1
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Ben Jomaa S, Chebbi E, Ben Hammouda S, Bel Haj M, Bouzid O, Haj Salem N. A case of suspected primary mediastinal large B-cell lymphoma: An uncommon cause of sudden death. Leg Med (Tokyo) 2023; 64:102299. [PMID: 37531821 DOI: 10.1016/j.legalmed.2023.102299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/06/2023] [Accepted: 07/21/2023] [Indexed: 08/04/2023]
Abstract
Primary mediastinal large B-cell lymphoma (PMLBCL) is an aggressive tumor originating from thymic B-cells. Clinically, it presents with general signs such as cough, chest pain and dyspnea. Although these symptoms are not specific, they are severe enough to reveal the disease. We report an autopsy case of a 25-year-old man, with a recent past history of cough and dyspnea, for which he consulted twice the emergency department and no diagnosis was made. He presented to the Emergency Unit, with a sudden onset of a dyspnea followed by a loss of consciousness. He was shortly declared dead after, a medico-legal autopsy was requested. On external examination, no traumatic lesions on the body were found, an important cyanosis of the face and ears, was, however, found. On autopsy, a mediastinal mass was found, measuring 19 cm × 25 cm and weighing 600 g, extending to the infra-hyoid region and to the thoracic cage and infiltrating the pericardium. Trachea had a necrotic mucosa with a partially obstructive lymph node mass. The diagnosis of a primary mediastinal large B-cell lymphoma was suspected based on pathological and immunohistochemical findings. The cause of death was finally attributed to respiratory failure due to this tumor.
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Affiliation(s)
- Sami Ben Jomaa
- Department of Forensic Medicine, Teaching Hospital Fattouma Bourguiba of Monastir, 5000, Tunisia.
| | - Elaa Chebbi
- Department of Forensic Medicine, Teaching Hospital Fattouma Bourguiba of Monastir, 5000, Tunisia.
| | - Seifeddine Ben Hammouda
- Department of Pathology, University Hospital of Fattouma Bourguiba of Monastir, 5000, Tunisia.
| | - Mariem Bel Haj
- Department of Forensic Medicine, Teaching Hospital Fattouma Bourguiba of Monastir, 5000, Tunisia.
| | - Oumeima Bouzid
- Department of Forensic Medicine, Teaching Hospital Fattouma Bourguiba of Monastir, 5000, Tunisia.
| | - Nidhal Haj Salem
- Department of Forensic Medicine, Teaching Hospital Fattouma Bourguiba of Monastir, 5000, Tunisia.
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2
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Zhou H, Liu Q, Lu S, Zou L. Primary mediastinal/thymic diffuse large B-cell lymphoma: a population-based study on incidence and survival. Ann Hematol 2023:10.1007/s00277-023-05225-2. [PMID: 37074378 DOI: 10.1007/s00277-023-05225-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/10/2023] [Indexed: 04/20/2023]
Abstract
Primary mediastinal large B-cell lymphoma is a rare subtype of lymphoma. The contemporary incidence of primary mediastinal large B-cell lymphoma remains unknown, and a large population-based study has not been reported. It is essential to provide guidance for further strategies in reducing the disease burden via population-based preventive initiatives. This study aims to explore the epidemiology and effect of therapeutic advances on the survival of patients with primary mediastinal large B-cell lymphoma. This population-based study was conducted using the Surveillance, Epidemiology, and End Results Program (SEER), covering the period from 1975 to 2018. A total of 774 patients in the SEER 9 and 1654 patients in the SEER 18 were analyzed. The age-adjusted incidence rate of primary mediastinal large B-cell lymphoma increased from 0.05/1,000,000 in 1975 to 2.38/1,000,000 in 2018. A significant positive linear increase in the incidence trend was found in primary mediastinal large B-cell lymphoma, with an annual percent change of 8.47% (95% confidence interval 7.7-9.2%, P < 0.001, z test). The survival in primary mediastinal large B-cell lymphoma was significantly superior to nodal diffuse large B-cell lymphoma. The incidence of PMBCL increases over the year. The survival of patients with primary mediastinal large B-cell lymphoma has improved over time.
