1.Clinical Significance of XPO1 High Expression in Diffuse Large B-Cell Lymphoma and Its Mechanism.
Jing ZHANG ; Yan GU ; Jia-Heng GUAN ; Xue WU ; Bao-An CHEN
Journal of Experimental Hematology 2025;33(2):393-406
OBJECTIVE:
To explore the expression and clinical significance of XPO1 in newly diagnosed adult diffuse large B-cell lymphoma (DLBCL), and further investigate its functional mechanism.
METHODS:
Immunohistochemical testing was conducted for XPO1 expression in 93 cases of DLBCL and 30 cases of reactive lymphoid hyperplasia. A risk model was construed to find survival related genes in DLBCL patients. Cell proliferation, apoptosis, and cell cycle assays were performed to explore the effect of XPO1 inhibitor (KPT-8602) and XPO1 knockdown. Differential expression gene (DEG) was examined based on the transcriptomes.
RESULTS
The expression of XPO1 in DLBCL patients was higher than that of the controls. Compared with XPO1 low-expression group, XPO1 high-expression group had a worse prognosis. The constructed risk model indicated that XPO1 and 14 genes in nucleocytoplasmic transport pathway (NTP) might be potential prediction marker of adverse outcome in DLBCL. Moreover, KPT-8602 as well as the XPO1 knockdown could inhibit cell proliferation, promote apoptosis, and induce cell cycle arrest in two DLBCL cell lines, Farage and SU-DHL-4. Based on the gene expression profiling in the datasets of DLBCL, patients were classified into XPO1 high and XPO1 low expression groups, and the MYBL1 was identified as the down-stream effector of XPO1. Inhibiting the function of XPO1 or reducing its expression can significantly decrease the expression of MYBL1 Conclusion: XPO1 is highly expressed in DLBCL, which is associated with poor prognosis. The oncogenic roles of the new XPO1/MYBL1 signaling are identified in DLBCL and XPO1 inhibitor may be a potential option for newly-diagnosed DLBCL patients.
Humans
;
Lymphoma, Large B-Cell, Diffuse/pathology*
;
Exportin 1 Protein
;
Karyopherins/metabolism*
;
Receptors, Cytoplasmic and Nuclear/metabolism*
;
Cell Proliferation
;
Apoptosis
;
Prognosis
;
Cell Line, Tumor
;
Clinical Relevance
2.Effect of TBL1XR1 Mutation on Cell Biological Characteristics of Diffuse Large B-Cell Lymphoma.
Hong-Ming FAN ; Le-Min HONG ; Chun-Qun HUANG ; Jin-Feng LU ; Hong-Hui XU ; Jie CHEN ; Hong-Ming HUANG ; Xin-Feng WANG ; Dan GUO
Journal of Experimental Hematology 2025;33(2):423-430
OBJECTIVE:
To investigate the effect of TBL1XR1 mutation on cell biological characteristics of diffuse large B-cell lymphoma (DLBCL).
METHODS:
The TBL1XR1 overexpression vector was constructed and DNA sequencing was performed to determine the mutation status. The effect of TBL1XR1 mutation on apoptosis of DLBCL cell line was detected by flow cytometry and TUNEL fluorescence assay; CCK-8 assay was used to detect the effect of TBL1XR1 mutation on cell proliferation; Transwell assay was used to detect the effect of TBL1XR1 mutation on cell migration and invasion; Western blot was used to detect the effect of TBL1XR1 mutation on the expression level of epithelial-mesenchymal transition (EMT) related proteins.
RESULTS:
The TBL1XR1 overexpression plasmid was successfully constructed. The in vitro experimental results showed that TBL1XR1 mutation had no significant effect on apoptosis of DLBCL cells. Compared with the control group, TBL1XR1 mutation enhanced cell proliferation, migration and invasion of DLBCL cells. TBL1XR1 gene mutation significantly increased the expression of N-cadherin protein, while the expression of E-cadherin protein decreased.
CONCLUSION
TBL1XR1 mutation plays a role in promoting tumor cell proliferation, migration and invasion in DLBCL. TBL1XR1 could be considered as a potential target for DLBCL therapy in future research.
