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Grau M, López C, Martín-Subero JI, Beà S. Cytogenomics of B-cell non-Hodgkin lymphomas: The "old" meets the "new". Best Pract Res Clin Haematol 2023; 36:101513. [PMID: 38092483 DOI: 10.1016/j.beha.2023.101513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 12/18/2023]
Abstract
For the routine diagnosis of haematological neoplasms an integrative approach is used considering the morphology, and the immunophenotypic, and molecular features of the tumor sample, along with clinical information. The identification and characterization of recurrent chromosomal aberrations mainly detected by conventional and molecular cytogenetics in the tumor cells has a major impact on the classification of lymphoid neoplasms. Some of the B-cell non-Hodgkin lymphomas are characterized by particular chromosomal aberrations, highlighting the relevance of conventional and molecular cytogenetic studies in their diagnosis and prognosis. In the current genomics era, next generation sequencing provides relevant information as the mutational profiles of haematological malignancies, improving their classification and also the clinical management of the patients. In addition, other new technologies have emerged recently, such as the optical genome mapping, which can overcome some of the limitations of conventional and molecular cytogenetics and may become more widely used in the cytogenetic laboratories in the upcoming years. Moreover, epigenetic alterations may complement genetic changes for a deeper understanding of the pathogenesis underlying B-cell neoplasms and a more precise risk-based patient stratification. Overall, here we describe the current state of the genomic data integrating chromosomal rearrangements, copy number alterations, and somatic variants, as well as a succinct overview of epigenomic changes, which altogether constitute a comprehensive diagnostic approach in B-cell non-Hodgkin lymphomas.
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Affiliation(s)
- Marta Grau
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Cristina López
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain; Universitat de Barcelona, Spain
| | - José Ignacio Martín-Subero
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain; Universitat de Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Sílvia Beà
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain; Universitat de Barcelona, Spain; Hematopathology Section, Pathology Department, Hospital Clínic Barcelona, Barcelona, Spain.
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2
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Stueber T, Jaitly V, Moore EM. The clinical significance of increased large cells in marginal zone lymphoma. Hum Pathol 2023; 141:130-138. [PMID: 37633532 DOI: 10.1016/j.humpath.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
Marginal zone lymphoma (MZL) is a primary, indolent small B-cell lymphoma. Subtypes include nodal, splenic, and those of extranodal mucosa-associated lymphoid tissue (MALT). These are slow growing and generally exhibit low rates of transformation to diffuse large B-cell lymphoma (DLBCL). At initial diagnosis, there can be an increase in large cells (LCs) that does not meet criteria for DLBCL. Prior studies have noted this finding, but the clinical significance of these LCs has not been well established. A total of 161 cases of MZL from 1994 to 2021 were evaluated, including all subtypes. There were 33 cases with increased LCs (>10 LCs per high-power field [hpf]), with the majority containing >15 LCs/hpf (28/33) and 128 cases without increased LCs. Cases with increased LCs were significantly more likely to have a Ki-67 proliferation index of ≥30% (P < .0001). Overall survival was not significantly different between the groups but progression-free survival was significantly worse in the LC group (P < .0001). MZL with increased LCs was also associated with a higher stage at diagnosis (P = .0035), was more likely to transform to DLBCL (P = .0016), and had a greater frequency of relapse (P < .0001). Subgroup analysis showed that both nodal and MALT LC groups had a worse progression-free survival and a higher rate of relapse than their standard nodal and MALT lymphoma counterparts, but only within the MALT subgroup did the LC cases present at a higher stage and have a higher rate of transformation to DLBCL than the standard cases. Although larger studies are needed for validation, these results suggest that the presence of LCs in MZL may serve as a useful prognostic indicator and potentially help guide clinical decision-making.
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Affiliation(s)
- Travis Stueber
- University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Vanya Jaitly
- University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Erika M Moore
- University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA.
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3
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Stuver R, Drill E, Qualls D, Okwali M, Lee Batlevi C, Caron PC, Dogan A, Epstein-Peterson ZD, Falchi L, Hamlin PA, Horwitz SM, Imber BS, Intlekofer AM, Johnson WT, Khan N, Kumar A, Lahoud OB, Lue JK, Matasar MJ, Moskowitz AJ, Noy A, Owens CN, Palomba ML, Schöder H, Vardhana SA, Yahalom J, Zelenetz AD, Salles G, Straus DJ. Retrospective characterization of nodal marginal zone lymphoma. Blood Adv 2023; 7:4838-4847. [PMID: 37307213 PMCID: PMC10469082 DOI: 10.1182/bloodadvances.2022009587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/08/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
Nodal marginal zone lymphoma (NMZL) is a rare non-Hodgkin B-cell lymphoma that has historically been difficult to define, though is now formally recognized by the World Health Organization Classification. To better characterize the clinical outcomes of patients with NMZL, we reviewed a sequential cohort of 187 patients with NMZL to describe baseline characteristics, survival outcomes, and time-to-event data. Initial management strategies were classified into five categories: observation, radiation, anti-CD20 monoclonal antibody therapy, chemoimmunotherapy, or other. Baseline Follicular Lymphoma International Prognostic Index scores were calculated to evaluate prognosis. A total of 187 patients were analyzed. The five-year overall survival was 91% (95% confidence interval [CI], 87-95), with a median follow-up time of 71 months (range, 8-253) among survivors. A total of 139 patients received active treatment at any point, with a median follow-up time of 56 months (range, 13-253) among survivors who were never treated. The probability of remaining untreated at five years was 25% (95% CI, 19-33). For those initially observed, the median time to active treatment was 72 months (95% CI, 49-not reached). For those who received at least one active treatment, the cumulative incidence of receiving a second active treatment at 60 months was 37%. Transformation to large B-cell lymphoma was rare, with a cumulative incidence of 15% at 10 years. In summary, our series is a large cohort of uniformly diagnosed NMZL with detailed analyses of survival and time to event analyses. We showed that NMZL commonly presents as an indolent lymphoma for which initial observation is often a reasonable strategy.
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Affiliation(s)
- Robert Stuver
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Esther Drill
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - David Qualls
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michelle Okwali
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Connie Lee Batlevi
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Philip C. Caron
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ahmet Dogan
- Department of Pathology and Laboratory Medicine, Hematopathology Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Zachary D. Epstein-Peterson
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Lorenzo Falchi
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Paul A. Hamlin
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Steven M. Horwitz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Department of Medicine, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brandon S. Imber
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrew M. Intlekofer
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Human Oncology & Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY
| | - William T. Johnson
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Department of Medicine, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Niloufer Khan
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Anita Kumar
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Oscar B. Lahoud
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Department of Medicine, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jennifer Kimberly Lue
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Matthew J. Matasar
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Alison J. Moskowitz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Ariela Noy
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Colette N. Owens
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - M. Lia Palomba
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Department of Medicine, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Heiko Schöder
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Department of Radiology, Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Santosha A. Vardhana
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Human Oncology & Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joachim Yahalom
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrew D. Zelenetz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Gilles Salles
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - David J. Straus
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
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4
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Epperla N, Zhao Q, Karmali R, Torka P, Shea L, Oh TS, Anampa-Guzmán A, Reves H, Tavakkoli M, Greenwell IB, Hansinger E, Umyarova E, Annunzio K, Sawalha Y, Christian B, Thomas C, Barta SK, Geethakumari PR, Bartlett NL, Grover NS, Olszewski AJ. Impact of detectable monoclonal protein at diagnosis on outcomes in marginal zone lymphoma: a multicenter cohort study. Blood Adv 2023; 7:5038-5046. [PMID: 37315169 PMCID: PMC10471932 DOI: 10.1182/bloodadvances.2023010133] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/16/2023] Open
Abstract
Given the paucity of data surrounding the prognostic relevance of monoclonal paraprotein (M-protein) in marginal zone lymphoma (MZL), we sought to evaluate the impact of detecting M-protein at diagnosis on outcomes in patients with MZL in a large retrospective cohort. The study included 547 patients receiving first-line therapy for MZL. M-protein was detectable at diagnosis in 173 (32%) patients. There was no significant difference in the time from diagnosis to initiation of any therapy (systemic and local) between the M-protein and no M-protein groups. Patients with M-protein at diagnosis had significantly inferior progression-free survival (PFS) compared with those without M-protein at diagnosis. After adjusting for factors associated with inferior PFS in univariate models, presence of M-protein remained significantly associated with inferior PFS (hazard ratio, 1.74; 95% confidence interval, 1.20-2.54; P = .004). We observed no significant difference in the PFS based on the type or quantity of M-protein at diagnosis. There were differential outcomes in PFS based on the first-line therapy in patients with M-protein at diagnosis, in that, those receiving immunochemotherapy had better outcomes compared with those receiving rituximab monotherapy. The cumulative incidence of relapse in stage 1 disease among the recipients of local therapy was higher in the presence of M-protein; however, this did not reach statistical significance. We found that M-protein at diagnosis was associated with a higher risk of histologic transformation. Because the PFS difference related to presence of M-protein was not observed in patients receiving bendamustine and rituximab, immunochemotherapy may be a preferred approach over rituximab monotherapy in this group and needs to be explored further.