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Affiliation(s)
- Huijie Zhou
- Division of Medical Oncology, Cancer Center and State Key Laboratory of Biotherapy, Sichuan University West China Hospital, Chengdu, China
| | - Qiuluo Liu
- Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Siyan Lu
- Department of Radiology, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, Sichuan, China
| | - Liqun Zou
- Division of Medical Oncology, Cancer Center and State Key Laboratory of Biotherapy, Sichuan University West China Hospital, Chengdu, China.
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3
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Martig DS, Fromm JR. A comparison and review of the flow cytometric findings in classic Hodgkin lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, T cell/histiocyte rich large B cell lymphoma, and primary mediastinal large B cell lymphoma. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2022; 102:14-25. [PMID: 34878224 DOI: 10.1002/cyto.b.22045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 06/13/2023]
Abstract
The "Hodgkin-like" lymphomas including classic Hodgkin lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, T cell/histiocyte rich large B cell lymphoma, and primary mediastinal large B cell lymphoma have been shown to be pathobiologically related. With the exception of primary mediastinal large B cell lymphoma, these lymphomas have similar morphologic growth patterns with occasional neoplastic cells within a prominent reactive cell background. Historically, distinguishing these entities was difficult by flow cytometry; however, over the past 15 years, our laboratory has developed antibody-fluorochrome combinations capable of accurately distinguishing these entities by their immunoprofile. Additionally, an algorithmic approach based on characterization of the background reactive B-cell and T-cell populations can aid in narrowing the differential diagnosis. This review summarizes both the morphologic and immunophenotypic features and the current flow cytometric insights of the neoplastic and reactive populations found in this unique subset of lymphomas.
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Affiliation(s)
- Daniel S Martig
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Jonathan R Fromm
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
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4
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Hishamnuri WNAD, Nakagun S, Maezawa M, Sakaguchi K, Akiyama N, Watanabe KI, Horiuchi N, Kobayashi Y, Inokuma H. Disseminated thymic B-cell lymphoma in a Holstein heifer. J Vet Diagn Invest 2019; 31:852-855. [PMID: 31551023 DOI: 10.1177/1040638719875501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 19-mo-old Holstein heifer was inactive and dyspneic. Physical examination revealed wheezing, exophthalmos, a cervical mass, and lymphadenopathy. Cytology of the cervical mass and lymph nodes showed predominantly large atypical lymphocytes. Lactate dehydrogenase and thymidine kinase activities were elevated. Although nested PCR for bovine leukemia virus (BLV) using blood was positive, quantitative PCR showed a low number of provirus copies. Autopsy revealed enlargement of most lymph nodes examined, as well as white masses of various sizes in muscles of the left hindlimb and thoracic and abdominal organs. Histopathology revealed severe infiltration with neoplastic lymphocytes in these organs. The cervical mass was immune-positive for B-cell markers. The final diagnosis was thymic B-cell lymphoma with BLV infection.
