1
|
Xu J, Li P, Chai J, Yu K, Xu T, Zhao D, Liu Y, Wang Y, Wang K, Ma J, Fan L, Yan Q, Guo S, Xiao H, Ao Q, Wang Z, Liu W, Zhao S, Yin W, Huang Y, Li Y, He M, Liang R, Li M, Wang Z. The clinicopathological and molecular features of sinusoidal large B-cell lymphoma. Mod Pathol 2021; 34:922-933. [PMID: 32973328 DOI: 10.1038/s41379-020-00685-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 11/09/2022]
Abstract
We report 17 cases of sinusoidal large B-cell lymphoma (SLBCL). Clinical, morphologic, immunophenotypic, and molecular features were detected and analyzed. All cases showed an obvious sinusoidal growth pattern, usually associated with residual atrophic lymphoid tissue. All tumors contained large pleomorphic lymphoid cells and one or more prominent nucleoli, with abundant amphophilic cytoplasms; 15/17 cases showed anaplastic morphologic features. The patient age ranged from 43 to 80 years (median 57 years), and 7 males and 10 females were included. Eleven of 15 (73.3%) patients had Ann Arbor stage III or IV disease, and 10/15 (66.6%) patients had an International Prognostic Index (IPI) score ≥3. Immunophenotypically, 16/17 (94.1%) cases displayed a nongerminal center B-cell (non-GCB) immunophenotype. Furthermore, 16/17 (94.1%) cases were positive for CD30, and p53 was expressed in 10/16 (62.5%) cases. In total, 12/14 (85.7%) cases expressed BCL2 and MYC simultaneously (double expression), and 11/14 (78.6%) cases showed PD-L1 positivity (6/11 had a PD-L1 tumor proportion score ≥50%). Cytogenetically, concurrent MYC and BCL2 and/or BCL6 abnormalities (break-apart or extra copy) were detected in 10/15 cases, and 7/13 (53.8%) cases harbored a PD-L1/L2 amplification. TP53 mutation was found in 7/13 (53.8%) cases by Sanger sequencing. Whole-exome and large-panel sequencing results revealed high mutation frequencies of TP53 (4/7), MYD88 (3/7), KMT2D (3/7), CREBBP (3/7), and PIM1 (3/7). Among the 13 patients with SLBCL treated with aggressive chemotherapy regimens, the median overall survival (OS) was 18 months, and the 2-year OS rate was 34.6%. The OS of patients with SLBCL was markedly worse than that of 35 control group patients with common diffuse large B-cell lymphoma (DLBCL) without sinusoidal features (P < 0.001). SLBCL may represent a specific type of DLBCL that has characteristic pathologic features. The cancer is aggressive in most clinical cases, and outcomes are poor. SLBCL and anaplastic DLBCL (A-DLBCL) have many overlapping clinicopathological and molecular features.
Collapse
Affiliation(s)
- Junpeng Xu
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Peifeng Li
- Department of Pathology, The 960th Hospital of PLA, Jinan, 250000, China
| | - Jia Chai
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Kangjie Yu
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Tianqi Xu
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Danhui Zhao
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Yixiong Liu
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Yingmei Wang
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Kaijing Wang
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Jing Ma
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Linni Fan
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Qingguo Yan
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Shuangping Guo
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Hualiang Xiao
- Department of Pathology, Daping Hospital, Army Military Medical University, Chongqing, 400042, China
| | - Qilin Ao
- Department of Pathology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Zhaoming Wang
- Department of Pathology, The First Affiliated Hospital of Zhejiang University, Zhejiang University, Hangzhou, 310000, China
| | - Weiping Liu
- Department of Pathology, West China Center of Medical Sciences, Sichuan University, Chengdu, 610000, China
| | - Sha Zhao
- Department of Pathology, West China Center of Medical Sciences, Sichuan University, Chengdu, 610000, China
| | - Weihua Yin
- Department of Pathology, Peking University Shenzhen Hospital, Peking University, Shenzhen, 518000, China
| | - Yuhua Huang
- Department of Pathology, Sun Yat-sen University Cancer Center, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Yaqin Li
- Department of Pathology, Shanxi Bethune Hospital, Taiyuan, 030000, China
| | - Miaoxia He
- Department of Pathology, Changhai Hospital, Naval Military Medical University, Shanghai, 200000, China
| | - Rong Liang
- Department of Hematology, People's Liberation Army Centre for Hematologic Disorders, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China.
| | - Mingyang Li
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China.
| | - Zhe Wang
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China.