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Affiliation(s)
- Narendranath Epperla
- Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Qiuhong Zhao
- Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Reem Karmali
- Department of Medicine, Northwestern University, Chicago, IL
| | - Pallawi Torka
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Lauren Shea
- Department of Medicine, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Timothy S. Oh
- Department of Medicine, Northwestern University, Chicago, IL
| | | | - Heather Reves
- Department of Medicine, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX
| | - Montreh Tavakkoli
- Department of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Irl Brian Greenwell
- Department of Medicine, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
| | - Emily Hansinger
- Department of Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Elvira Umyarova
- Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH
- Department of Medicine, University of Vermont, Burlington, VT
| | - Kaitlin Annunzio
- Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Yazeed Sawalha
- Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Beth Christian
- Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Colin Thomas
- Department of Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Stefan K. Barta
- Department of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Nancy L. Bartlett
- Department of Medicine, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Natalie S. Grover
- Department of Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
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5
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Miyake M, Sakata S, Tsuyama N, Togashi Y, Noguchi M, Tsukada N, Kumagai T, Mishima Y, Takeuchi K. Eosinophil-rich variant of nodal marginal zone lymphoma: a clinicopathological study of 11 cases. Histopathology 2023; 83:443-452. [PMID: 37222201 DOI: 10.1111/his.14963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/25/2023]
Abstract
AIMS Tissue eosinophilia is commonly observed in T-cell and classic Hodgkin lymphomas, but rarely in B-cell lymphomas. Herein, we present the first report of a case series on nodal marginal zone lymphoma (NMZL) with tissue eosinophilia. METHODS AND RESULTS All 11 patients in this study had nodal disease at primary presentation. The mean age at diagnosis was 64 years. The mean follow-up period was 39 months, and all patients were alive. Nine of the 11 patients (82%) showed no recurrence, but the other two patients experienced recurrence in the lymph nodes or skin. Marked eosinophilic infiltration was observed in all biopsied lymph nodes. Nine of the 11 patients had a preserved nodular architecture with expanded interfollicular areas. The other two patients showed diffuse lymphoma cell infiltration with effacement of nodal architecture. One of them was diagnosed as having diffuse large B-cell lymphoma transformed from NMZL because large cells accounted for >50% of the lymphoma cells and formed sheet-like patterns. Cells were positive for CD20 and BCL2 and negative for CD5, CD10, and BCL6. Some patients showed myeloid cell nuclear differentiation antigen (MNDA) positivity. All patients showed B-cell monoclonality via flow cytometry, southern blotting, and/or polymerase chain reaction (PCR). CONCLUSION All patients showed distinctive morphological features and could be misdiagnosed with peripheral T-cell lymphoma due to their eosinophil-rich backgrounds. The predominance of B cells, absence of histiocytes, and high endothelial venules in the interfollicular areas are key factors for diagnosis. B-cell monoclonality is the most reliable evidence of differentiation. We designated this type of lymphoma as an eosinophil-rich variant of NMZL.
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Affiliation(s)
- Misayo Miyake
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Seiji Sakata
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naoko Tsuyama
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuki Togashi
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masaaki Noguchi
- Department of Hematology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Nobuhiro Tsukada
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Takashi Kumagai
- Department of Hematology, Ome Municipal General Hospital, Tokyo, Japan
| | - Yuko Mishima
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kengo Takeuchi
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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6
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Kitamura W, Asada N, Tabata T, Shibata R, Nishi T, Kato Y, Takasuka H, Fujiwara H, Ennishi D, Nishimori H, Fujii N, Matsuoka KI, Kiura K, Yoshino T, Maeda Y. Transformed diffuse large B-cell lymphoma from marginal zone lymphoma in the anterior mediastinum: A case report and review of the literature. J Clin Exp Hematop 2021; 62:35-40. [PMID: 34840205 PMCID: PMC9010493 DOI: 10.3960/jslrt.21010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Marginal zone lymphoma (MZL) arising from the anterior mediastinum is rare. In the majority of reported cases, the tumor was incidentally discovered, reflecting its indolent clinical features. We present a 38-year-old woman who had no medical history, and presented with a bulky anterior mediastinal tumor complicated by life-threatening compression of the vasculature and bronchi. Biopsy specimens of the neoplasm suggested transformed diffuse large B-cell lymphoma (DLBCL) from MZL. To our best knowledge, this is the first case report of anterior mediastinum MZL associated with an aggressive clinical course and life-threatening complications likely due to transformation to DLBCL.
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Affiliation(s)
- Wataru Kitamura
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Noboru Asada
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Tetsuya Tabata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Rei Shibata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Tatsuya Nishi
- Department of Respiratory and Allergy, Okayama University Hospital, Okayama, Japan
| | - Yuka Kato
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Hiroki Takasuka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Hideaki Fujiwara
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Daisuke Ennishi
- Center for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama, Japan
| | - Hisakazu Nishimori
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Nobuharu Fujii
- Department of Transfusion Medicine, Okayama University Hospital, Okayama, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Katsuyuki Kiura
- Department of Respiratory and Allergy, Okayama University Hospital, Okayama, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
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7
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Xia D, Leon AJ, Yan J, Silva A, Bakhtiari M, Tremblay-LeMay R, Selvarajah S, Sabatini P, Diamandis P, Pugh T, Kridel R, Delabie J. DNA Methylation-Based Classification of Small B-Cell Lymphomas: A Proof-of-Principle Study. J Mol Diagn 2021; 23:1774-1786. [PMID: 34562613 DOI: 10.1016/j.jmoldx.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 08/17/2021] [Accepted: 09/01/2021] [Indexed: 11/15/2022] Open
Abstract
Although most small B-cell lymphomas (SBCLs) can be diagnosed using routine methods, challenges exist. For example, marginal zone lymphomas (MZLs) can be difficult to rule-in, in large part because no widely-used, sensitive, and specific biomarker is available for the marginal zone cell of origin. In this study, it was hypothesized that DNA methylation array profiling can assist with the classification of SBCLs, including MZLs. Extramedullary SBCLs, including challenging cases, were reviewed internally for pathology consensus and profiled. By combining the resulting array data set with data sets from other groups, a set of 26 informative probes was selected and used to train machine learning models to classify 4 common SBCLs: chronic lymphocytic leukemia/small lymphocytic lymphoma, follicular lymphoma, mantle cell lymphoma, and MZL. Prediction probability cutoff was used to separate classifiable from unclassifiable cases, and show that the trained model was able to classify 95% of independent test cases (n = 264/279). The concordance between model predictions and pathology diagnoses was 99.6% (n = 262/263) among classifiable test cases. One validation reference test case was reclassified based on model prediction. The model was also used to predict the diagnoses of two challenging SBCLs. Although the differential examined and data on difficult cases are limited, these results support accurate methylation-based classification of SBCLs. Furthermore, high specificities of predictions suggest that methylation signatures can be used to rule-in MZLs.
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Affiliation(s)
- Daniel Xia
- Division of Hematopathology and Transfusion Medicine, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
| | - Alberto Jose Leon
- Translational Genomics Laboratory, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Jiong Yan
- Division of Hematopathology and Transfusion Medicine, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Anjali Silva
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Vector Institute, Toronto, Ontario, Canada
| | | | - Rosemarie Tremblay-LeMay
- Division of Hematopathology and Transfusion Medicine, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Shamini Selvarajah
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Peter Sabatini
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Division of Clinical Laboratory Genetics, University Health Network, Toronto, Ontario, Canada
| | - Phedias Diamandis
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Trevor Pugh
- Translational Genomics Laboratory, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Robert Kridel
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Jan Delabie
- Division of Hematopathology and Transfusion Medicine, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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8
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Wang F, Wang G, Wu W. Lymphocyte nuclei of nodal marginal zone lymphoma mimicking granulocytic morphology with Pelger-Huët-like features. Pathology 2021; 53:929-930. [PMID: 34049716 DOI: 10.1016/j.pathol.2021.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/09/2021] [Accepted: 02/15/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Fei Wang
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Geng Wang
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Wu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
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9
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Follicular lymphoma t(14;18)-negative is genetically a heterogeneous disease. Blood Adv 2021; 4:5652-5665. [PMID: 33211828 DOI: 10.1182/bloodadvances.2020002944] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/05/2020] [Indexed: 12/19/2022] Open
Abstract
Fifty-five cases of t(14;18)- follicular lymphoma (FL) were genetically characterized by targeted sequencing and copy number (CN) arrays. t(14;18)- FL predominated in women (M/F 1:2); patients often presented during early clinical stages (71%), and had excellent prognoses. Overall, t(14;18)- FL displayed CN alterations (CNAs) and gene mutations carried by conventional t(14;18)+ FL (cFL), but with different frequencies. The most frequently mutated gene was STAT6 (57%) followed by CREBBP (49%), TNFRSF14 (39%), and KMT2D (27%). t(14;18)- FL showed significantly more STAT6 mutations and lacked MYD88, NOTCH2, MEF2B, and MAP2K1 mutations compared with cFL, nodal marginal zone lymphoma (NMZL), and pediatric-type FL (PTFL). We identified 2 molecular clusters. Cluster A was characterized by TNFRSF14 mutations/1p36 alterations (96%) and frequent mutations in epigenetic regulators, with recurrent loss of 6q21-24 sharing many features with cFL. Cluster B showed few genetic alterations; however, a subgroup with STAT6 mutations concurrent with CREBBP mutations/16p alterations without TNFRSF14 and EZH2 mutations was noted (65%). These 2 molecular clusters did not distinguish cases by inguinal localization, growth pattern, or presence of STAT6 mutations. BCL6 rearrangements were demonstrated in 10 of 45 (22%) cases and did not cluster together. Cases with predominantly inguinal presentation (20 of 50; 40%) had a higher frequency of diffuse growth pattern, STAT6 mutations, CD23 expression, and a lower number of CNAs, in comparison with noninguinal cases (5.1 vs 9.1 alterations per case; P < .05). STAT6 mutations showed a positive correlation with CD23 expression (P < .001). In summary, t(14;18)- FL is genetically a heterogeneous disorder with features that differ from cFL, NMZL, and PTFL.