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Affiliation(s)
- Wan N A D Hishamnuri
- Central Region Veterinary Laboratory, Department of Veterinary Service, Selangor, Malaysia (Hishamunuri).,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan (Hishamunuri, Nakagun, Maezawa, Sakaguchi, Akiyama, Watanabe, Horiuchi, Kobayashi, Inokuma).,United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan (Nakagun, Maezawa, Horiuchi, Kobayashi, Inokuma)
| | - Shotaro Nakagun
- Central Region Veterinary Laboratory, Department of Veterinary Service, Selangor, Malaysia (Hishamunuri).,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan (Hishamunuri, Nakagun, Maezawa, Sakaguchi, Akiyama, Watanabe, Horiuchi, Kobayashi, Inokuma).,United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan (Nakagun, Maezawa, Horiuchi, Kobayashi, Inokuma)
| | - Masaki Maezawa
- Central Region Veterinary Laboratory, Department of Veterinary Service, Selangor, Malaysia (Hishamunuri).,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan (Hishamunuri, Nakagun, Maezawa, Sakaguchi, Akiyama, Watanabe, Horiuchi, Kobayashi, Inokuma).,United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan (Nakagun, Maezawa, Horiuchi, Kobayashi, Inokuma)
| | - Kana Sakaguchi
- Central Region Veterinary Laboratory, Department of Veterinary Service, Selangor, Malaysia (Hishamunuri).,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan (Hishamunuri, Nakagun, Maezawa, Sakaguchi, Akiyama, Watanabe, Horiuchi, Kobayashi, Inokuma).,United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan (Nakagun, Maezawa, Horiuchi, Kobayashi, Inokuma)
| | - Nao Akiyama
- Central Region Veterinary Laboratory, Department of Veterinary Service, Selangor, Malaysia (Hishamunuri).,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan (Hishamunuri, Nakagun, Maezawa, Sakaguchi, Akiyama, Watanabe, Horiuchi, Kobayashi, Inokuma).,United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan (Nakagun, Maezawa, Horiuchi, Kobayashi, Inokuma)
| | - Ken-Ichi Watanabe
- Central Region Veterinary Laboratory, Department of Veterinary Service, Selangor, Malaysia (Hishamunuri).,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan (Hishamunuri, Nakagun, Maezawa, Sakaguchi, Akiyama, Watanabe, Horiuchi, Kobayashi, Inokuma).,United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan (Nakagun, Maezawa, Horiuchi, Kobayashi, Inokuma)
| | - Noriyuki Horiuchi
- Central Region Veterinary Laboratory, Department of Veterinary Service, Selangor, Malaysia (Hishamunuri).,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan (Hishamunuri, Nakagun, Maezawa, Sakaguchi, Akiyama, Watanabe, Horiuchi, Kobayashi, Inokuma).,United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan (Nakagun, Maezawa, Horiuchi, Kobayashi, Inokuma)
| | - Yoshiyasu Kobayashi
- Central Region Veterinary Laboratory, Department of Veterinary Service, Selangor, Malaysia (Hishamunuri).,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan (Hishamunuri, Nakagun, Maezawa, Sakaguchi, Akiyama, Watanabe, Horiuchi, Kobayashi, Inokuma).,United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan (Nakagun, Maezawa, Horiuchi, Kobayashi, Inokuma)
| | - Hisashi Inokuma
- Central Region Veterinary Laboratory, Department of Veterinary Service, Selangor, Malaysia (Hishamunuri).,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan (Hishamunuri, Nakagun, Maezawa, Sakaguchi, Akiyama, Watanabe, Horiuchi, Kobayashi, Inokuma).,United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan (Nakagun, Maezawa, Horiuchi, Kobayashi, Inokuma)
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5
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Cabanillas F, Shah B. Advances in Diagnosis and Management of Diffuse Large B-cell Lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2017; 17:783-796. [PMID: 29126866 DOI: 10.1016/j.clml.2017.10.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 10/23/2017] [Indexed: 12/16/2022]
Abstract
The management of diffuse large B-cell lymphoma (DLBCL) has been gradually evolving since the discovery of its 2 major forms, the germinal center B-like (GCB) and activated B-cell (ABC) types. Although the reference standard for the identification of these cell types is considered gene expression profiling (GEP), currently the only method commercially available is immunohistochemistry (IHC). The application of various IHC-based algorithms and their correlation with GEP and clinical outcome are discussed. Because of the adverse prognostic implications of the non-GCB type and its potential effects on treatment selection, the recently revised World Health Organization classification has included these biologic cell types. The management of double hit lymphomas, which almost exclusively fall under the GCB category, is discussed, together with the double expresser phenotype, which is usually grouped under the non-GCB type. The role of lenalidomide and ibrutinib in the management of the non-GCB type is examined. We also discuss the front-line management of primary mediastinal large cell lymphoma using the EPOCH (etoposide, prednisolone, Oncovin [vincristine], cyclophosphamide, hydroxydaunorubicin [doxorubicin]) regimen and examine new salvage data on immune checkpoint inhibitors for this clinical subtype. The prognosis, clinical features, and management of de novo CD5+ DLBCL are discussed, and newer and promising developments in the management of primary central nervous system lymphomas are presented in detail. The most popular salvage regimens and the application of high-dose chemotherapy with stem cell transplantation are assessed in detail. Finally, data on new treatment tactics such as CART (chimeric antigen receptor T-cell) cells and promising new drugs, including blinatumomab and venetoclax, are presented.