Humans
;
Lymphoma, Large B-Cell, Diffuse/pathology*
;
Cell Proliferation
;
Mutation
;
Receptors, Cytoplasmic and Nuclear/genetics*
;
Apoptosis
;
Cell Line, Tumor
;
Epithelial-Mesenchymal Transition
;
Cell Movement
;
Repressor Proteins/genetics*
;
Nuclear Proteins/genetics*
;
Cadherins/metabolism*
3.Predictive Value of Peripheral Blood cfDNA Combined with IL-10 in Central Nervous System Infiltration of Diffuse Large B-Cell lymphoma.
Yuan ZHANG ; Li-Hua WANG ; Yan GUO ; Guo-Qing LYU ; Sun WU ; Jing-Hang ZHANG
Journal of Experimental Hematology 2025;33(4):1063-1068
OBJECTIVE:
To investigate the predictive value of circulating free DNA (cfDNA) combined with interleukin 10 (IL-10) in predicting central nervous system infiltration (CNSI) in diffuse large B-cell lymphoma (DLBCL).
METHODS:
The clinical data of 63 patients with DLBCL in our hospital from May 2021 to April 2023 were retrospectively analyzed. The 63 patients were divided into CNSI group (15 cases) and non-CNSI group (48 cases) base on whether CNSI occurred. The age, sex, Ann Arbor stage, ECOG score, IPI risk, CNS-IPI risk, number of extranodal sites involved, bone marrow involvement, hypertrophic disease, B symptoms, source cells, glucose quantification, Pandy test, cerebrospinal fluid (CSF) chlorine, CSF nucleated cell count, CSF protein, peripheral blood cfDNA, and IL-10 status were compared between the two groups. The correlation between cfDNA, IL-10 in peripheral blood and CSF protein was analyzed by Pearson correlation analysis. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of peripheral blood cfDNA and IL-10 on secondary CNSI in DLBCL patients. The last follow-up was on November 30, 2023. Kaplan-Meier method was used to calculate the time of secondary CNSI in the non-CNSI group.
RESULTS:
The IPI risk, CNS-IPI risk, number of extranodal sites involved, and CSF protein in the CNSI group were significantly higher than those in the non-CNSI group (all P <0.05). The levels of cfDNA and IL-10 in peripheral blood of CNSI group were significantly higher than those of non-CNSI group (both P <0.01). cfDNA and IL-10 in peripheral blood were both positively correlated with CSF protein (r =0.402 4, 0.315 1). ROC curve analysis showed that peripheral blood cfDNA and IL-10 had certain predictive value for CNSI, and the area under the curve (AUC) was 0.829 and 0.742, respectively. The AUC of the combined detection was 0.910, with a sensitivity of 80.00% and a specificity of 93.70%. The diagnostic efficacy was significantly higher than that of the two prediction values alone. The median follow-up time was 20 (6-31) months. Non-CNSI patients were grouped based on peripheral blood cfDNA combined with IL-10 positive or negative pairs. The time of secondary CNSI in positive group was significantly shorter than that in negative group (P <0.05).
CONCLUSION
cfDNA and IL-10 in peripheral blood of DLBCL patients with CNSI are significantly increased, and the combined detection of cfDNA and IL-10 has good predictive value for CNSI.
Humans
;
Interleukin-10/blood*
;
Lymphoma, Large B-Cell, Diffuse/blood*
;
Retrospective Studies
;
Female
;
Male
;
Cell-Free Nucleic Acids/blood*
;
Middle Aged
;
ROC Curve
;
Prognosis
;
Central Nervous System Neoplasms
;
Central Nervous System/pathology*
;
Adult
;
Predictive Value of Tests
4.Comparative Study of Diffuse Large B-Cell Lymphoma and Reactive Lymphoid Hyperplasia Lymph Node Derived Mesenchymal Stem Cells.
