India
| | | | - Sanjay Byakodi
- Department of Oral & Maxillofacial Surgery, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, India
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Fujita N, Kobayashi R, Atsuta Y, Iwasaki F, Suzumiya J, Sasahara Y, Inoue M, Koh K, Hori T, Goto H, Ichinohe T, Hashii Y, Kato K, Suzuki R, Mitsui T. Hematopoietic stem cell transplantation in children and adolescents with relapsed or refractory B-cell non-Hodgkin lymphoma. Int J Hematol 2019; 109:483-490. [PMID: 30701466 DOI: 10.1007/s12185-019-02608-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/19/2019] [Accepted: 01/23/2019] [Indexed: 01/03/2023]
Abstract
We undertook a retrospective study using the national registry data of hematopoietic stem cell transplantation (HSCT) in Japan to investigate the effect of graft source, particularly autologous or allogeneic tissue, on the treatment outcome in patients aged less than 18 years with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL). Survival analysis was conducted on 31 autologous HSCT (auto-HSCT) and 48 allogeneic HSCT (allo-HSCT) recipients between 1990 and 2013. The 5-year survival rates were significantly lower for allo-HSCT compared to auto-HSCT recipients (32% vs. 55%; P = 0.036). Multivariate analysis of survival rates identified allogeneic graft, Burkitt histology, and lack of response to chemotherapy as poor prognostic factors for survival. The cumulative incidence of treatment-related mortality (TRM) was significantly higher in allo-HSCT compared to auto-HSCT recipients (P = 0.017), explaining the difference in survival rates. In patients with Burkitt lymphoma (BL), overall survival was significantly inferior in the group of patients undergoing HSCT within 12 months from the initial diagnosis (P = 0.039). These data indicate that treatment outcomes for HSCT in children and adolescents with B-NHL were better in autograft recipients, suggesting that greater attention should be paid to the risk of TRM, especially after allografts, for patients with BL.
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Affiliation(s)
- Naoto Fujita
- Department of Pediatrics, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-Machi, Naka-ku, Hiroshima, 730-8619, Japan.
| | - Ryoji Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fuminori Iwasaki
- Department of Hematology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Junji Suzumiya
- Department of Oncology/Hematology, Shimane University Hospital, Izumo, Japan
| | - Yoji Sasahara
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masami Inoue
- Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Tsukasa Hori
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroaki Goto
- Division of Hemato-Oncology/Regenerative Medicine, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Hashii
- Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Koji Kato
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Ritsuro Suzuki
- Department of Oncology and Hematology, Shimane University Hospital Cancer Center, Izumo, Japan
| | - Tetsuo Mitsui
- Department of Pediatrics, Yamagata University School of Medicine, Yamagata, Japan
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Stepniak A, Czuczwar P, Szkodziak P, Wozniakowska E, Wozniak S, Paszkowski T. Primary ovarian Burkitt's lymphoma: a rare oncological problem in gynaecology: a review of literature. Arch Gynecol Obstet 2017; 296:653-660. [PMID: 28770352 PMCID: PMC5591814 DOI: 10.1007/s00404-017-4478-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 07/25/2017] [Indexed: 11/29/2022]
Abstract
Purpose This review presents the information about epidemiology, clinical manifestation, diagnosis and treatment of primary ovarian Burkitt’s lymphoma (BL), including a literature search of available BL cases. The purpose of this review is to draw clinicians’ attention to the possibility of ovarian BL occurrence, which may be important in the differential diagnosis of ovarian tumours. Methods PubMed and Web of Science databases were searched using the keywords ‘‘Burkitt’s’’, ‘‘Lymphoma’’, ‘‘Ovarian’’, ‘‘Primary’’, ‘‘Burkitt’s lymphoma’’. Only cases with histopathologically confirmed diagnosis of primary ovarian BL were included in this review. Results Fifty articles, reporting cases with an ovarian manifestation of primary non-Hodgkin’s lymphoma, were found. Twenty-one cases with a histopathologically confirmed BL were evaluated to compare various manifestations, treatment and prognosis in ovarian BL. Conclusions Primary ovarian BL is a rare condition, included in the entity of non-Hodgkin lymphoma. The tumour can occur uni- or bilaterally in the ovaries with major symptoms such as abdominal pain or a large abdominal mass. Differential diagnosis, based on imaging features and pathological examination of the specimens, is essential for further treatment due to various aetiology of ovarian tumours. Although most of the patients suffering from ovarian BL underwent surgery after the ovarian tumour had been detected, surgical treatment is not the treatment of choice in patients with ovarian lymphoma. The mainstay of therapy is chemotherapy without further surgery. The prognosis is better if the chemotherapy protocol is more aggressive and followed by prophylactic central nervous system chemotherapy. Nowadays, multiagent protocols are administered, which improves the survival rate.
