Differences in germinal centre and non-germinal center phenotype in gastric and intestinal diffuse large B-cell lymphomas

Mitchell, Kisha A.; Finn, William G.; Owens, Scott

doi:10.1080/10428190802238552

Cited by 18 publications

(20 citation statements)

References 29 publications

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“…Hans et al reported that a combination of CD10, BCL6 and MUM1 expression could subdivide DLBCL patients into long- and short-term survivors [8]. However, contradictory results have been reported on the prognostic role of the Hans classifier [9], [10], [35]. Although non-GCB subgroup was correlated with inferior 5-year OS and PFS in BLBCL, when stratified by treatment non-GCB was only correlated inferior 5-year PFS in the CHOP cohort.…”

Section: Discussionmentioning

confidence: 99%

MYC Expression in Concert with BCL2 and BCL6 Expression Predicts Outcome in Chinese Patients with Diffuse Large B-Cell Lymphoma, Not Otherwise Specified

et al. 2014

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Recent studies provide convincing evidence that a combined immunohistochemical or fluorescence in situ hybridization (FISH) score of MYC, BCL2, BCL6 proteins and MYC translocations predicted outcome in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). However, by far, all these researches are based on Western populations. Therefore, we investigate the prognostic relevance of MYC-, BCL2- and BCL6-rearrangements and protein expression by immunohistochemistry and FISH from 336 de novo DLBCL, NOS treated with CHOP or R-CHOP. Breaks in MYC and BCL6, and fusion in IGH/BCL2 were detected in 9.7%, 20.0%, and 11.1% of the cases, respectively, and were not significantly associated with clinical outcomes. Protein overexpression of MYC (≥40%), BCL2 (≥70%) and BCL6 (≥50%) was encountered in 51%, 51% and 36% of the tumors, respectively. On the basis of MYC, BCL2 and BCL6 expression, double-hit scores (DHSs) and triple-hit score (THS) were assigned to all patients with DLBCL. Patients with high MYC/BCL2 DHS, high MYC/BCL6 DHS and high THS had multiple adverse prognostic factors including high LDH level, poor performance status, advanced clinical stage, high International Prognostic Index (IPI) score, and non-germinal center B-cell. In univariate analysis, high MYC/BCL2 DHS, high MYC/BCL6 DHS and high THS were associated with inferior OS and PFS in both CHOP and R-CHOP cohorts (P<0.05). The highly significant correlations with OS and PFS were maintained in multivariate models that controlled for IPI (P<0.05). DLBCLs with high DHSs and high THS share the clinical features and poor prognosis of double-hit lymphoma (P>0.05). These data together suggest that the immunohistochemical DHSs and THS defined a large subset of DLBCLs with double-hit biology and was strongly associated with poor outcome in patients treated with R-CHOP or CHOP.

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Section: Discussionmentioning

confidence: 99%

MYC Expression in Concert with BCL2 and BCL6 Expression Predicts Outcome in Chinese Patients with Diffuse Large B-Cell Lymphoma, Not Otherwise Specified

et al. 2014

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“…The expression of MUM1 denotes the final step of germinal center B-cell differentiation with subsequent B-cell maturation toward plasma cells (10). A previous report revealed predominance of GCB-like DLBCL in the small intestine, which might be explained by the accumulation of naïve B-cell population in the pre-existing lymphoid tissue such as Peyer's patch (11). In contrast, the present patient showed a non-GCB pattern.…”

Section: Discussioncontrasting

confidence: 52%

Diffuse Large B-cell Lymphoma Arising Primarily at the Stoma After Bladder Reconstruction Using Ileal Conduit

et al. 2012

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A 76-year-old man suffered from swelling stoma for several weeks. A biopsy sample revealed the diffuse infiltration of large lymphoid cells which were positive for CD20, bcl-6, and MUM1. The patient was diagnosed with diffuse large B-cell lymphoma, with a non-germinal center B-cell pattern. A whole-body PET-CT scan revealed that the lymphoma was restricted to the stomal site. Bladder reconstruction was undertaken using the ileal conduit: this is the first reported case of lymphoma that developed primarily at the stoma. During the long-term maintenance after bladder reconstruction, clinicians should consider the possibility of lymphoma at the stomal site.

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“…In primary GI tract DLBCL, the frequency of ABC‐like/ non‐GCB‐like DLBCL was reported to be 42–73 % in the stomach, 6–14 % in the small intestine, and 57 % in the colon . In this study, the frequency of ABC‐like DLBCL was 79 % (19/24) and 58 % (14/24) in the stomach, 70 % (7/10) and 40 % (4/10) in the small intestine, and 60 % (9/15) and 40 % (6/15) in the colon by Choi's and Hans' algorithm, respectively.…”

Section: Discussionmentioning

confidence: 55%

“…The ratio of ABC/ non‐GCB‐like and GCB‐like phenotypes in GI DLBCL varied according to the sites of the GI tract. Specifically, the frequency of ABC/non‐GCB‐like DLBCL was 42–73 % in the stomach, 40 % in the duodenum, 6–14 % in the small intestine, and 57 % in the large intestine …”

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confidence: 99%

Clinicopathological features of 49 primary gastrointestinal diffuse large B‐cell lymphoma cases; comparison with location, cell‐of‐origin, and frequency of MYD88 L265P

Nagakita

Takata

Taniguchi

et al. 2016

Pathology International

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The gastrointestinal (GI) tract is the most common primary site of extranodal diffuse large B-cell lymphoma (DLBCL), with approximately one-third of extranodal DLBCL occurring in the GI tract. We investigated the clinicopathological features and immunohistochemically-assessed cell-of-origin of 49 GI DLBCL cases (stomach, 24; small intestine, 10; colon, 15) and also examined the presence of MYD88 L265P as recently this mutation has been frequently identified in ABC-like DLBCL, particularly in extranodal sites. Small intestinal DLBCL was characterized by the preponderance of women (P = 0.041) and elevated LDH (P = 0.002) and soluble interleukin-2 receptor (P = 0.033). Small intestinal DLBCL more frequently showed anemia (P = 0.031) and elevated CRP (P = 0.029) than gastric DLBCL. ABC-like phenotype was seen in 71.4 % cases (stomach, 79 %; small intestine, 70 %; colon, 60 %). MYD88 L265P was detected in 6.1 % cases; all were primary gastric DLBCL with ABC-like phenotype but had no distinct clinicopathological features. In conclusion, GI DLBCL had different clinicopathological features according to the primary site especially in the small intestine. Also, MYD88 L265P had little involvement in GI DLBCL compared with other extranodal DLBCLs, suggesting that its pathogenesis might be different from that of organs with a high frequency of MYD88 L265P.

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Differences in germinal centre and non-germinal center phenotype in gastric and intestinal diffuse large B-cell lymphomas

Cited by 18 publications

References 29 publications

MYC Expression in Concert with BCL2 and BCL6 Expression Predicts Outcome in Chinese Patients with Diffuse Large B-Cell Lymphoma, Not Otherwise Specified

MYC Expression in Concert with BCL2 and BCL6 Expression Predicts Outcome in Chinese Patients with Diffuse Large B-Cell Lymphoma, Not Otherwise Specified

Diffuse Large B-cell Lymphoma Arising Primarily at the Stoma After Bladder Reconstruction Using Ileal Conduit

Clinicopathological features of 49 primary gastrointestinal diffuse large B‐cell lymphoma cases; comparison with location, cell‐of‐origin, and frequency of MYD88 L265P

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