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10
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Poveda J, Cassidy DP, Zhou Y, Alderuccio JP, Lossos IS, Vega F, Chapman J. Expression of germinal center cell markers by extranodal marginal zone lymphomas of MALT type within colonized follicles, a diagnostic pitfall with follicular lymphoma. Leuk Lymphoma 2020; 62:1116-1122. [PMID: 33283568 DOI: 10.1080/10428194.2020.1855347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We reviewed 341 consecutive cases of marginal zone lymphoma (MZL) (47) or follicular lymphoma (FL) (294) of which 7 were difficult to distinguish due to perceived coexpression of BCL6 and BCL2 by tumor cells in follicular foci. This stimulated us to develop dual BCL6/BCL2 immunohistochemistry, allowing us to assess coexpression among individual cells. Dual staining confirmed coexpression in 6 of 7 cases, all extranodal MZL (ENMZL) based on overall features and representing 13% of MZL in this series. These findings confirm that MZL cells have plasticity regarding protein expression within the germinal center (GC) microenvironment, an important diagnostic pitfall. Intriguingly, in all MZL expressing BCL6, non-neoplastic GC B cells within colonized follicles showed diminished or absent CD10 expression but preserved BCL6 and high ki67. This finding suggests plasticity of CD10 expression in non-neoplastic GC B cells in the context of colonization by MZL, possibly related to NF-kB dysregulation.
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Affiliation(s)
- Julio Poveda
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Daniel P Cassidy
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Yi Zhou
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Juan Pablo Alderuccio
- Division of Hematology, Department of Medicine, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Izidore S Lossos
- Division of Hematology, Department of Medicine, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Francisco Vega
- Division of Hematopathology, Department of Pathology, MDAnderson Cancer Center, Houston, TX, USA
| | - Jennifer Chapman
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA
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11
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Koh J, Jang I, Choi S, Kim S, Jang I, Ahn HK, Lee C, Paik JH, Kim CW, Lim MS, Kim K, Jeon YK. Discovery of Novel Recurrent Mutations and Clinically Meaningful Subgroups in Nodal Marginal Zone Lymphoma. Cancers (Basel) 2020; 12:cancers12061669. [PMID: 32585984 PMCID: PMC7352856 DOI: 10.3390/cancers12061669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 11/22/2022] Open
Abstract
Nodal marginal zone lymphoma (NMZL) is a rare B-cell neoplasm, the genetic and transcriptomic landscape of which are unclear. Using high-throughput sequencing for whole-exome and transcriptome, we investigated the genetic characteristics of NMZL in a discovery cohort (n = 8) and validated their features in an extended cohort (n = 30). Novel mutations in NFKBIE and ITPR2 were found in 7.9% (3/38) and 13.9% (5/36), respectively, suggesting roles for the NF-κB pathway and B-cell-receptor-mediated calcium signaling pathway in the pathogenesis of NMZL. RNA-seq showed that NMZLs were characterized by an aberrant marginal zone differentiation, associated with an altered IRF4-NOTCH2 axis and the enrichment of various oncogenic pathways. Based on gene expression profile, two subgroups were identified. Compared with subgroup 1, subgroup 2 showed the following: the significant enrichment of cell cycle-associated and MYC-signaling pathways, a more diverse repertoire of upstream regulators, and higher Ki-67 proliferation indices. We designated two subgroups according to Ki-67 labeling, and subgroup 2 was significantly associated with a shorter progression-free survival (p = 0.014), a greater proportion of large cells (p = 0.009), and higher MYC expression (p = 0.026). We suggest that NMZL has unique features and, in this study, we provide information as to the heterogeneity of this enigmatic entity.
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Affiliation(s)
- Jiwon Koh
- Department of Pathology, Seoul National University Hospital, Seoul 03080, Korea; (J.K.); (S.K.); (C.L.); (C.W.K.)
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Insoon Jang
- Division of Clinical Bioinformatics, Biomedical Research Institute, Seoul National University Hospital, Seoul 03080, Korea; (I.J.); (S.C.)
| | - Seongmin Choi
- Division of Clinical Bioinformatics, Biomedical Research Institute, Seoul National University Hospital, Seoul 03080, Korea; (I.J.); (S.C.)
- Seoul National University College of Medicine, Seoul 03080, Korea
| | - Sehui Kim
- Department of Pathology, Seoul National University Hospital, Seoul 03080, Korea; (J.K.); (S.K.); (C.L.); (C.W.K.)
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Ingeon Jang
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Hyun Kyung Ahn
- Cancer Research Institute, Seoul National University, Seoul 03080, Korea;
| | - Cheol Lee
- Department of Pathology, Seoul National University Hospital, Seoul 03080, Korea; (J.K.); (S.K.); (C.L.); (C.W.K.)
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Jin Ho Paik
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam-si 46371, Korea;
| | - Chul Woo Kim
- Department of Pathology, Seoul National University Hospital, Seoul 03080, Korea; (J.K.); (S.K.); (C.L.); (C.W.K.)
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Megan S. Lim
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA;
| | - Kwangsoo Kim
- Division of Clinical Bioinformatics, Biomedical Research Institute, Seoul National University Hospital, Seoul 03080, Korea; (I.J.); (S.C.)
- Correspondence: (K.K.); (Y.K.J.)
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University Hospital, Seoul 03080, Korea; (J.K.); (S.K.); (C.L.); (C.W.K.)
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Korea;
- Cancer Research Institute, Seoul National University, Seoul 03080, Korea;
- Correspondence: (K.K.); (Y.K.J.)
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12
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Burgess HJ, MacDonald Dickinson V, Kerr M, Bienzle D. Marginal zone lymphoma in a dog. Vet Clin Pathol 2020; 49:312-318. [PMID: 32524625 DOI: 10.1111/vcp.12874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 12/20/2022]
Abstract
A 13-year-old spayed female American Cocker Spaniel was presented for evaluation of a cough and weight loss. Physical exam revealed generalized lymphadenopathy. The patient was diagnosed with marginal zone lymphoma (MZL) on histopathology of an extirpated lymph node. This report demonstrates an unusual case of a pleomorphic neoplastic population documented on cytologic evaluation that had moncytoid features and peripheral blood involvement; a previously undocumented IgG1 monoclonal gammopathy was also an interesting feature of this canine MZL. The patient did not undergo chemotherapy for lymphoma and was euthanized over 4 years after the initial presentation.
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Affiliation(s)
- Hilary J Burgess
- Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Valerie MacDonald Dickinson
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Moira Kerr
- Prairie Diagnostic Services Inc., Saskatoon, SK, Canada
| | - Dorothee Bienzle
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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13
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Complexities in the diagnosis of large B-cell lymphomas, classic Hodgkin lymphomas and overlapping peripheral T-cell lymphomas simplified: An evidence-based guide. Ann Diagn Pathol 2020; 46:151534. [PMID: 32473554 DOI: 10.1016/j.anndiagpath.2020.151534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/01/2020] [Indexed: 12/27/2022]
Abstract
The diagnosis of a large B-cell lymphoma and classic Hodgkin lymphoma (CHL) is often straightforward. However, in select circumstances, these simple diagnoses can be quite complex. In part, diagnostic difficulty may be due to uncertainty in the evaluation of morphologic and immunophenotypic features along a biologic continuum, or alternatively arise from uncertainty in predicting the behavior and outcomes of patients. Here, we systematically discuss and review areas of diagnostic difficulty in the diagnosis of large B-cell lymphomas (LBCL), classic Hodgkin lymphomas (CHL) and peripheral T-cell lymphomas (PTCL). We provide careful data-driven analyses and evidence-based approaches to help guide pathologists and clinicians. We discuss: 1) marginal zone lymphomas with increased large cells versus diffuse large B-cell lymphoma (DLBCL), 2) chronic lymphocytic leukemia with expanded proliferation centers versus diffuse large B-cell lymphoma (DLBCL), 3) chronic lymphocytic leukemia with Hodgkin/Reed-Sternberg-like cells versus CHL arising from chronic lymphocytic leukemia, 4) complex cases of follicular lymphoma versus DLBCL, 5) PTCL with large B-cell proliferations versus PTCL with LBCL, 6) PTCL with Hodgkin/Reed-Sternberg-like cells versus CHL, and finally 7) blastoid/pleomorphic mantle cell lymphoma versus DLBCL. Our evidence and data driven approach may serve as a useful diagnostic guide.