| |
Collapse
|
2
|
Megahed NA, Kohno K, Sakakibara A, Eladl AE, Elsayed AA, Wu CC, Suzuki Y, Takahara T, Kato S, Nakamura S, Satou A, Asano N. Anaplastic variant of diffuse large B-cell lymphoma: Reappraisal as a nodal disease with sinusoidal involvement. Pathol Int 2020; 69:697-705. [PMID: 31872533 DOI: 10.1111/pin.12871] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/22/2019] [Indexed: 02/06/2023]
Abstract
Anaplastic variant (av) of diffuse large B-cell lymphoma (DLBCL) is morphologically defined in the 2017 World Health Organization classification, but still an enigmatic disease in its clinicopathologic distinctiveness, posing the differential diagnostic problem from gray zone lymphoma (GZL) and classic Hodgkin lymphoma (cHL). Thirty-one cases previously diagnosed as avDLBCL were reassessed. Of these, 27 (87%) and 4 (13%) were node-based and extranodal diseases, respectively. They were further reclassified into nodal avDLBCL (n = 18), nodal CD30+ DLBCL with T-cell/histiocyte-rich large B-cell lymphoma-like features (CD30+ DLBCL-THRLBCL) (n = 6), GZL with features intermediate between DLBCL and cHL (n = 3) and CD30+ extranodal DLBCL, NOS (n = 4). The nodal avDLBCL cases had a sheet-like proliferation of large cells and/or Hodgkin/Reed-Sternberg (HRS)-like cells in 12 (67%) notably with a sinusoidal pattern in 16 (89%). They showed an expression of CD20 and/or CD79a in all and CD30 in 15 of 18. All of them were negative for PD-L1 on tumor cells, although HRS-like cells showed negativity or partial loss of other B-cell markers to varying degrees. The present study highlighted the distinctiveness of the nodal avDLBCL with sinusoidal pattern, but without neoplastic PD-L1 expression, which provide refined diagnostic criteria for a more precise pathologic and clinical characterization of this disease.
Collapse
Affiliation(s)
- Nirmeen A Megahed
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan.,Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Kei Kohno
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan
| | - Ayako Sakakibara
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan
| | - Ahmed E Eladl
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan.,Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed A Elsayed
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan.,Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Chun-Chieh Wu
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan.,Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yuka Suzuki
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan
| | - Taishi Takahara
- Department of Surgical Pathology, Aichi Medical University Hospital, Aichi, Japan
| | - Seiichi Kato
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Aichi, Japan
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Aichi, Japan
| | - Akira Satou
- Department of Surgical Pathology, Aichi Medical University Hospital, Aichi, Japan
| | - Naoko Asano
- Department of Clinical Laboratory, Nagano Prefectural Suzaka Hospital, Nagano, Japan
| |
Collapse
|
4
|
Su P, Jug R, Liu X, Wang E. An Epstein-Barr virus-positive classical Hodgkin lymphoma with exclusive sinusoidal growth pattern: An unusual morphologic variant. Pathol Res Pract 2017; 213:710-712. [PMID: 28552534 DOI: 10.1016/j.prp.2017.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 02/24/2017] [Accepted: 02/24/2017] [Indexed: 10/20/2022]
Abstract
Classical Hodgkin lymphoma (cHL) typically involves lymph node parenchyma, and a case with Hodgkin cells confined within nodal sinusoids is extremely rare. Herein we report a case of cHL with a sinusoidal growth pattern. This 15-year old patient presented with B symptoms and was found to have bilateral cervical lymphadenopathy and an anterior mediastinal mass. Biopsy of a cervical lymph node demonstrated cohesive clusters of Reed-Sternberg (RS)-like cells suggestive of sinusoidal growth with an extrasinusoidal mixed inflammatory cell infiltrate characteristic of the microenvironment seen in cHL. The RS cells/variants were positive for CD30 and CD15, and showed down-regulation of B-cell program and CD45, an immunophenotypic profile consistent with cHL. The sinusoidal growth pattern was also highlighted by EBV staining. To the best of our knowledge, this is the first case of EBV-positive cHL that displays a sinusoidal growth pattern. The patient was treated with children's high risk cHL chemotherapy protocol and responded well.
Collapse
Affiliation(s)
- Pu Su
- Department of Medicine, East Hospital affiliated to Tongji University School of Medicine, Shanghai, People's Republic of China; Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Rachel Jug
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Xin Liu
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Endi Wang
- Department of Pathology, Duke University Medical Center, Durham, NC, USA.
| |
Collapse
|