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Affiliation(s)
- Anna Stepniak
- 3rd Department of Gynecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
| | - Piotr Czuczwar
- 3rd Department of Gynecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland.
| | - Piotr Szkodziak
- 3rd Department of Gynecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
| | - Ewa Wozniakowska
- 3rd Department of Gynecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
| | - Slawomir Wozniak
- 3rd Department of Gynecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
| | - Tomasz Paszkowski
- 3rd Department of Gynecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
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Jourdain A, Auperin A, Minard-Colin V, Aladjidi N, Zsiros J, Coze C, Gandemer V, Bertrand Y, Leverger G, Bergeron C, Michon J, Patte C. Outcome of and prognostic factors for relapse in children and adolescents with mature B-cell lymphoma and leukemia treated in three consecutive prospective "Lymphomes Malins B" protocols. A Société Française des Cancers de l'Enfant study. Haematologica 2015; 100:810-7. [PMID: 25724577 DOI: 10.3324/haematol.2014.121434] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/25/2015] [Indexed: 11/09/2022] Open
Abstract
To describe relapsed B-cell lymphoma or leukemia in children/adolescents treated with a "Lymphomes Malins B" regimen and their outcome and to identify prognostic factors for survival, we studied relapses in the LMB89, 96 and 2001 studies of the Société Française d'Oncologie Pédiatrique (Société Française des Cancers de l'Enfant). Therapeutic guidelines at relapse were to obtain a second complete remission and to consolidate the remission with high-dose chemotherapy followed by autologous stem-cell transplantation. Between July 1989 and March 2007, 67 patients of 1322 (5%) relapsed: 57 had Burkitt lymphoma and 10 had large-cell histology. Three patients were initially treated in risk group A, 41 in group B and 23 in group C. Thirty-three patients had a relapse in one site (15 in the central nervous system) and 34 at multiple sites. Sixty-five patients received salvage chemotherapy and 33 achieved complete remission. Forty-one patients also received high-dose chemotherapy followed by autologous (n=33) or allogeneic (n=8) transplantation. With a median follow-up of 6.4 years, the 5-year survival rate was 29.9%. Nineteen patients were still alive, all but one (group A) received consolidation treatment. Multivariate analysis showed the following factors to be significantly associated with better survival: relapse at one site (P=0.0006), large-cell histology (P=0.012), initial prognostic group A or B with lactate dehydrogenase level below twice the normal value (P=0.005), and time to relapse more than 6 months (P=0.04).
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Affiliation(s)
- Anne Jourdain
- Paediatric Onco-Hematology Unit, Hopital de Clocheville, Tours, France
| | - Anne Auperin
- Biostatistics and Epidemiology Unit, Gustave Roussy, Villejuif, France
| | | | - Nathalie Aladjidi
- Pediatric Onco-Hematology Unit, Bordeaux University Hospital, France
| | - Josef Zsiros
- Department of Pediatric Oncology, Emma Children's Hospital Academic Medical Centre, Amsterdam, The Netherlands
| | - Carole Coze
- Pediatric Hematology Oncology Unit, Aix-Marseille University and APHM, Hôpital d'Enfants de La Timone, Marseille, France
| | - Virginie Gandemer
- Pediatric Onco-Hematology Unit, Rennes University Hospital, Rennes, France
| | - Yves Bertrand
- Institute of Pediatric Hematology and Oncology, Lyon, France
| | - Guy Leverger
- Pediatric Onco-Hematology Unit, AP-HP, Armand Trousseau Hospital, UPMC Univ Paris 06, France
| | | | - Jean Michon
- Department of Pediatric Oncology, Institut Curie, Paris, France
| | - Catherine Patte
- Department of Pediatric Oncology, Gustave Roussy, Villejuif, France