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Affiliation(s)
- Fernando Cabanillas
- Auxilio Mutuo Cancer Center, San Juan, Puerto Rico; Hematology-Oncology Section, University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Department of Lymphoma-Myeloma, MD Anderson Cancer Center, Houston, TX; Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
| | - Bijal Shah
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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6
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Cherian S, Fromm JR. Evaluation of primary mediastinal large B cell lymphoma by flow cytometry. CYTOMETRY PART B-CLINICAL CYTOMETRY 2017; 94:459-467. [DOI: 10.1002/cyto.b.21544] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 06/17/2017] [Accepted: 07/18/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Sindhu Cherian
- Department of Laboratory Medicine; University of Washington; Seattle Washington
| | - Jonathan R. Fromm
- Department of Laboratory Medicine; University of Washington; Seattle Washington
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7
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Sturgis CD, Monaco SE, Sakr H, Pantanowitz L. Cytologic perspectives on neoteric B-cell lymphoproliferative disorders. Diagn Cytopathol 2017; 45:1005-1019. [PMID: 28594112 DOI: 10.1002/dc.23766] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/09/2017] [Accepted: 05/17/2017] [Indexed: 12/16/2022]
Abstract
The 2008 World Health Organization (WHO) classification of hematopoietic and lymphoid tissues has been recently revised, and publication of the updated 2016 version is expected soon. Given that cytopathologists are often involved in the diagnosis of primary, recurrent, and transformed lymphoproliferative disorders, knowledge of updates to the WHO lymphoma classification, including terminology, pathogenesis, ancillary techniques, and targeted therapies is necessary. Herein, we reference the last decade of cytology specific literature for seven newer B-cell disorders and provide illustrative examples of each entity from our files.
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Affiliation(s)
| | - Sara E Monaco
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA
| | - Hany Sakr
- Department of Pathology, Cleveland Clinic, Cleveland, OH
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8
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Pianko MJ, Liu Y, Bagchi S, Lesokhin AM. Immune checkpoint blockade for hematologic malignancies: a review. Stem Cell Investig 2017; 4:32. [PMID: 28529947 PMCID: PMC5420526 DOI: 10.21037/sci.2017.03.04] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 03/08/2017] [Indexed: 12/26/2022]
Abstract
Immune checkpoint blockade has revolutionized the treatment of cancer, with impressive responses seen in a broad variety of tumor types. Blockade of immune checkpoints and immune signaling antibodies has shown promise in multiple types of hematologic malignancies (HMs), with dramatic single agent responses for pembrolizumab and nivolumab in Hodgkin lymphoma (HL). In this review, we outline the current state of immune checkpoint blockade drug development in HMs, and discuss mechanisms of activity and resistance, and highlight potential targets in the immune tumor microenvironment (TME). Blockade of T-cell checkpoint molecules PD-1/PD-L1 and CTLA-4 are the most clinically mature of the immune checkpoint strategies. Novel and upcoming strategies for immune checkpoint blockade drug development in HMs using innovative combinations to modulate immunologic targets shows significant promise as a way to expand the number of patients with blood cancers who could benefit from immunotherapy.