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14
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Nakamura S, Ponzoni M. Marginal zone B-cell lymphoma: lessons from Western and Eastern diagnostic approaches. Pathology 2019; 52:15-29. [PMID: 31757436 DOI: 10.1016/j.pathol.2019.08.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/23/2019] [Accepted: 08/28/2019] [Indexed: 02/06/2023]
Abstract
Marginal zone B-cell lymphomas (MZLs) are a group of clinically indolent B-cell lymphomas postulated to derive from memory B lymphocytes in the 'marginal zone' of secondary lymphoid tissue. Today, MZL is recognised as a nosological umbrella term encompassing distinct entities with some shared phenotypic and genotypic features, including extranodal marginal zone B-cell lymphoma (EMZL) or mucosa-associated lymphoid tissue (MALT) lymphoma, splenic MZL, and nodal MZL, accounting for approximately 70%, 20%, and 10% of MZLs, respectively. These lymphomas share some phenotypic and genotypic features and have some variants and related provisional diseases, but are different in regards to their clinical and molecular characteristics. In addition, they are frequently associated with chronic antigenic stimulation represented either by infectious agents, particularly bacteria and viruses, or autoimmune diseases as exemplified by Sjögren syndrome, Hashimoto thyroiditis, and newly recognised IgG4-related disease. Furthermore, several chromosomal translocations have been identified in EMZL. In this review, we will focus on the updated histopathological criteria and the main problems with differential diagnoses in order to aid the diagnostic approach in our routine practice.
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Affiliation(s)
- Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan.
| | - Maurilio Ponzoni
- Pathology and Lymphoid Malignancies Unit, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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15
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Brown A, Sciascia-Visani I, Farrell D, Smith M, Felix C, Mutharajah V, Ruell J, Taylor G. A patient with a diagnosis of nodal marginal zone B-cell lymphoma and a t(2;14)(p24;q32) involving MYCN and IGH. Mol Cytogenet 2019; 12:3. [PMID: 30733831 PMCID: PMC6359751 DOI: 10.1186/s13039-019-0419-3] [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: 09/24/2018] [Accepted: 01/28/2019] [Indexed: 12/22/2022] Open
Abstract
Background Nodal marginal zone B-cell lymphoma is a rare entity in which the cytogenetic findings are not well defined. The t(2;14)(p24;q32) has previously been reported in three patients with blastic mantle cell lymphoma and one patient with follicular lymphoma. This rearrangement has not been reported previously in a patient with a diagnosis of nodal marginal zone B-cell lymphoma. Case presentation We present a male patient who presented with lymphadenopathy. On the basis of his clinicoradiologic presentation, morphological appearances, immunophenotype and molecular findings he was determined to have a diagnosis of nodal marginal zone B-cell lymphoma. Cytogenetic analysis demonstrated a t(2;14)(p24;q32). Further FISH testing showed this rearrangement to involve the MYCN and IGH genes. Conclusions We present the first patient with a diagnosis of nodal marginal zone B-cell lymphoma with a t(2;14)(p24;q32). This rearrangement has been described in three other patients who have had a diagnosis of lymphoma. Our findings suggest this rearrangement is not specific to mantle cell lymphoma or follicular lymphoma. The number of cases described are still too low to draw firm conclusions regarding the nature of this rearrangement. In order to refine the clinical and prognostic picture of this finding, publication of further cases is required.
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Affiliation(s)
- Angela Brown
- 1Genetic Services, Wellington Hospital, Riddiford St, Newtown, Wellington, 6021 New Zealand
| | | | - Dianna Farrell
- 1Genetic Services, Wellington Hospital, Riddiford St, Newtown, Wellington, 6021 New Zealand
| | - Meg Smith
- 1Genetic Services, Wellington Hospital, Riddiford St, Newtown, Wellington, 6021 New Zealand
| | - Clive Felix
- 1Genetic Services, Wellington Hospital, Riddiford St, Newtown, Wellington, 6021 New Zealand
| | - Vanaja Mutharajah
- 2Department of Pathology, Wellington Hospital, Riddiford St, Newtown, Wellington, 6021 New Zealand
| | - Jackie Ruell
- 4Department of Haematology, Wellington Hospital, Riddiford St, Newtown, Wellington, 6021 New Zealand
| | - Graeme Taylor
- Department of Pathology, Nelson Hospital, 115 Kawai St, Nelson South, Nelson, 7010 New Zealand
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16
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Rout ED, Hughes KL, Boostrom BO, Seelig DM, Avery AC, Avery PR. Indolent T-cell-rich small B-cell hepatic lymphoma in a Golden Retriever. Clin Case Rep 2018; 6:1436-1444. [PMID: 30147878 PMCID: PMC6099017 DOI: 10.1002/ccr3.1580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/11/2018] [Accepted: 04/13/2018] [Indexed: 12/19/2022] Open
Abstract
An 11-year-old female spayed Golden Retriever presented for an incidentally found liver mass. The hepatic mass and intra-abdominal lymph nodes had a marked heterogeneous T-cell population and far fewer numbers of small clonal B cells. This T-cell-rich small B-cell lymphoma had a unique histological pattern and indolent clinical course.
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Affiliation(s)
- Emily D. Rout
- Department of Microbiology, Immunology and PathologyColorado State UniversityFort CollinsCOUSA
| | - Kelly L. Hughes
- Department of Microbiology, Immunology and PathologyColorado State UniversityFort CollinsCOUSA
| | | | - Davis M. Seelig
- Department of Veterinary Clinical SciencesUniversity of MinnesotaSt. PaulMNUSA
| | - Anne C. Avery
- Department of Microbiology, Immunology and PathologyColorado State UniversityFort CollinsCOUSA
| | - Paul R. Avery
- Department of Microbiology, Immunology and PathologyColorado State UniversityFort CollinsCOUSA
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17
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Ramos CA. Marginal Zone Lymphomas (Extranodal/Malt, Splenic, and Nodal). Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00079-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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18
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Igawa T, Omote R, Sato H, Taniguchi K, Miyatani K, Yoshino T, Sato Y. A possible new morphological variant of mantle cell lymphoma with plasma-cell type Castleman disease-like features. Pathol Res Pract 2017; 213:1378-1383. [DOI: 10.1016/j.prp.2017.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/06/2017] [Accepted: 09/15/2017] [Indexed: 01/09/2023]
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19
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Pizzi M, Agostinelli C, Righi S, Gazzola A, Mannu C, Galuppini F, Fassan M, Visentin A, Piazza F, Semenzato GC, Rugge M, Sabattini E. Aberrant expression of CD10 and BCL6 in mantle cell lymphoma. Histopathology 2017. [PMID: 28628241 DOI: 10.1111/his.13286] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIMS Mantle cell lymphoma (MCL) is characterized by distinctive histological and molecular features. Aberrant expression of BCL6 and CD10 has been reported occasionally, but the biological features of such cases are largely unknown. This study aimed to define the epidemiological, histological and cytogenetic characteristics of BCL6 and CD10-positive MCLs, also investigating possible biological features. METHODS AND RESULTS A total of 165 cases of cyclin D1 and t(11;14)(q13;q34)-positive MCLs were studied for CD10 and BCL6 immunohistochemical expression, which was documented in 26 of 165 (15.8%) cases (BCL6 17 of 165; CD10 11 of 165; BCL6 and CD10 co-expression two of 165). CD10-positivity was significantly more frequent in females (63.3%; P < 0.01). Either expression correlated significantly with higher mean proliferation index and higher prevalence of MUM1 positivity (P < 0.05). Fluorescence in-situ hybridization (FISH) for BCL6 (3q27) gene derangements was performed on the BCL6- and CD10-positive cases and 98 matched controls: amplifications were documented more frequently in BCL6-positive than -negative cases (50.0% versus 19.4% of cases) (P < 0.05). The mutational status of the variable immunoglobulin heavy chain genes (IGVH) was investigated by Sanger sequencing: five of the six successfully tested cases (83.3%) showed no somatic hypermutations. CONCLUSIONS Aberrant CD10 and BCL6 expression defines a subset of MCLs with higher mean Ki-67 index and higher prevalence of MUM1 expression. BCL6 protein positivity correlates with cytogenetic aberrations involving the BCL6 gene. Although examined successfully in few cases, the high prevalence of unmutated IGVH genes also points at a pregerminal cell origin for these phenotypically aberrant cases.
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Affiliation(s)
- Marco Pizzi
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Claudio Agostinelli
- Haematopathology Unit, Department of Hematology and Oncology/Department of Experimental Diagnostic and Specialty Medicine, Sant'Orsola University Hospital, Bologna, Italy
| | - Simona Righi
- Haematopathology Unit, Department of Hematology and Oncology/Department of Experimental Diagnostic and Specialty Medicine, Sant'Orsola University Hospital, Bologna, Italy
| | - Anna Gazzola
- Haematopathology Unit, Department of Hematology and Oncology/Department of Experimental Diagnostic and Specialty Medicine, Sant'Orsola University Hospital, Bologna, Italy
| | - Claudia Mannu
- Haematopathology Unit, Department of Hematology and Oncology/Department of Experimental Diagnostic and Specialty Medicine, Sant'Orsola University Hospital, Bologna, Italy
| | - Francesca Galuppini
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Matteo Fassan
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Francesco Piazza
- Hematology and Clinical Immunology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Gianpietro C Semenzato
- Hematology and Clinical Immunology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Massimo Rugge
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Elena Sabattini
- Haematopathology Unit, Department of Hematology and Oncology/Department of Experimental Diagnostic and Specialty Medicine, Sant'Orsola University Hospital, Bologna, Italy
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20
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Pathology of nodal marginal zone lymphomas. Best Pract Res Clin Haematol 2017; 30:50-55. [DOI: 10.1016/j.beha.2016.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 11/25/2016] [Indexed: 11/20/2022]
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21
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Abstract
B-cell non-Hodgkin lymphomas with plasmacytic differentiation are a diverse group of entities with extremely variable morphologic features. Diagnostic challenges can arise in differentiating lymphoplasmacytic lymphoma from marginal zone lymphoma and other low-grade B-cell lymphomas. In addition, plasmablastic lymphomas can be difficult to distinguish from diffuse large B-cell lymphoma or other high-grade lymphomas. Judicious use of immunohistochemical studies and molecular testing can assist in appropriate classification.