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Ota-Kuroki J, Ragsdale JM, Bawa B, Wakamatsu N, Kuroki K. Intraocular and periocular lymphoma in dogs and cats: a retrospective review of 21 cases (2001-2012). Vet Ophthalmol 2013; 17:389-96. [DOI: 10.1111/vop.12106] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Juri Ota-Kuroki
- Midwest Veterinary Referral Center; 17497 N. Outer 40 Drive Chesterfield MO 63005 USA
| | - John M. Ragsdale
- Veterinary Diagnostic Services; New Mexico Department of Agriculture; New Mexico State University; 1101 Camino de Salud NE Albuquerque NM 87102 USA
| | - Bhupinder Bawa
- Department of Diagnostic Medicine and Pathobiology; Kansas State University; Manhattan KS 66506 USA
| | - Nobuko Wakamatsu
- Department of Pathobiological Sciences; Louisiana State University; Baton Rouge LA 70803 USA
| | - Keiichi Kuroki
- Veterinary Medical Diagnostic Laboratory; University of Missouri; 1600 E. Rollins Columbia MO 65211 USA
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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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Sagaert X, Tousseyn T, Yantiss RK. Gastrointestinal B-cell lymphomas: From understanding B-cell physiology to classification and molecular pathology. World J Gastrointest Oncol 2012; 4:238-49. [PMID: 23443141 PMCID: PMC3581849 DOI: 10.4251/wjgo.v4.i12.238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 08/29/2012] [Accepted: 11/20/2012] [Indexed: 02/05/2023] Open
Abstract
The gut is the most common extranodal site where lymphomas arise. Although all histological lymphoma types may develop in the gut, small and large B-cell lymphomas predominate. The sometimes unexpected finding of a lymphoid lesion in an endoscopic biopsy of the gut may challenge both the clinician (who is not always familiar with lymphoma pathogenesis) and the pathologist (who will often be hampered in his/her diagnostic skill by the limited amount of available tissue). Moreover, the past 2 decades have spawned an avalanche of new data that encompasses both the function of the reactive B-cell as well as the pathogenic pathways that lead to its neoplastic counterpart, the B-cell lymphoma. Therefore, this review aims to offer clinicians an overview of B-cell lymphomas in the gut, and their pertinent molecular features that have led to new insights regarding lymphomagenesis. It addresses the question as how to incorporate all presently available information on normal and neoplastic B-cell differentiation, and how this knowledge can be applied in daily clinical practice (e.g., diagnostic tools, prognostic biomarkers or therapeutic targets) to optimalise the managment of this heterogeneous group of neoplasms.
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Affiliation(s)
- Xavier Sagaert
- Xavier Sagaert, Thomas Tousseyn, Department of Pathology University Hospitals Leuven, B-3000 Leuven, Belgium
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8
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Molecular profiling of aggressive lymphomas. Adv Hematol 2011; 2012:464680. [PMID: 22190944 PMCID: PMC3235419 DOI: 10.1155/2012/464680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 09/15/2011] [Indexed: 12/14/2022] Open
Abstract
In the last years, several studies of molecular profiling of aggressive lymphomas were performed. In particular, it was shown that DLBCL can be distinguished in two different entities according to GEP. Specifically, ABC and GCB subtypes were characterized by having different pathogenetic and clinical features. In addition, it was demonstrated that DLBCLs are distinct from BL. Indeed, the latter is a unique molecular entity. However, relevant pathological differences emerged among the clinical subtypes. More recently, microRNA profiling provided further information concerning BL-DLBCL distinction as well as for their subclassification. In this paper, the authors based on their own experience and the most updated literature review, the main concept on molecular profiling of aggressive lymphomas.