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Affiliation(s)
- Matthew J. Pianko
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yuzhou Liu
- Department of Medicine, Mount Sinai St. Luke’s and Mount Sinai West, New York, NY, USA
| | - Srishti Bagchi
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexander M. Lesokhin
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Immunotherapeutics Core, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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9
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Menter T, Bodmer-Haecki A, Dirnhofer S, Tzankov A. Evaluation of the diagnostic and prognostic value of PDL1 expression in Hodgkin and B-cell lymphomas. Hum Pathol 2016; 54:17-24. [DOI: 10.1016/j.humpath.2016.03.005] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/23/2016] [Accepted: 03/01/2016] [Indexed: 12/20/2022]
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10
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Shimada M, Fukuda M, Horio K, Suyama T, Kitazaki T, Hashiguchi K, Fukuda M, Shigematsu K, Nakamura Y, Honda T, Ashizawa K, Mukae H. Primary Mediastinal Large B-cell Lymphoma Exhibiting Endobronchial Involvement. Intern Med 2016; 55:3147-3150. [PMID: 27803409 PMCID: PMC5140864 DOI: 10.2169/internalmedicine.55.7117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Primary mediastinal large B-cell lymphoma (PMLBCL) is one of the subtypes of diffuse large B-cell lymphoma. We experienced a rare case of PMLBCL that exhibited endobronchial involvement. A 33-year-old Japanese female with the chief complaints of epigastralgia, back pain, and nausea visited a primary care hospital. Computed tomography of the chest and abdomen demonstrated a bulky mass in the left anterior mediastinum, multiple pulmonary nodules, axillary lymph node swelling, and a pancreatic tumor. Fiberoptic bronchoscopy showed a white-tinged irregularly shaped endobronchial tumor accompanied by capillary vessel dilation in the left upper lobar bronchus. Taken together, these findings resulted in a diagnosis of PMLBCL.
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Affiliation(s)
- Midori Shimada
- Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Hospital, Japan
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11
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Abstract
Abstract
The diffuse aggressive large B-cell lymphomas are a heterogeneous group of B-cell malignancies. Although many are readily recognized due to characteristic clinical and pathologic features, several problematic areas still exist in diagnosis of these lymphomas due to a variety of reasons that include imprecise or difficult-to-apply diagnostic criteria, gaps in our understanding of lymphoma biology, and limitations in technologies available in the clinical laboratory compared to the research laboratory. This may result in some degree of confusion in the pathology report, particularly if the issues are not clearly explained, leading to frustration or misinterpretation on the part of the reader. In this review, I will discuss the pathologic features of a subset of the WHO 2008 classification diffuse aggressive large B-cell lymphomas, focusing on areas in which difficulties exist in diagnosis and/or biomarker marker assessment. A deeper understanding of the issues and areas of uncertainty due to limitations in our knowledge about the biology of these diseases should lead to better communication between pathologists and clinicians.
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12
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[Pathology of the mediastinum. Case 1. Primary mediastinal large B-cell lymphoma]. Ann Pathol 2015; 35:211-7. [PMID: 26004308 DOI: 10.1016/j.annpat.2015.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 03/16/2015] [Indexed: 11/22/2022]
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13
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Li KD, Miles R, Tripp SR, Glenn MJ, Perkins SL, Salama M. Clinicopathologic evaluation of MYC expression in primary mediastinal (thymic) large B-cell lymphoma. Am J Clin Pathol 2015; 143:598-604. [PMID: 25780014 DOI: 10.1309/ajcpkug0uqo0hmdj] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES Based on previous molecular studies, a small fraction of primary mediastinal (thymic) large B-cell lymphoma (PMBL) demonstrates MYC alterations. However, no studies have evaluated MYC protein expression by immunohistochemistry (IHC) with follow-up fluorescence in situ hybridization (FISH) analysis. We aim to evaluate the clinicopathologic importance of MYC IHC expression in PMBL. METHODS Three pathologists independently evaluated MYC IHC expression in 32 cases of PMBL for percent tumor positivity and nuclear intensity. FISH analysis for MYC rearrangement was performed on cases with high MYC IHC expression. Clinical data including treatment, follow-up, and outcome were also reviewed in a subset of cases. RESULTS Variable MYC protein expression by IHC was detected in 30 (94%) of 32 cases of PMBL. One-third of the positive cases (10/30) showed high MYC IHC expression of at least 30% nuclear positivity. FISH analyses for MYC rearrangement on these 10 cases were negative. Review of clinical data on a subset of cases with high and low MYC IHC expression showed no differences in clinical outcome. CONCLUSIONS MYC protein expression by IHC is present in most PMBLs. Increased MYC protein expression can be seen in one-third of the cases; however, it does not correlate with genetic abnormalities by FISH. There is also no significant impact of MYC protein expression on clinical outcomes.
