Management of children and adolescents with gray zone lymphoma: A case series

Perwein, Thomas; Lackner, Herwig; Ebetsberger‐Dachs, Georg; Beham‐Schmid, Christine; Zach, Klara; Tamesberger, Melanie; Simonitsch‐Klupp, Ingrid; Lüftinger, Roswitha; Dworzak, Michael; Mann, Georg; Benesch, Martin; Attarbaschi, Andishe

doi:10.1002/pbc.28206

Cited by 8 publications

(10 citation statements)

References 14 publications

(129 reference statements)

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“…19 In a retrospective study about the management of six pediatric patients with GZL, five received a B-cell non-Hodgkin lymphoma (NHL)-directed treatment, with or without rituximab, and one a CHL-like therapy; four patients (67%) had a complete response, two after first-line therapy and the other two after second-line therapy. 20 About one third of patients with GZL have primary refractory disease; in our series, two of four patients did not improve or showed partial response to first-line treatment. In relapsed or refractory disease, a variety of therapeutic efforts, including radiotherapy 18 and HSCT, both autologous and allogenic, 17,19,21,22 have been experienced, almost only in adulthood.…”

Section: Discussionmentioning

confidence: 46%

Pediatric gray zone lymphoma according to the 2022 WHO classification: An Italian cohort study

Restivo,

Farruggia,

Pillon

et al. 2023

Pediatric Blood & Cancer

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Background:The 2022 World Health Organization (WHO) classification redefines the concept of gray zone lymphoma (GZL), restricting it in practice to cases of mediastinal/thymic origin (mediastinal gray zone lymphoma, MGZL) with overlapping features between primary mediastinal B-cell lymphoma (PMBCL) and classical Hodgkin lymphoma (CHL). Cases with histological characteristics of GZL but occurring without mediastinal involvement are better classified as diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS), with few exceptions. Procedure:We collected clinical and pathological data about all Italian pediatric patients diagnosed with GZL over a 20-year period.

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Section: Discussionmentioning

confidence: 46%

Pediatric gray zone lymphoma according to the 2022 WHO classification: An Italian cohort study

Restivo,

Farruggia,

Pillon

et al. 2023

Pediatric Blood & Cancer

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“…A total of 79 cHL/diffuse large B-cell composite lymphomas from 35 articles were analyzed [ 1 , 3 , 6 , 13 , 14 , 16 , 58 , 64 , 66 , 76 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 ].…”

Section: Resultsmentioning

confidence: 99%

Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review

Trécourt

Donzel

Fontaine

et al. 2022

Cancers

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The co-occurrence of several lymphomas in a patient defines composite/synchronous lymphoma. A common cellular origin has been reported for both contingents of such entities. In the present review, we aimed to gather the available data on composite lymphomas associating a classical Hodgkin lymphoma (cHL) with another lymphoma, to better understand the plasticity of mature B and T-cells. This review highlights that >70% of patients with a composite lymphoma are ≥55 years old, with a male predominance. The most reported associations are cHL with follicular lymphoma or diffuse large B-cell lymphoma, with over 130 cases reported. The cHL contingent is often of mixed cellularity type, with a more frequent focal/weak CD20 expression (30% to 55.6%) compared to de novo cHL, suggesting a particular pathophysiology. Moreover, Hodgkin cells may express specific markers of the associated lymphoma (e.g., BCL2/BCL6 for follicular lymphoma and Cyclin D1 for mantle cell lymphoma), sometimes combined with common BCL2/BCL6 or CCND1 rearrangements, respectively. In addition, both contingents may share similar IgH/IgK rearrangements and identical pathogenic variants, reinforcing the hypothesis of a common clonal origin. Finally, cHL appears to be endowed with a greater plasticity than previously thought, supporting a common clonal origin and a transdifferentiation process during lymphomagenesis of composite lymphomas.

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“…Though clinically and radiologically the anterior mediastinal mass has a similar presentation, accurate pathological diagnosis is essential for appropriate treatment ( Figure 4 ). In this review, we will discuss the most common mediastinal lymphomas T-LBL, HL, PMBCL and their differential diagnosis ( 14 - 16 ).…”

Section: Introductionmentioning

confidence: 99%

“… Treatment protocols* for mediastinal lymphoma ( 14 - 16 ). *, Protocol may vary institution to institutions.…”

Section: Introductionmentioning

confidence: 99%

Pediatric mediastinal lymphoma

Mallick¹,

Jain²,

Ramteke³

2020

Mediastinum

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The mediastinum is the visceral compartment of thoracic cavity divided into the superior and inferior mediastinum, further inferior compartmentalize into anterior, middle, and posterior mediastinum. Lymphoma in the mediastinum may be primary or secondary to systemic disease. Lymphoma may arise from lymphoid organs-like thymus, mediastinal lymph nodes or other mediastinal organs like heart, lung, pleura, and pericardium. It comprises about 12% of all the mediastinal tumors in adults however, it constitutes 50% of the pediatric mediastinal mass. Anatomically lymphoma most commonly involves anterior mediastinum. Among the pediatric mediastinal lymphomas, lymphoblastic lymphoma (LBL) predominate followed by Hodgkin lymphoma (HL), primary mediastinal large B cell lymphoma (PMBCL) and very rarely Grey zone lymphoma. Other types of non-HLs (NHLs) are rare among pediatric population. Radiologically and clinically present as an anterior mediastinal mass with symptoms of dyspnea, cough, and superior vena cava syndrome. Also, clinically and radiologically all the pediatric mediastinal mass shares the overlapping features, hence, for treatment and prognostic points of view its essential to differentiate the three entities, i.e., LBL, HL and PMBCL. The pathological diagnosis of pediatric mediastinal lymphomas is quite challenging for general histopathologists. In this review, we describe the pathology, genetics, differential diagnosis, treatment, prognosis, and a simplified histopathological and immunophenotypical approach to differentiate the pediatric mediastinal lymphomas.

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Management of children and adolescents with gray zone lymphoma: A case series

Cited by 8 publications

References 14 publications

Pediatric gray zone lymphoma according to the 2022 WHO classification: An Italian cohort study

Pediatric gray zone lymphoma according to the 2022 WHO classification: An Italian cohort study

Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review

Pediatric mediastinal lymphoma

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