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Tapia G, Lopez R, Muñoz-Mármol AM, Mate JL, Sanz C, Marginet R, Navarro JT, Ribera JM, Ariza A. Immunohistochemical detection of MYC protein correlates with MYC gene status in aggressive B cell lymphomas. Histopathology 2011; 59:672-8. [DOI: 10.1111/j.1365-2559.2011.03978.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Lu B, Zhou C, Yang W, Huang H, Gao Z, He Y, Liu H, Zhou X, Gong L. Morphological, immunophenotypic and molecular characterization of mature aggressive B-cell lymphomas in Chinese pediatric patients. Leuk Lymphoma 2011; 52:2356-64. [DOI: 10.3109/10428194.2011.602772] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Van Noorden S, Lampert IA, Xue SA, Lykidis D, Phillips JA, Molyneux E, Griffin BE. Burkitt's lymphoma: maximising the use of fine needle aspirates by long-term preservation for diagnosis and research. Trans R Soc Trop Med Hyg 2011; 105:86-94. [DOI: 10.1016/j.trstmh.2010.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 11/05/2010] [Accepted: 11/05/2010] [Indexed: 10/18/2022] Open
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B Cell Lymphoma Unclassifiable with Features Intermediate Between Diffuse Large B Cell and Burkitt Lymphoma—Presented with Multiple Lymphomatous Polyposis of Gastrointestinal Tract. J Gastrointest Cancer 2011; 42:282-6. [DOI: 10.1007/s12029-010-9244-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Bacher U, Kohlmann A, Haferlach T. Gene expression profiling for diagnosis and therapy in acute leukaemia and other haematologic malignancies. Cancer Treat Rev 2010; 36:637-46. [DOI: 10.1016/j.ctrv.2010.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 05/09/2010] [Accepted: 05/10/2010] [Indexed: 01/05/2023]
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Bellan C, Stefano L, Giulia DF, Rogena EA, Lorenzo L. Burkitt lymphoma versus diffuse large B-cell lymphoma: a practical approach. Hematol Oncol 2010; 28:53-6. [PMID: 19844983 DOI: 10.1002/hon.916] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Burkitt Lymphoma (BL) is listed in the World Health Organization (WHO) classification of lymphoid tumours as an 'aggressive B-cell non-Hodgkin's lymphoma', characterized by a high degree of proliferation of the malignant cells and deregulation of the c-MYC gene. The main diagnostic challenge in BL is to distinguish it from diffuse large B-cell lymphoma (DLBCL). While in children BL and DLBCL types probably do not differ clinically, and the differential diagnosis between BL and DLBCL may theoretically appear clear-cut, in adults daily practice shows the existence of cases that have morphological features, immunophenotypic and cytogenetics intermediate between DLBCL and BL, and cannot be classified with certainty in these categories. Distinguishing between BL and DLBCL is critical, as the two diseases require different management. This review summarizes the current practical approach, including the use of a large panel of antibodies, and cytogenetic and molecular diagnostic techniques, to distinguish between BL, DLBCL and the provisional category of 'B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma', now listed in the updated WHO classification.
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Affiliation(s)
- Cristiana Bellan
- Department of Human Pathology and Oncology, University of Siena, Siena, Italy
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López-Vicente J, Pérez-Carreras M, Idrovo F. [Acute cholestasis in an immunosuppressed patient with renal transplantation and chronic hepatitis C]. Med Clin (Barc) 2010; 134:457-61. [PMID: 19939414 DOI: 10.1016/j.medcli.2009.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2009] [Revised: 09/28/2009] [Accepted: 09/29/2009] [Indexed: 12/01/2022]
Affiliation(s)
- Jorge López-Vicente
- Servicio de Medicina Aparato Digestivo, Hospital Universitario 12 de Octubre, Madrid, España.
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16
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May PC, Foot N, Dunn R, Geoghegan H, Neat MJ. Detection of cryptic and variant IGH-MYC rearrangements in high-grade non-Hodgkin's lymphoma by fluorescence in situ hybridization: implications for cytogenetic testing. ACTA ACUST UNITED AC 2010; 198:71-5. [DOI: 10.1016/j.cancergencyto.2009.12.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Revised: 12/15/2009] [Accepted: 12/15/2009] [Indexed: 02/07/2023]
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17
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Bellan C, Stefano L, Giulia DF, Rogena EA, Lorenzo L. Burkitt lymphoma versus diffuse large B-cell lymphoma: a practical approach. Hematol Oncol 2009; 27:182-5. [PMID: 19670467 DOI: 10.1002/hon.914] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Burkitt Lymphoma (BL) is listed in the World Health Organization (WHO) classification of lymphoid tumours as an "aggressive B-cell non-Hodgkin's lymphoma", characterized by a high degree of proliferation of the malignant cells and deregulation of the c-MYC gene. The main diagnostic challenge in BL is to distinguish it from diffuse large B-cell lymphoma (DLBCL). While in children BL and DLBCL types probably do not differ clinically, and the differential diagnosis between BL and DLBCL may theoretically appear clear-cut, in adults daily practice shows the existence of cases that have morphological features, immunophenotypic and cytogenetics intermediate between DLBCL and BL, and cannot be classified with certainty in these categories. Distinguishing between BL and DLBCL is critical, as the two diseases require different management. This review summarizes the current practical approach, including the use of a large panel of antibodies, and cytogenetic and molecular diagnostic techniques, to distinguish between BL, DLBCL and the provisional category of "B-cell lymphoma, unclassificable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma", now listed in the updated WHO classification.
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Affiliation(s)
- Cristiana Bellan
- Department of Human Pathology and Oncology, University of Siena, Siena, Italy
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18
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Broyde A, Boycov O, Strenov Y, Okon E, Shpilberg O, Bairey O. Role and prognostic significance of the Ki-67 index in non-Hodgkin's lymphoma. Am J Hematol 2009; 84:338-43. [PMID: 19384938 DOI: 10.1002/ajh.21406] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Expression of Ki-67, a nuclear antigen protein present in all cycling cells, is used to determine the growth fraction of tumors. The aim of this study was to evaluate the role and prognostic significance of the Ki-67 proliferation index (PI) in non-Hodgkin's lymphoma. Ki-67 was assayed immunohistochemically in tissue samples of 319 patients with newly-diagnosed non-Hodgkin's lymphoma. In 268 patients, the Ki-67 PI was correlated with clinical course and outcome. The mean Ki-67 PI ranged from 26.6% in indolent lymphomas to 97.6% in very aggressive lymphomas (P < 0.001). The index was <45% in 82.8% of indolent lymphomas and >45% in 85% of aggressive lymphomas (AUC = 0.877, P < 0.001). In patients with diffuse large B-cell lymphoma (n = 141), a Ki-67 PI of 70% was found to significantly discriminate patients with good or bad prognosis (AUC = 0.65, P = 0.004). Three-year survival was 75% +/- 5.6% in patients with a low Ki-67 index compared with 55.9% +/- 6% in patients with a high index (P = 0.015). In patients with a low IPI (<or=2), 3-year survival was 94% +/- 4% in those with a Ki-67 index <or=70% and 64% +/- 8.1% in those with a higher index (P = 0.002); in patients with bulky disease (>10 cm), the corresponding 3-year survival by Ki-67 index was 100% and 25% +/- 12% (P = 0.012). Our results suggest that the mean Ki-67 PI differs by type of lymphoma. A cut-off value of 45% can help differentiate indolent from aggressive disease. In diffuse large B-cell lymphoma, a cut-off value of 70% can distinguish patients with a good and bad prognosis when combined with other prognostic factors of low IPI score and bulky disease.
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Affiliation(s)
- Adi Broyde
- Institute of Hematology, Rabin Medical Center, Beilinson Hospital, Petah Tiqwa, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Bacher U, Kohlmann A, Haferlach T. Perspectives of gene expression profiling for diagnosis and therapy in haematological malignancies. BRIEFINGS IN FUNCTIONAL GENOMICS AND PROTEOMICS 2009; 8:184-93. [PMID: 19474126 DOI: 10.1093/bfgp/elp011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Considering the heterogeneity of leukaemias and the widening spectrum of therapeutic strategies, novel diagnostic methods are urgently needed for haematological malignancies. For a decade, gene expression profiling (GEP) has been applied in leukaemia research. Thus, various studies demonstrated worldwide that the majority of genetically defined leukaemia subtypes are accurately predictable by GEP, for example, with respect to reciprocal rearrangements in acute myeloid leukaemia (AML). Moreover, novel prognostically relevant gene classifiers were developed as, for example, in normal karyotype AML. Considering the lymphatic malignancies, GEP studies defined novel clinically relevant subtypes in diffuse large B cell lymphoma (DLBCL), and improved the discrimination of Burkitt lymphoma and DLBCL cases, overcoming considerable overlaps of these entities that exist from morphological and genetic perspectives. Treatment-specific sensitivity assays are being developed for targeted drugs such as farnesyl transferase inhibitors in AML or imatinib in BCR-ABL1 positive acute lymphoblastic leukaemia (ALL). Irrespectively of these proceedings, an introduction of the microarray technology in haematological practice requires diagnostic algorithms and strategies for interaction with currently established diagnostic techniques. Large multicentre studies such as the MILE Study (Microarray Innovations in LEukemia) aim at translating this methodology into clinical routine workflows and to catalyze this process.
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Affiliation(s)
- Ulrike Bacher
- MLL Munich Leukemia Laboratory, D-81377 Munich, Germany
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