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MESH Headings
- Diagnosis, Differential
- Humans
- Immunophenotyping
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/immunology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Plasmacytoma/diagnosis
- Plasmacytoma/immunology
- Plasmacytoma/pathology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Prognosis
- Waldenstrom Macroglobulinemia/diagnosis
- Waldenstrom Macroglobulinemia/immunology
- Waldenstrom Macroglobulinemia/pathology
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Affiliation(s)
- Charles M Harmon
- Department of Pathology, University of Michigan Hospitals and Health Systems, 1301 Catherine Street, Ann Arbor, MI 48109, USA
| | - Lauren B Smith
- Department of Pathology, University of Michigan Hospitals and Health Systems, 5320 Medical Science I, 1301 Catherine Street, Ann Arbor, MI 48109-5602, USA.
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22
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Synchronous immunophenotypically and clonally distinct follicular lymphoma and marginal zone lymphoma with massive amyloid deposition. HUMAN PATHOLOGY: CASE REPORTS 2016. [DOI: 10.1016/j.ehpc.2015.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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23
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Starr AG, Caimi PF, Fu P, Massoud MR, Meyerson H, Hsi ED, Mansur DB, Cherian S, Cooper BW, De Lima MJG, Lazarus HM, Gerson SL, Jagadeesh D, Smith MR, Dean RM, Pohlman BL, Hill BT, William BM. Dual institution experience of nodal marginal zone lymphoma reveals excellent long-term outcomes in the rituximab era. Br J Haematol 2016; 175:275-280. [DOI: 10.1111/bjh.14228] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 05/25/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Adam G. Starr
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Paolo F. Caimi
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - PingFu Fu
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Mira R. Massoud
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Howard Meyerson
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Eric D. Hsi
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - David B. Mansur
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Sheen Cherian
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brenda W. Cooper
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Marcos J. G. De Lima
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Hillard M. Lazarus
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Stanton L. Gerson
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Deepa Jagadeesh
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Mitchell R. Smith
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Robert M. Dean
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brad L. Pohlman
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brian T. Hill
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Basem M. William
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
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Laribi K, Tempescul A, Ghnaya H, Denizon N, Besançon A, Anghel A, Farhi J, Truong C, Lemaire P, Poulain S, Bolle D, Ianotto JC, Baugier de Materre A. The bendamustine plus rituximab regimen is active against primary nodal marginal zone B-cell lymphoma. Hematol Oncol 2016; 35:536-541. [PMID: 27443419 DOI: 10.1002/hon.2334] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/21/2016] [Accepted: 06/29/2016] [Indexed: 12/13/2022]
Abstract
Primary nodal marginal zone lymphoma (NMZL) is a rare disease. There is no current consensus on how to treat it. The bendamustine plus rituximab (BR) regimen is effective for the treatment of follicular and other indolent lymphomas, but its efficacy in NMZL is not known. We analyzed the outcome of 14 patients diagnosed with NMZL (median age 67 years) who were treated with 375 mg/m2 of rituximab on day 1 and 90 mg/m2 of bendamustine on days 1 and 2. The overall and complete response rates were 93% and 71%, respectively. Major toxicity (grade 3/4 neutropenia) occurred in 5% of treatment courses. After a median follow-up of 22 months (range: 18-55), the overall survival and the free survival rates were 100% and 93%, respectively. None of the patients showing a complete or partial response developed secondary myelodysplastic syndrome/acute myeloid leukemia. Bendamustine plus rituximab was found to be an active and well-tolerated regimen leading to the rapid control of disease.
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Affiliation(s)
- Kamel Laribi
- Department of Hematology, Centre Hospitalier du Mans, Le Mans, France
| | - Adrien Tempescul
- Department of Hematology, Institut de Cancéro-Hématologie, CHRU Brest, Brest, France
| | - Habib Ghnaya
- Department of Hematology, Centre Hospitalier du Mans, Le Mans, France
| | - Nathalie Denizon
- Department of Hematology, Centre Hospitalier du Mans, Le Mans, France
| | - Anne Besançon
- Department of Hematology, Centre Hospitalier du Mans, Le Mans, France
| | - Andreea Anghel
- Department of Hematology, Centre Hospitalier du Mans, Le Mans, France
| | - Jonathan Farhi
- Department of Hematology, Centre Hospitalier du Mans, Le Mans, France
| | - Catherine Truong
- Clinical Research Center, Centre Hospitalier du Mans, Le Mans, France
| | - Pierre Lemaire
- Laboratory of Biology and Hematology, Centre Hospitalier du Mans, Le Mans, France
| | - Stephanie Poulain
- Service d'Hématologie-Immunologie-Cytogénétique, Centre Hospitalier de Valenciennes, Valenciennes, France.,Laboratoire d'Hématologie, Centre de Biologie et Pathologie, CHRU de Lille, Lille, France.,INSERM UMR 1172, IRCL, Lille, France
| | - Delphine Bolle
- Department of Pharmacy, Centre Hospitalier du Mans, Le Mans, France
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Barzenje DA, Holte H, Fosså A, Ghanima W, Liestøl K, Delabie J, Kolstad A. Long-term outcome for patients with early stage marginal zone lymphoma and mantle cell lymphoma. Leuk Lymphoma 2016; 58:623-632. [PMID: 27389974 DOI: 10.1080/10428194.2016.1204653] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In this study with prolonged follow up, we compared clinical outcome, including cause of death and incidence of second cancer, for patients with early stage extranodal marginal zone lymphoma (EMZL, 49 patients), nodal marginal zone lymphoma (NMZL, nine patients) and mantle cell lymphoma (MCL, 42 patients) with emphasis on potential benefit of radiotherapy. Radiotherapy was given to 40 patients with EMZL (nine had surgery only) and all NMZL patients. MCL patients received radiotherapy (17 patients), chemotherapy followed by radiotherapy (13 patients) or chemotherapy alone (12 patients). Compared to a matched control population no increased risk of second cancer or cardiovascular disease was observed. Radiotherapy alone was effective in EMZL and NMZL with low-relapse rates (20% and 33%) and a 10-year overall survival of 78% and 56%, respectively. High-relapse rate and inferior OS in MCL underline the need for extended staging with endoscopy and PET/CT and possibly for novel strategies.
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Affiliation(s)
| | - Harald Holte
- b Department of Oncology , Oslo University Hospital , Oslo , Norway
| | - Alexander Fosså
- b Department of Oncology , Oslo University Hospital , Oslo , Norway
| | - Waleed Ghanima
- c Department of Medicine , Ostfold Hospital Trust , Kalnes , Norway
| | - Knut Liestøl
- d Department of Biostatistics , Oslo University Hospital , Oslo , Norway.,e Center for Cancer Biomedicine, University of Oslo , Oslo , Norway
| | - Jan Delabie
- f Department of Pathology , Oslo University Hospital , Oslo , Norway
| | - Arne Kolstad
- b Department of Oncology , Oslo University Hospital , Oslo , Norway
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Abstract
The non-Hodgkin lymphomas (NHLs) are a heterogeneous family of lymphoid malignancies that are among the most common neoplasms of both dogs and humans. Owing to shared molecular, signaling, incidence, and pathologic features, there is a strong framework supporting the utilization of canine lymphoma as a comparative, large animal model of human NHL. In alignment with the biologic similarities, the current approach towards the diagnosis and classification of canine lymphoma is based upon the human World Health Organization guidelines. While this approach has contributed to an increasing appreciation of the potential biological scope of canine lymphoma, it has also become apparent that the most appropriate diagnostic philosophy must be multimodal, namely by requiring knowledge of microscopic, immunophenotypic, and clinical features before establishing a final disease diagnosis. This review seeks to illustrate the comparative similarities and differences in the diagnosis of canine lymphoma through the presentation of the microscopic and immunophenotypic features of its most common forms.
