Primary breast diffuse large B-cell lymphoma shows a non-germinal center B-cell phenotype

Yoshida, Sayaka; Nakamura, Naoya; Sasaki, Yasutaka; Yoshida, Shigeaki; Yasuda, Mitsuhiko; Sagara, Hideto; Ohtake, Tohru; Takenoshita, Seiichi; Abe, Masafumi

doi:10.1038/modpathol.3800266

Cited by 82 publications

(47 citation statements)

References 35 publications

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“…We found 71% of Bcl-2-positive tumor samples when more than 30% of the tumor cells were positive. This result was concordant with the 10/15 Bcl-2-positive PBL reported by Yoshiba et al [23] and the proportion of Bcl-2-positive DLBCLs reported in the literature [25][26][27][28][29][30][31][32][33][34][35][36]. Finally, we observed 14% of CD10 positivity suggesting a large amount of PBL of nongerminal center B-cell lymphoma (non-GCB), as shown by Yoshida et al who observed 15/ 15 non-GCB PBL [23].…”

Section: Discussionsupporting

confidence: 93%

“…This result was concordant with the 10/15 Bcl-2-positive PBL reported by Yoshiba et al [23] and the proportion of Bcl-2-positive DLBCLs reported in the literature [25][26][27][28][29][30][31][32][33][34][35][36]. Finally, we observed 14% of CD10 positivity suggesting a large amount of PBL of nongerminal center B-cell lymphoma (non-GCB), as shown by Yoshida et al who observed 15/ 15 non-GCB PBL [23]. Our results are therefore concordant with those that have been previously reported in PBL, as in DLBCLs [28,31,32,34,35,37] (Table III).…”

Section: Discussionsupporting

confidence: 93%

“…In our series and in these reports, almost all cases had a B-cell non-Hodgkin's lymphoma, which was high-grade in about 80% of cases (range: 50-100%), and particularly of DLBCLs. However, very few series have evaluated the bcl-2 expression [23] and the germinal center B-cell expression profile in PBL [23,24]. We found 71% of Bcl-2-positive tumor samples when more than 30% of the tumor cells were positive.…”

Section: Discussionmentioning

confidence: 73%

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Primary breast non‐Hodgkin's lymphoma: A large single center study of initial characteristics, natural history, and prognostic factors

et al. 2009

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The aims of this study were to define the initial pathological and clinical characteristics, and prognostic factors of patients with primary breast malignant lymphoma (PBL). All patients treated at the Institut Curie for lymphoma with breast involvement were reviewed. A pathological review of all cases was performed. Fortyfive cases were selected in whom 38 cases were of diffuse large B-cell lymphoma. A complete analysis was then performed on these 38 patients. Twenty out of 28 cases (71%) of cases were Bcl-2 positive and four out of 28 (14%) had a CD10 positive staining. Peculiar initial characteristics showed nodal involvement in 58% of the cases and two or more extra-nodal sites in 31% of the cases. Among the 37 patients for whom all data were available, and according to the International Prognostic Index, 19 patients (51%) were classified in the low-risk group, 5 cases (14%) in the low-to intermediate-risk group, 6 patients (16%) in the intermediate-to high-risk group, and 7 (19%) case in the high-risk group. At the end of initial therapy, 34 patients (89%) achieved CR. With a median follow-up of 96 months, 18 patients (47%) relapsed of whom 3 had a relapse in central nervous system site. The 5-year disease-free (DFS) and overall survivals (OS) were 54% and 61%, respectively. In multivariate analysis, the presence of 2 or more extranodal sites was prognostic for lower DFS (P 5 0.0008) and OS (P 5 0.09), and a performance status ‡1 was prognostic for lower OS (P 5 0.005). Finally, when our series was compared with a historical series of 111 patients with aggressive nodal lymphomas, we observed significant lower survival rates in localized PBL (P < 0.03). Initial breast localization has a pejorative impact on the outcome of patients with Non-Hodgkin's Lymphoma (NHL), with an impressive adverse influence of additional extranodal sites. These results suggest a specific management of NHL with breast involvement. Am. J. Hematol. 84:133-139, 2009. V

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 73%

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Primary breast non‐Hodgkin's lymphoma: A large single center study of initial characteristics, natural history, and prognostic factors

et al. 2009

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“…MUM1 positive cases are assigned to the nongerminal center subtype and MUM1 negative tumors to the germinal center subtype. Several studies have investigated the validity of using this stratification scheme in other extranodal diffuse large B-cell lymphomas; [13][14][15][16][17][18] however, it remains unclear whether primary central nervous system diffuse large B-cell lymphomas can be subdivided into these same two prognostic groups.…”