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Affiliation(s)
- K. David Li
- Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT
| | - Rodney Miles
- Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT
| | - Sheryl R. Tripp
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT
| | | | - Sherrie L. Perkins
- Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT
| | - Mohamed Salama
- Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT
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14
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Genomic rearrangements involving programmed death ligands are recurrent in primary mediastinal large B-cell lymphoma. Blood 2014; 123:2062-5. [PMID: 24497532 DOI: 10.1182/blood-2013-10-535443] [Citation(s) in RCA: 226] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The pathogenesis of primary mediastinal large B-cell lymphoma (PMBCL) is incompletely understood. Recently, specific genotypic and phenotypic features have been linked to tumor cell immune escape mechanisms in PMBCL. We studied 571 B-cell lymphomas with a focus on PMBCL. Using fluorescence in situ hybridization here, we report that the programmed death ligand (PDL) locus (9p24.1) is frequently and specifically rearranged in PMBCL (20%) as compared with diffuse large B-cell lymphoma, follicular lymphoma, and Hodgkin lymphoma. Rearrangement was significantly correlated with overexpression of PDL transcripts. Utilizing high-throughput sequencing techniques, we characterized novel translocations and chimeric fusion transcripts involving PDLs at base-pair resolution. Our data suggest that recurrent genomic rearrangement events underlie an immune privilege phenotype in a subset of B-cell lymphomas.
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15
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A Rare Case of Primary Thymic Hodgkin Lymphoma in an Elderly Patient Detected by 18F-FDG PET/CT. Clin Nucl Med 2013; 38:e236-8. [DOI: 10.1097/rlu.0b013e318252e01b] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Cogen A, Bries G, Verbeke S, Van Schil P. Unclassifiable B-cell lymphoma occurring after necrotizing pneumonia. Eur J Cardiothorac Surg 2012; 43:e89-91. [PMID: 23220936 DOI: 10.1093/ejcts/ezs611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report a case of CD20+ grey zone lymphoma (GZL) with Reed Sternberg cells as an unexpected pathological diagnosis of a destroyed right lower lobe after necrotizing pneumonia. These GZLs show overlapping features of classical Hodgkin's lymphoma and diffuse large B-cell lymphoma. GZLs are a rare specific entity of lymphomas, and the aetiology is unknown. The diagnosis is confirmed by pathological, immunohistochemical and molecular analyses. The optimal treatment is unknown. The prognosis of these patients is poor.
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Affiliation(s)
- Anouschka Cogen
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem (Antwerp), Belgium
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17
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Zeballos C, Moraca RJ, Bailey SH, Magovern GJ. Temporary Mechanical Circulatory Support for Takotsubo Cardiomyopathy Secondary to Primary Mediastinal B-Cell Lymphoma. J Card Surg 2012; 27:119-21. [DOI: 10.1111/j.1540-8191.2011.01391.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Gualberto A. Brentuximab Vedotin (SGN-35), an antibody–drug conjugate for the treatment of CD30-positive malignancies. Expert Opin Investig Drugs 2011; 21:205-16. [DOI: 10.1517/13543784.2011.641532] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
Abstract
PIM serine/threonine kinases are overexpressed, translocated, or amplified in multiple B-cell lymphoma types. We have explored the frequency and relevance of PIM expression in different B-cell lymphoma types and investigated whether PIM inhibition could be a rational therapeutic approach. Increased expression of PIM2 was detected in subsets of mantle cell lymphoma, diffuse large B-cell lymphoma (DLBLC), follicular lymphoma, marginal zone lymphoma-mucosa–associated lymphoid tissue type, chronic lymphocytic leukemia, and nodal marginal zone lymphoma cases. Increased PIM2 protein expression was associated with an aggressive clinical course in activated B-like-DLBCL patients. Pharmacologic and genetic inhibition of PIM2 revealed p4E-BP1(Thr37/46) and p4E-BP1(Ser65) as molecular biomarkers characteristic of PIM2 activity and indicated the involvement of PIM2 kinase in regulating mammalian target of rapamycin complex 1. The simultaneous genetic inhibition of all 3 PIM kinases induced changes in apoptosis and cell cycle. In conclusion, we show that PIM2 kinase inhibition is a rational approach in DLBCL treatment, identify appropriate biomarkers for pharmacodynamic studies, and provide a new marker for patient stratification.
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