Primary testicular diffuse large B-cell lymphoma belongs to the nongerminal center B-cell-like subgroup: a study of 18 cases

Al‐Abbadi, Mousa A.; Hattab, Eyas M.; Tarawneh, Musleh S.; Amr, Samir S.; Orazi, Attilio; Ulbright, Thomas M.

doi:10.1038/modpathol.3800691

Cited by 92 publications

(63 citation statements)

References 50 publications

(63 reference statements)

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“…Immunohistological staining of BCL-2, CD10, BCL-6, MUM1, FOXP1 and AID as well as of p53 was interpreted as positive if more than 30% of all cells displayed a positive signal (2). The expression of BCL-2 and AID (16) was positive if cytoplasm or nuclear envelope was stained positive.…”

Section: Interpretation Of Immunohistochemistrymentioning

confidence: 99%

“…As only 1% of testicular neoplasms and about 5% of all lymphoma presentations are due to primary testicular lymphomas, most of the publications dealing with testicular lymphomas are case reports (1). Newer publications tried to characterize this rare testicular entity on larger series systematically in retrospective analyses (2)(3)(4). Patients usually present with enlargement of testis caused by a homogeneous tumor mass.…”

Section: Introductionmentioning

confidence: 99%

“…Differently to previous studies dealing with primary testicular lymphoma (2,12) this retrospective analyses investigated the clinical outcome (overall survival) (OS) based on the expression pattern of hematological differentiation markers.…”

Section: Introductionmentioning

confidence: 99%

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Primary testicular lymphoma: A strictly homogeneous hematological disease?

Kemmerling

Stintzing²,

Mühlmann³

et al. 2010

Oncol Rep

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Abstract. Primary testicular lymphomas display mostly aggressive diffuse large cell B-cell lymphomas, which could be further subclassified into germinal center B-cell-like and an activated B-cell phenotype via immunohistochemistry. A retrospective analysis of primary testicular lymphomas diagnosed at the Institute of Pathology, Salzburger Landeskliniken (SALK) between January 1997 and December 2008 was done. Immunohistochemical staining and complete clinical data evaluation was carried out and linked to overall survival time. We found 18 cases of primary testicular lymphoma diagnosed in elderly patients showing no side predilection and having an aggressive clinical behavior with short overall survival independent of treatment. The lymphomas could for the most be classified into diffuse large cell B-cell lymphomas [15/18 (83.3%)] showing a nonsignificant prevalence of activated B cell phenotype [9/15 (60%)] compared to the germinal centre phenotype [6/15 (40%)]. Two of the cases were mantle cell lymphomas consisting of the infrequent pleomorphic subtype. The survival analysis revealed no significant difference for any of the investigated antigens. Primary testicular lymphomas are for the most DLBCL, but subtype classification reveal molecular heterogeneity inside this lymphoma entity. A distinction between those subtypes is necessary because of different clinical behavior and treatment.

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Section: Interpretation Of Immunohistochemistrymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary testicular lymphoma: A strictly homogeneous hematological disease?

Kemmerling

Stintzing²,

Mühlmann³

et al. 2010

Oncol Rep

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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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“…Intratubular germ cell neoplasia was not identified in any case in our series as documented by others. 3,18 The prognosis of testicular lymphoma is typically dismal and management of patients with testicular lymphoma presents several daunting challenges; thus, an aggressive therapeutic approach is typically warranted. 17,19,20 Lymphomas involving of the prostate are rare and account for less than 0.1% of newly diagnosed lymphomas.…”

Section: Discussionmentioning

confidence: 99%

Lymphoid neoplasms of the urinary tract and male genital organs: a clinicopathological study of 40 cases

Schniederjan

Osunkoya

2009

Modern Pathology

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Lymphoid neoplasms of the urinary tract and male genital organs are relatively rare, comprising less than 5% of all primary extranodal lymphomas; only a handful of small case series and isolated case reports have been published describing their predominant sites and subtypes. We identified 40 patients with lymphoid neoplasms of the urinary tract and male genital organs. Hematoxylin and eosin slides and immunohistochemical stains were reviewed, and follow-up data were also obtained. Twenty-six of 40 cases (65%) were primary genitourinary lymphomas. Mean age at diagnosis was 56 years (range 4-86 years). Among renal, bladder, and ureter lymphomas, a male predominance was noted (1.6:1). The subtypes of the lymphoid neoplasms observed were diffuse large B-cell lymphoma (17 cases, 43%); Burkitt lymphoma, extranodal marginal zone lymphoma, SLL/CLL, and follicular lymphoma (4 cases, or 10% each); B-cell ALL (2 cases, 5%); B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma, mantle cell lymphoma, plasmacytoma, polymorphic post-transplant lymphoproliferative disorder, and peripheral T-cell lymphoma NOS (1 case, or 2.5% each). In most cases, the genitourinary tract was the site of initial presentation. Genitourinary tract lymphomas most commonly occurred in the kidney. B-cell non-Hodgkin's lymphomas predominated, with diffuse large B-cell lymphoma being the most common subtype in the entire group. Extranodal marginal zone lymphoma was seen only in the kidney, rather than the bladder, where it is typically thought to be more common. Although this study confirms the predominance of diffuse large B-cell lymphoma in extranodal sites, the findings also highlight the variety of lymphomas that may occur in the genitourinary tract. This diversity of subtypes affirms the importance of fully characterizing lymphomas by immunohistochemistry and other modalities, which are indispensable for accurate diagnosis.

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Primary testicular diffuse large B-cell lymphoma belongs to the nongerminal center B-cell-like subgroup: a study of 18 cases

Cited by 92 publications

References 50 publications

Primary testicular lymphoma: A strictly homogeneous hematological disease?

Primary testicular lymphoma: A strictly homogeneous hematological disease?

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

Lymphoid neoplasms of the urinary tract and male genital organs: a clinicopathological study of 40 cases

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