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Affiliation(s)
- Davis M. Seelig
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55455, USA
- Correspondence: ; Tel.: +1-612-626-0471
| | - Anne C. Avery
- Department of Microbiology, Immunology, and Pathology and the Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA; (A.C.A.); (E.J.E.)
| | - E. J. Ehrhart
- Department of Microbiology, Immunology, and Pathology and the Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA; (A.C.A.); (E.J.E.)
| | - Michael A. Linden
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA;
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Igawa T, Hayashi T, Ishiguro K, Maruyama Y, Takeuchi M, Takata K, Yoshino T, Sato Y. IgG4-producing lymphoma arising in a patient with IgG4-related disease. Med Mol Morphol 2016; 49:243-249. [PMID: 27068526 DOI: 10.1007/s00795-016-0139-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 03/31/2016] [Indexed: 12/24/2022]
Abstract
We herein report a case in which an IgG4-producing lymphoma arose in a patient with a previous diagnosis consistent with an IgG4-related disease. A 43-year-old man presented with enlarged cervical lymph nodes and was treated with steroids and radiation for what was initially assumed to be Kimura's disease, although the lesions were later histologically re-diagnosed as IgG4-related lymphadenopathy. Fourteen years later, when the patient was 58-years-old, he presented with retroperitoneal fibrosis and swollen lymph nodes. The suspicious lesions were not histologically examined as the patient did not give consent. However, the serum IgG4 concentration was high (1400 mg/dL) and he was clinically diagnosed with systemic IgG4-related disease. Although steroid administration reduced the size of the lesions, tapering the dose finally resulted in systemic, prominently enlarged lymph nodes. Analysis of the biopsy specimen revealed that these multiple lymph node lesions were marginal zone B cell lymphomas that themselves expressed IgG4. Complete remission was achieved after a total of six courses of chemotherapy including rituximab. This case suggests that the infiltrating IgG4-expressing cells observed in IgG4-related disease can clonally expand to malignant lymphomas.
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Affiliation(s)
- Takuro Igawa
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshiaki Hayashi
- Department of Gastroenterology, Rheumatology, and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kazuya Ishiguro
- Department of Gastroenterology, Rheumatology, and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yumiko Maruyama
- Department of Gastroenterology, Rheumatology, and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mai Takeuchi
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Katsuyoshi Takata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuharu Sato
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
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28
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Optimizing therapy for nodal marginal zone lymphoma. Blood 2016; 127:2064-71. [PMID: 26989202 DOI: 10.1182/blood-2015-12-624296] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 01/27/2016] [Indexed: 12/20/2022] Open
Abstract
Nodal marginal zone lymphoma (NMZL) is a rare form of indolent small B-cell lymphoma which has only been clearly identified in the last 2 decades and which to date remains incurable. Progress in therapeutic management has been slow, largely due to the very small number of patients treated and the heterogeneity of treatments administered; thus, standard-of-care treatment is currently nonspecific for this lymphoma entity. In this review, treatments routinely used to manage adult NMZL patients are presented, principally based on immunochemotherapy (when treatment is needed). Biological research behind the key axes of agents currently under development is described; development of novel agents is heavily based on data from gene profiling and genome-wide sequencing research, uncovering a number of critical deregulated pathways specific to NMZL tumors. These include B-cell receptor, JAK/STAT, NF-κB, NOTCH, and Toll-like receptor signaling pathways, as well as intracellular processes such as the cell cycle, chromatin remodeling, and transcriptional regulation in terms of epigenetic modifiers, histones, or transcriptional co-repressors, along with immune escape via T-cell-mediated tumor surveillance. These pathways are examined in detail and a projection of how the field may evolve in the near future for an efficient personalized treatment approach for NMZL patients is presented.
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Laribi K, Ghnaya H, Mention PJ, Rousset H, Baugier de Materre A, Pineau-Vincent F, Truong C, Bolle D. Quadri-lineage disease involving nodal B-cell marginal zone lymphoma, high-grade B-cell lymphoma, Kaposi's syndrome, and acute myeloid leukemia. Clin Case Rep 2016; 4:39-42. [PMID: 26783433 PMCID: PMC4706404 DOI: 10.1002/ccr3.393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 06/30/2015] [Accepted: 08/11/2015] [Indexed: 11/12/2022] Open
Abstract
A patient with a marginal zone lymphoma received RCHOP and obtained PR. He received RDHAP, autograft, and obtained CR. Three months later, he developed Kaposi's sarcoma with spontaneous regression. Two months later, he developed DLBCL treated with R‐MIV with CR. Thereafter, he developed AML and died a few days later.
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Affiliation(s)
- Kamel Laribi
- Department of Hematology Centre Hospitalier Le Mans France
| | - Habib Ghnaya
- Department of Hematology Centre Hospitalier Le Mans France
| | | | - Hoel Rousset
- Department of Hematology Centre Hospitalier Le Mans France
| | | | | | | | - Delphine Bolle
- Department of pharmacy Centre Hospitalier Le Mans France
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Jelic TM, Huang TWE, Brenholz P, Estallila OC, Khalid AA, Juranovic T, Kuenstner TJ. Nodal Marginal Zone Large B-Cell Lymphoma with Burkitt Translocation and Complex Chromosomal Changes Associated with Overexpression of BCL2, MYC, and BCL6. J Clin Exp Hematop 2016; 55:175-80. [PMID: 26763367 DOI: 10.3960/jslrt.55.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
We report the first case of a nodal marginal zone large B-cell lymphoma and the first with MYC rearrangement. This high proliferation rate lymphoma (40% of cells) occurred in the bilateral cervical, axillary, and para-aortic lymph nodes of an 82 year old woman. It involved extensively her bone marrow, and was lethal. Malignant B-cells were CD10 negative, harbored Burkitt translocation, and multiple chromosomal changes including trisomies of chromosomes 3 and 18, and three copies of 8q with an intact q24 cytoband (in addition to MYC rearrangement), associated with overexpression of BCL6, BCL2, and MYC respectively. We suggest that in aggressive nodular marginal zone lymphomas (clinical picture or high proliferation rate of lymphoma cells), fluorescence in situ hybridization analysis for MYC rearrangement, with break-apart probe, and for MYC/IGH translocation, in addition to chromosome analysis, should be performed. MYC rearrangement associated with a more rapid progression of the neoplasia, might warrant a more aggressive treatment.
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Affiliation(s)
- Tomislav M Jelic
- Department of Pathology and Laboratory Medicine, Memorial Hospital CAMC
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31
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van den Brand M, van der Velden WJFM, Diets IJ, Ector GICG, de Haan AFJ, Stevens WBC, Hebeda KM, Groenen PJTA, van Krieken HJM. Clinical features of patients with nodal marginal zone lymphoma compared to follicular lymphoma: similar presentation, but differences in prognostic factors and rate of transformation. Leuk Lymphoma 2015; 57:1649-56. [DOI: 10.3109/10428194.2015.1106535] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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A subset of low-grade B cell lymphomas with a follicular growth pattern but without a BCL2 translocation shows features suggestive of nodal marginal zone lymphoma. J Hematop 2015; 9:3-8. [PMID: 26949422 PMCID: PMC4764621 DOI: 10.1007/s12308-015-0259-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 08/17/2015] [Indexed: 02/06/2023] Open
Abstract
In our consultation practice, it was noted that many cases that were considered to represent follicular lymphoma (FL) without a BCL2 translocation were ultimately classified as nodal marginal zone lymphoma (NMZL). This study set out to define recurrent morphological features of these cases. Thirty-three low-grade B cell lymphomas without a BCL2 rearrangement were studied for recurrent morphological features. These features were then applied on 20 randomly selected cases to verify if these criteria are able to distinguish between lymphomas with and without a BCL2 rearrangement, assigning them to one of five categories ranging from "certain FL" to "certain NMZL." Highly recurrent morphological features were noted in the lymphomas without a BCL2 rearrangement, which were strongly overlapping with the morphological features of NMZL. All six cases that were assigned to the category of certainly FL or most likely FL indeed harbored a BCL2 rearrangement, whereas all 12 cases assigned to the category of most likely NMZL or certain NMZL had no BCL2 break. Of the two cases in the ambiguous category, one had received a final diagnosis of FL and the other of NMZL. This study raises the hypothesis that a subset of low-grade B cell lymphomas with a follicular growth pattern but without a BCL2 translocation actually represents NMZL. This is at present difficult to prove, because no gold standard is available to differentiate between NMZL and FL without a BCL2 rearrangement, so further investigations are needed.
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33
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van den Brand M, Mathijssen JJM, Garcia-Garcia M, Hebeda KM, Groenen PJTA, Falini B, Serrano S, van Krieken JHJM. Immunohistochemical differentiation between follicular lymphoma and nodal marginal zone lymphoma--combined performance of multiple markers. Haematologica 2015; 100:e358-60. [PMID: 26069292 DOI: 10.3324/haematol.2014.120956] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Michiel van den Brand
- Department of Pathology, Radboud university medical center, Nijmegen, the Netherlands
| | | | - Mar Garcia-Garcia
- Department of Pathology, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Spain
| | - Konnie M Hebeda
- Department of Pathology, Radboud university medical center, Nijmegen, the Netherlands
| | | | - Brunangelo Falini
- Institute of Hematology, University of Perugia, Ospedale S. Maria della Misericordia, Italy
| | - Sergio Serrano
- Department of Pathology, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Spain
| | - J Han J M van Krieken
- Department of Pathology, Radboud university medical center, Nijmegen, the Netherlands
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Sakata S, Tsuyama N, Takeuchi K. Pathology of indolent B-cell neoplasms other than follicular lymphoma. J Clin Exp Hematop 2015; 54:11-22. [PMID: 24942942 DOI: 10.3960/jslrt.54.11] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Indolent B-cell lymphomas include follicular lymphoma (FL), chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and marginal zone lymphomas (MZLs). They are a diverse group of disorders with different clinical, morphological, immunophenotypic and genetic features. However, because of several histological similarities, such as in cell size and nodular structure, it may sometimes be difficult to differentiate them and to make a definitive diagnosis. In this review article, we summarize the histopathology of indolent B-cell neoplasms excluding FL and including hairy cell leukemia, and briefly mention recent genetic findings useful for their differential diagnosis. In addition, a provisional subtype of low-grade B-cell lymphoma, "prolymphocytic/paraimmunoblastic lymphoma", is described.