Yu-Shuo MA ; Zhi-He LIU ; Yang SUN ; Yu-Hang ZHANG ; Wen-Qiu WANG ; Li-Sheng WANG ; Xia ZHAO
Journal of Experimental Hematology 2025;33(5):1516-1523
OBJECTIVE:
To investigate the biological behavior, differentiation ability, and differential gene expression of lymph node mesenchymal stem cells (MSCs) in patients with diffuse large B-cell lymphoma (DLBCL) and reactive lymphoid hyperplasia (RLH), providing a theoretical basis for clinical chemotherapy resistance.
METHODS:
Lymph node MSCs from patients with DLBCL and RLH were separated, passaged and cultured. The cell morphology and growth status were observed. Flow cytometry was performed to detect the immune phenotype of MSCs. The in vitro directed differentiation ability of the two types of MSCs was observed. High-throughput sequencing was used to analyze the differential gene expression and enrichment of two groups of MSCs.
RESULTS:
The lymph node MSCs of patients with DLBCL and RLH had similar cell morphology and growth characteristics, and both groups of MSCs expressed CD90, CD105, and CD73 on the cell surface. Compared with lymph node MSCs derived from patients with RLH, lymph node MSCs derived from DLBCL patients showed stronger osteogenic and adipogenic differentiation abilities. High-throughput sequencing results displayed that lymph node MSCs derived from DLBCL patients significantly upregulated some genes such as TOP2A, LFNG, GRIA3, SEC14L2, SPON2, AURKA, LRRC15, FOXD1, HOXC9, CDC20 and remarkably downregulated some genes such as TBC1D8, LDLR, PCDHAC2, POLH, PKP2, ANKRD37, DMKN, HSD11B1, ARHGAP20, PTGS1,etc.
CONCLUSION
Lymph node MSCs in DLBCL patients exhibit unique biological behavior and gene expression profiles, which may be closely related to clinical chemotherapy resistance.
Humans
;
Mesenchymal Stem Cells/cytology*
;
Lymphoma, Large B-Cell, Diffuse/pathology*
;
Cell Differentiation
;
Lymph Nodes/pathology*
;
Pseudolymphoma/pathology*
5.Comparison of clinical characteristics between nasal cavity and sinus NK/T-cell lymphoma and diffuse large B-cell lymphoma.
Yi DONG ; Shunjiu CUI ; Qian HUANG ; Yunfu LIU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(5):457-469
<b>Objective:b>To compare the clinical characteristics of nasal NK/T-cell lymphoma(NKTL) and diffuse large B-cell lymphoma(DLBCL) to improve the diagnosis and differential diagnosis of nasal lymphomas. <b>Methods:b>A retrospective analysis of cases of nasal NKTL and DLBCL was conducted. The clinical symptoms, signs, and imaging features of both groups were compared and statistically analyzed. Results: The DLBCL group showed more symptoms like exophthalmos/diplopia and epiphora compared to the NKTL group (both P=0.040). NKTL cases were more likely to be misdiagnosed as sinusitis(P=0.007). In NKTL cases, nasal mucosal swelling(P<0.01), destruction of nasal structures(P=0.002), and external nasal structural abnormalities(P=0.003) were more prevalent. In imaging, the DLBCL group more commonly demonstrated worm-eaten destruction of sinus bones (P=0.004), sinus masses (P=0.018), and invasion of adjacent structures including the pterygopalatine fossa, infratemporal fossa (P<0.01), orbit (P=0.039), and skull base (P=0.011). NKTL involved the turbinates(P=0.001), nasal cavity and septum(P=0.016), nasopharynx(P<0.01), and "skip" infiltration of external nasal tissues(P=0.042) more frequently. No statistically significant differences were found in other clinical features between the two groups. <b>Conclusion:b>For patients with nasal obstruction and discharge, it is essential to inquire about systemic B symptoms, such as fever, and eye symptoms, such as periorbital swelling, diplopia, and lacrimation. Lymphoma should be suspected if local examination reveals diffuse nasal swelling, destruction of turbinates or septum, and external nasal structural abnormalities. Worm-eaten bone destruction and "cast-like" changes of the turbinates, septum, and nasal cavity, as well as "skip" infiltration of the external nose, are more common in NKTL. