Primary splenic low-grade follicular lymphoma presenting with leukaemia and large cell transformation in the marrow

Jhuang, Jie-Yang; Hsieh, Yu‐Chia; Kuo, Chun-Chi; Su, Ying-Jhen; Chuang, Shih‐Sung

doi:10.1016/j.pathol.2017.04.010

Cited by 2 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11 Although transformation of low-grade lymphoma to large B-cell lymphoma is not pathologically defined in the context of bone marrow biopsy, the finding of discrepant morphology (ie, sheets of large cells in bone marrow versus small cells in tissue biopsy) has been reported. 12 Hence, the distinction of concordant versus discordant marrow infiltration by DLBCL is considered possible by histology alone. 13,14 This evaluation is based largely on the finding of either mostly large, noncleaved cells versus mostly small, mature-appearing lymphoma cells.…”

Section: Chronic Lymphocytic Leukemiamentioning

confidence: 99%

Histopathologic and Machine Deep Learning Criteria to Predict Lymphoma Transformation in Bone Marrow Biopsies

Irshaid¹,

Bleiberg

Weinberger

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

Context.— Large-cell transformation (LCT) of indolent B-cell lymphomas, such as follicular lymphoma (FL) and chronic lymphocytic leukemia (CLL), signals a worse prognosis, at which point aggressive chemotherapy is initiated. Although LCT is relatively straightforward to diagnose in lymph nodes, a marrow biopsy is often obtained first given its ease of procedure, low cost, and low morbidity. However, consensus criteria for LCT in bone marrow have not been established. Objective.— To study the accuracy and reproducibility of a trained convolutional neural network in identifying LCT, in light of promising machine learning tools that may introduce greater objectivity to morphologic analysis. Design.— We retrospectively identified patients who had a diagnosis of FL or CLL who had undergone bone marrow biopsy for the clinical question of LCT. We scored morphologic criteria and correlated results with clinical disease progression. In addition, whole slide scans were annotated into patches to train convolutional neural networks to discriminate between small and large tumor cells and to predict the patient's probability of transformation. Results.— Using morphologic examination, the proportion of large lymphoma cells (≥10% in FL and ≥30% in CLL), chromatin pattern, distinct nucleoli, and proliferation index were significantly correlated with LCT in FL and CLL. Compared to pathologist-derived estimates, machine generated quantification demonstrated better reproducibility and stronger correlation with final outcome data. Conclusions.— These histologic findings may serve as indications of LCT in bone marrow biopsies. The pathologist—augmented with machine system appeared to be the most predictive, arguing for greater efforts to validate and implement these tools to further enhance physician practice.

show abstract

Section: Chronic Lymphocytic Leukemiamentioning

confidence: 99%

Histopathologic and Machine Deep Learning Criteria to Predict Lymphoma Transformation in Bone Marrow Biopsies

Irshaid¹,

Bleiberg

Weinberger

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

show abstract

“…The incidence of PSFL is unknown and may be overestimated because the vast majority of FL in the spleen represent secondary disease. In general, PSFL accounts for a small fraction of PSL and only a few case series are available on this entity [ 17 , 18 , 19 ].…”

Section: Epidemiologymentioning

confidence: 99%

Low-Grade Primary Splenic CD10-Positive Small B-Cell Lymphoma/Follicular Lymphoma

et al. 2021

View full text Add to dashboard Cite

Primary splenic lymphoma (PSL) is a rare malignancy representing about 1% of all lymphoproliferative disorders, when using a strict definition that allows only involvement of spleen and hilar lymph nodes. In contrast, secondary low-grade B-cell lymphomas in the spleen, such as follicular lymphomas (FL), lymphoplasmacytic lymphoma and chronic lymphocytic leukemia/ small lymphocytic lymphoma, particularly as part of advanced stage disease, are more common. Indolent B cell lymphomas expressing CD10 almost always represent FL, which in its primary splenic form is the focus of this review. Primary splenic follicular lymphoma (PSFL) is exceedingly infrequent. This type of lymphoproliferative disorder is understudied and, in most cases, clinically characterized by splenomegaly or cytopenias related to hypersplenism. The diagnosis requires correlation of histopathology of spleen, blood and/or bone marrow with the correct immunophenotype (determined by flow cytometry and/or immunohistochemistry) and if necessary, additional molecular profiling. Management of this incurable disease is evolving, and splenectomy remains the mainstream treatment for stage I PSFL.

show abstract

Primary splenic low-grade follicular lymphoma presenting with leukaemia and large cell transformation in the marrow

Cited by 2 publications

References 11 publications

Histopathologic and Machine Deep Learning Criteria to Predict Lymphoma Transformation in Bone Marrow Biopsies

Histopathologic and Machine Deep Learning Criteria to Predict Lymphoma Transformation in Bone Marrow Biopsies

Low-Grade Primary Splenic CD10-Positive Small B-Cell Lymphoma/Follicular Lymphoma

Contact Info

Product

Resources

About