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Affiliation(s)
- Seiji Sakata
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research
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Abstract
Marginal zone lymphomas (MZL) represent around 8 % of all non-Hodgkin lymphomas. During the last decades a number of studies have addressed the mechanisms underlying the disease development. Extranodal MZL lymphoma usually arises in mucosal sites where lymphocytes are not normally present from a background of either autoimmune processes, such as Hashimoto thyroiditis or Sjögren syndrome or chronic infectious conditions. In the context of a persistent antigenic stimulation, successive genetic abnormalities can progressively hit a B-cell clone among the reactive B-cells of the chronic inflammatory tissue and give rise to a MALT lymphoma. The best evidence of an etiopathogenetic link is available for the association between Helicobacter pylori-positive gastritis and gastric MALT lymphoma. Indeed, a successful eradication of this micro-organism with antibiotics can be followed by gastric MALT lymphoma regression in more than 2/3 of cases. Other microbial agents have been implicated in the pathogenesis of MZL arising in the skin (Borrelia burgdorferi), in the ocular adnexa (Chlamydophila psittaci), and in the small intestine (Campylobacter jejuni). The prevalence of hepatitis C virus (HCV) has also been reported higher in MZL patients (particularly of the splenic type) than in the control population, suggesting a possible causative role of the virus. In non-gastric MALT lymphoma and in splenic MZL the role of the antimicrobial therapy is, however, less clear. This review summarizes the recent advances in Marginal Zone Lymphomas, addressing the critical points in their diagnosis, staging and clinical management.
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36
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Seo SW, Lee SH, Lee DJ, Kim KM, Kang JK, Kim DW, Lee JH. Colonic mucosa-associated lymphoid tissue lymphoma identified by chromoendoscopy. World J Gastroenterol 2014; 20:18487-18494. [PMID: 25561821 PMCID: PMC4277991 DOI: 10.3748/wjg.v20.i48.18487] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 08/18/2014] [Accepted: 10/15/2014] [Indexed: 02/06/2023] Open
Abstract
Colonic mucosa-associated lymphoid tissue (MALT) lymphomas are a rare occurrence and the definitive treatment has not been established. Solitary or multiple, elevated or polypoid lesions are the usual appearances of MALT lymphoma in the large intestine and sometimes the surface may reveal abnormal vascularity. Herein, we report a case of MALT lymphoma and review the relevant literature. Upon colonoscopy, a suspected pathologic lesion was observed in the proximal transverse colon. The lesion could be distinguished more prominently after using narrow-band imaging mode and indigo carmine-dye spraying chromoendoscopy. Histopathologic examination of this biopsy specimen revealed lymphoepithelial lesions with diffuse proliferation of atypical lymphoid cells effacing the glandular architecture and centrocyte-like cells infiltrating the lamina propria. Immunohistochemical analyses showed that tumor cells were positive for CD20 and Bcl-2e, and negative for CD10, CD23, and Bcl-6. According to Ann-Arbor staging system, the patient had stage IIE. A partial colectomy with dissection of the paracolic lymph nodes was performed. Until now, there is no recurrence of lymphoma at follow-up.
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Gebauer N, Thorns C, Bernard V, Senft A, Schillert A, Merz H, Feller AC, Bernd HW. MicroRNA profiling of low-grade and transformed nodal marginal zone lymphoma reveals a similar signature pattern distinct from diffuse large B cell lymphoma. Acta Haematol 2014; 133:214-20. [PMID: 25376122 DOI: 10.1159/000363096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 04/21/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS As critical post-transcriptional regulators of gene expression, microRNAs are involved in several cellular processes of vital impact including cell growth and apoptosis. Many hematologic malignancies exhibit distinct microRNA signatures. MicroRNA implication in the pathogenesis of nodal marginal zone lymphoma (NMZL), however, remains widely elusive. METHODS Comprehensive morphologic, immunophenotypic and cytogenetic studies were carried out on a cohort of NMZL (n = 30) incorporating indolent as well as transformed MZL. In addition, microRNA signatures were generated, employing a quantitative real-time polymerase chain reaction approach. These were then compared to signatures from cases of diffuse large B cell lymphoma (DLBCL) alongside reactive lymph node controls. RESULTS While microRNA signatures of low-grade and transformed NMZL did not differ significantly, several microRNAs were differentially expressed between transformed NMZL and DLBCL, hinting at molecularly distinct mechanisms of lymphomagenesis and indicating the biological disparity of transformed NMZL from DLBCL. CONCLUSION In the light of the unresolved issue regarding the classification of marginal zone-derived transformed B-cell neoplasms, microRNAs may be a valuable aid in discriminating NMZL from DLBCL.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Female
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Humans
- Lymph Nodes/metabolism
- Lymph Nodes/pathology
- Lymphoma, B-Cell, Marginal Zone/metabolism
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- MicroRNAs/biosynthesis
- Middle Aged
- RNA, Neoplasm/biosynthesis
- Retrospective Studies
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Affiliation(s)
- Niklas Gebauer
- Department of Pathology, Reference Centre for Lymph Node Pathology and Hematopathology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
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van den Brand M, van Krieken JHJM. Recognizing nodal marginal zone lymphoma: recent advances and pitfalls. A systematic review. Haematologica 2014; 98:1003-13. [PMID: 23813646 DOI: 10.3324/haematol.2012.083386] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The diagnosis of nodal marginal zone lymphoma is one of the remaining problem areas in hematopathology. Because no established positive markers exist for this lymphoma, it is frequently a diagnosis of exclusion, making distinction from other low-grade B-cell lymphomas difficult or even impossible. This systematic review summarizes and discusses the current knowledge on nodal marginal zone lymphoma, including clinical features, epidemiology and etiology, histology, and cytogenetic and molecular features. In particular, recent advances in diagnostics and pathogenesis are discussed. New immunohistochemical markers have become available that could be used as positive markers for nodal marginal zone lymphoma. These markers could be used to ensure more homogeneous study groups in future research. Also, recent gene expression studies and studies describing specific gene mutations have provided clues to the pathogenesis of nodal marginal zone lymphoma, suggesting deregulation of the nuclear factor kappa B pathway. Nevertheless, nodal marginal zone lymphoma remains an enigmatic entity, requiring further study to define its pathogenesis to allow an accurate diagnosis and tailored treatment. However, recent data indicate that it is not related to splenic or extranodal lymphoma, and that it is also not related to lymphoplasmacytic lymphoma. Thus, even though the diagnosis is not always easy, it is clearly a separate entity.
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Affiliation(s)
- Michiel van den Brand
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
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39
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Zinzani PL, Pellegrini C, Broccoli A, Gandolfi L, Stefoni V, Casadei B, Maglie R, Argnani L, Pileri S. Fludarabine-Mitoxantrone-Rituximab regimen in untreated indolent non-follicular non-Hodgkin's lymphoma: experience on 143 patients. Hematol Oncol 2014; 33:141-6. [DOI: 10.1002/hon.2151] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 06/04/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Pier Luigi Zinzani
- Institute of Hematology ‘L. e A. Seràgnoli’; University of Bologna; Bologna Italy
| | - Cinzia Pellegrini
- Institute of Hematology ‘L. e A. Seràgnoli’; University of Bologna; Bologna Italy
| | - Alessandro Broccoli
- Institute of Hematology ‘L. e A. Seràgnoli’; University of Bologna; Bologna Italy
| | - Letizia Gandolfi
- Institute of Hematology ‘L. e A. Seràgnoli’; University of Bologna; Bologna Italy
| | - Vittorio Stefoni
- Institute of Hematology ‘L. e A. Seràgnoli’; University of Bologna; Bologna Italy
| | - Beatrice Casadei
- Institute of Hematology ‘L. e A. Seràgnoli’; University of Bologna; Bologna Italy
| | - Roberto Maglie
- Institute of Hematology ‘L. e A. Seràgnoli’; University of Bologna; Bologna Italy
| | - Lisa Argnani
- Institute of Hematology ‘L. e A. Seràgnoli’; University of Bologna; Bologna Italy
| | - Stefano Pileri
- Institute of Hematology ‘L. e A. Seràgnoli’; University of Bologna; Bologna Italy
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40
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Angelopoulou MK, Kalpadakis C, Pangalis GA, Kyrtsonis MC, Vassilakopoulos TP. Nodal marginal zone lymphoma. Leuk Lymphoma 2013; 55:1240-50. [DOI: 10.3109/10428194.2013.840888] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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41
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Jaso JM, Yin CC, Wang SA, Miranda RN, Jabcuga CE, Chen L, Medeiros LJ. Clinicopathologic features of CD5-positive nodal marginal zone lymphoma. Am J Clin Pathol 2013; 140:693-700. [PMID: 24124149 DOI: 10.1309/ajcpemvxes72duif] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To describe the clinicopathologic findings of seven patients with CD5-positive nodal marginal zone lymphoma (NMZL). METHODS We searched cases of NMZL over a 10-year interval and identified seven cases of CD5-positive NMZL. The clinical, histologic, and immunophenotypic findings of this group were reviewed, and the frequency of dissemination in this group was compared with that of 66 patients with CD5-negative NMZL. RESULTS Other than CD5 expression, the histologic and immunophenotypic findings were typical of NMZL. Six (86%) of seven patients had lymphadenopathy above and below the diaphragm, and all six patients assessed had bone marrow involvement. In the CD5-negative group, 28 (42%) patients had lymphadenopathy above and below the diaphragm, and 36 (55%) had bone marrow involvement (P = .045 and P = .037, respectively). Six of seven patients were alive at last follow-up, with a median follow-up of 32 months (3-154 months). CONCLUSIONS CD5 expression in NMZL correlates with a higher frequency of dissemination, but patients have an indolent clinical course and excellent overall survival.