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confidence: 99%

Most primary central nervous system diffuse large B-cell lymphomas occurring in immunocompetent individuals belong to the nongerminal center subtype: a retrospective analysis of 31 cases

et al. 2010

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Primary central nervous system lymphomas are rare neoplasms characterized by a dismal prognosis relative to other extranodal lymphomas. Approximately 98% of primary central nervous system lymphomas are of B-cell origin, and most belong to the diffuse large B-cell type. Recently, diffuse large B-cell lymphomas have been subcategorized into germinal center and nongerminal center types based on gene expression profiles and immunohistochemical expression of CD10, Bcl-6, and MUM1. Studies have shown that the overall survival rate of the germinal center group is better than that of the nongerminal center lymphomas. In this study, 31 cases of primary central nervous system lymphomas of the diffuse large B-cell type were retrieved, reviewed, and immunostained for CD10, Bcl-6, MUM1, and Ki-67. Subclassification was carried out as described earlier, where CD10 and/or Bcl-6 positivity and negativity for MUM1 were considered characteristic of germinal center subtype and the opposite expression of nongerminal center subtype. Furthermore, the proliferative activity was semiquantitatively assessed using percent positive cells staining with Ki-67. Of the 31 cases examined, 26 (84%) were found to belong to the nongerminal center type. The Ki-67 index in these 26 cases ranged from 30 to 90% (mean, 69%). Five cases were categorized as the germinal center subtype. They had an Ki-67 index between 70 and 90% (mean, 78%). Interestingly, none of our patients were known to be HIV positive. One patient had a 10-year history of orthotopic liver transplant. We also performed fluorescence in situ hybridization analysis on formalin-fixed material and found that 38% of the cases where tissue was available had abnormalities of MYC/ IGH and/or IGH/BCL2. We conclude that most primary central nervous system diffuse large B-cell lymphomas are of the nongerminal center origin. Regardless of the germinal center status, all cases showed a high proliferative rate. A statistically significant difference in the overall survival between the two groups was not seen.

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“…[18] Regarding laterality, although the largest study of PBL so far showed predilection of right breast involvement, as in ours, left side predilection has been reported and there was no obvious tendency of laterality reported in most other studies. [4,[20][21][22] The reason for such differences is still unknown, and the evidence of laterality predilection is limited.…”

Section: Discussionmentioning

confidence: 99%

Primary breast lymphoma: A single-institute experience in Taiwan

Ou¹,

Shih²,

Wang³

et al. 2014

Biomed J

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Background:Breast is an uncommon location of lymphoma involvement. The most common type of primary breast lymphoma (PBL) is diffuse large B-cell lymphoma (DLBCL). Rituximab is the widely used monoclonal antibody against CD20+ B-cell lymphoma, especially DLBCL. We aimed to analyze the clinical features, prognostic factors, and treatment outcome with or without rituximab in primary breast DLBCL. Methods:We retrospectively analyzed patients diagnosed with PBL from October 1987 to March 2012 in our hospital, excluding metastasis by whole-body computed tomography and bone marrow study. Results:Twenty-three patients were diagnosed with PBL. All were females. Eighteen patients were stage IE and five were stage IIE according to the Ann Arbor staging system. Two patients had lymphoma other than DLBCL. The median age of primary breast DLBCL patients was 48 years (range 27-79). Two were excluded from the analysis due to refusal or ineligibility for chemotherapy. No significant prognostic factor was found. Patients receiving chemotherapy with (RC) or without (C) rituximab were not significantly different in the 5-year overall survival (RC: 57.1%; C: 58.3%; p = 0.457) or progression-free survival (RC: 57.1%; C: 50.0%; p = 0.456). A high incidence of relapse in the central nervous system (CNS) (17.6%) was observed. Conclusions: In accordance with prior literature reports, our Taiwanese cohort of primary breast DLBCL seemed younger than those reported in Japan, Korea, and Western societies. Relapse in the CNS was not uncommon. The benefit of rituximab in addition to chemotherapy was not statistically significant. Treatment modality remained to be defined by further large-scale studies. (Biomed J 2014;37:321-325)

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Primary breast diffuse large B-cell lymphoma shows a non-germinal center B-cell phenotype

Cited by 82 publications

References 35 publications

Primary breast non‐Hodgkin's lymphoma: A large single center study of initial characteristics, natural history, and prognostic factors

Primary breast non‐Hodgkin's lymphoma: A large single center study of initial characteristics, natural history, and prognostic factors

Most primary central nervous system diffuse large B-cell lymphomas occurring in immunocompetent individuals belong to the nongerminal center subtype: a retrospective analysis of 31 cases

Primary breast lymphoma: A single-institute experience in Taiwan

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