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Affiliation(s)
- Jesse Manuel Jaso
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
- Department of Pathology, The University of Texas Medical School at Houston
| | - C. Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Sa A. Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Roberto N. Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | | | - Lei Chen
- Department of Pathology, The University of Texas Medical School at Houston
| | - L. Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
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Traverse-Glehen A, Bachy E, Baseggio L, Callet-Bauchu E, Gazzo S, Verney A, Hayette S, Jallades L, Ffrench M, Salles G, Coiffier B, Felman P, Berger F. Immunoarchitectural patterns in splenic marginal zone lymphoma: correlations with chromosomal aberrations,IGHVmutations, and survival. A study of 76 cases. Histopathology 2013; 62:876-93. [DOI: 10.1111/his.12092] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 12/19/2012] [Indexed: 12/11/2022]
Affiliation(s)
| | | | | | | | | | - Aurélie Verney
- UMR CNRS 5239 Equipe ‘Pathologie des Cellules Lymphoides’; Pierre Bénite; France
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43
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Dreyling M, Thieblemont C, Gallamini A, Arcaini L, Campo E, Hermine O, Kluin-Nelemans JC, Ladetto M, Le Gouill S, Iannitto E, Pileri S, Rodriguez J, Schmitz N, Wotherspoon A, Zinzani P, Zucca E. ESMO Consensus conferences: guidelines on malignant lymphoma. part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma. Ann Oncol 2013; 24:857-77. [PMID: 23425945 DOI: 10.1093/annonc/mds643] [Citation(s) in RCA: 223] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
To complement the existing treatment guidelines for all tumour types, ESMO organizes consensus conferences to focus on specific issues in each type of tumour. In this setting, a consensus conference on the management of lymphoma was held on 18 June 2011 in Lugano, next to the 11th International Conference on Malignant Lymphoma. The conference convened ∼30 experts from all around Europe, and selected six lymphoma entities to be addressed; for each of them, three to five open questions were to be addressed by the experts. For each question, a recommendation should be given by the panel, referring to the strength of the recommendation based on the level of evidence. This consensus report focuses on the three less common lymphoproliferative malignancies: marginal zone lymphoma, mantle cell lymphoma, and peripheral T-cell lymphomas. A first report had focused on diffuse large B-cell lymphoma, follicular lymphoma, and chronic lymphocytic leukaemia.
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Affiliation(s)
- M Dreyling
- Department of Medicine III, University Hospital, LMU Munich, Germany.
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Abstract
The small B-cell neoplasms represent some of the most frequently encountered lymphoproliferative disorders in routine surgical pathology practice. This report reviews the current diagnostic criteria for classifying small B-cell neoplasms and distinguishing them from newly recognized precursor conditions that do not appear to represent overt lymphomas. Newly available immunohistochemical stains and molecular studies that may assist in the diagnosis and classification of these neoplasms are also discussed.
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Affiliation(s)
- James R Cook
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA.
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45
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Tabata R, Tabata C, Nagai T, Yasumizu R, Kojima M. Nodal marginal zone B cell lymphoma with prominent follicular colonization with deletion of chromosome 13. Pathol Res Pract 2012; 208:679-82. [PMID: 22963839 DOI: 10.1016/j.prp.2012.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 07/23/2012] [Accepted: 07/24/2012] [Indexed: 11/25/2022]
Abstract
Nodal marginal zone B cell lymphoma is a rare type of malignant lymphoma and appears to be heterogeneous. Here we report a 60-year-old woman with stage I splenic type of nodal marginal zone B cell lymphoma with prominent follicular colonization. She was treated only by radiation therapy, and remained free of disease on examination for 4 years. The lymph node cells showed an abnormal chromosome of deletion 13, although neither bone marrow cells nor peripheral blood cells demonstrated the same abnormal chromosome. This type of chromosomal abnormality has not been previously reported and may be related to good prognosis in the present case.
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Affiliation(s)
- Rie Tabata
- Department of Internal Medicine, Hyogo Prefectural Tsukaguchi Hospital, Hyogo, Japan.
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46
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Stary S, Vinatzer U, Müllauer L, Raderer M, Birner P, Streubel B. t(11;14)(q23;q32) involving IGH and DDX6 in nodal marginal zone lymphoma. Genes Chromosomes Cancer 2012; 52:33-43. [PMID: 22965301 DOI: 10.1002/gcc.22004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 08/06/2012] [Indexed: 11/09/2022] Open
Abstract
Nodal marginal zone lymphoma (NMZL) is a primary nodal B-cell lymphoma that shares morphological and immunophenotypic characteristics with extranodal and splenic marginal zone lymphoma. Data on altered genes and signaling pathways are scarce in this rare tumor entity. To gain further insights into the genetic background of NMZL, seven cases were investigated by microarray analysis, G-banding, and FISH. Chromosomal imbalances were observed in 3/7 cases (43%) with gains of chromosome arms 1q, 8q, and 12q being the most frequent findings. Furthermore, we identified a translocation t(11;14)(q23;q32) involving IGH and DDX6. Chromosomal walking, expression analysis, siRNA-mediated gene knockdown and a yeast two hybrid screen were performed for further characterization of the translocation in vitro. In siRNA experiments, DDX6 appeared not to be involved in NF-κB activation as frequently observed for genes promoting lymphomagenesis but was found to interfere with the expression of BCL6 and BCL2 in an NF-κB independent manner. In conclusion, we identified several unbalanced aberrations and a t(11;14) involving IGH and DDX6 providing evidence for a contribution of DDX6 to lymphomagenesis by deregulation of BCL6 in NMZL.
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Affiliation(s)
- Susanne Stary
- Department of Pathology, Medical University of Vienna, Vienna, Austria
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Abstract
PURPOSE OF REVIEW Non-MALT marginal zone lymphoma regroups two subtypes of lymphoma, the splenic marginal zone lymphoma (SMZL) and the nodal marginal zone lymphoma (NMZL). Although they share a common cell of origin from the 'marginal zone', they display different clinical characteristics, reflecting probable biological variations according to the organ. RECENT FINDINGS Within the past decade, new data regarding pathogenic mechanisms as well as therapeutic advances have been reported. SUMMARY SMZL and NMZL often present with disseminated disease at diagnosis, with specific clinical presentation, SMZL with predominant enlarged splenomegaly and NMZL with disseminated nodal involvement. Diagnosis may be difficult among the small B-cell lymphomas and criteria for diagnosis have been recently improved. The therapeutic approaches comprise splenectomy for SMZL, and immunochemotherapy for both of SMZL and NMZL, but with no consensus about the best treatment, except when associated with hepatitis C virus. This review addresses the current knowledge on the biological findings, clinical features and therapeutic approaches for the individual SMZLs and NMZLs.
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Molina TJ, Lin P, Swerdlow SH, Cook JR. Marginal zone lymphomas with plasmacytic differentiation and related disorders. Am J Clin Pathol 2011; 136:211-25. [PMID: 21757594 DOI: 10.1309/ajcp63ogxhxcsksc] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Marginal zone lymphomas of all types (nodal, splenic, and extranodal mucosa-associated lymphoid tissue [MALT]) may show plasmacytic differentiation. Distinguishing marginal zone lymphomas from other small B-cell lymphomas with plasmacytic differentiation, especially lymphoplasmacytic lymphoma, or from plasma cell neoplasms may be challenging. Marginal zone lymphomas with plasmacytic differentiation were discussed in 2 sessions of the 2009 Society for Hematopathology/European Association for Haematopathology Workshop. Session 4 focused on nodal marginal zone lymphomas, including cases exhibiting classic features and cases displaying atypical phenotypes. The difficulties of classification of cases with increased numbers of large cells were also discussed. Session 5 examined nonnodal marginal zone lymphomas and related entities, including splenic marginal zone lymphoma, MALT lymphoma, γ heavy chain disease, and cryoglobulin-associated lymphoproliferative disorders. These cases illustrate the importance of clinical data and, in some cases, phenotypic and cytogenetic findings in appropriately applying the 2008 World Health Organization criteria.
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Kaur P. Nodal Marginal Zone Lymphoma With Increased Large Cells: Myth Versus Entity. Arch Pathol Lab Med 2011; 135:964-6. [DOI: 10.5858/2010-0741-ler] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Prabhjot Kaur
- Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756
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50
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Kojima M, Nakamura N, Nakazato Y, Igarashi T, Masawa N, Inagaki H. Light-chain-restricted monocytoid B-cell cluster in reactive lymphadenitis associated with Sjögren syndrome. Leuk Lymphoma 2011; 52:1150-2. [PMID: 21417825 DOI: 10.3109/10428194.2011.562574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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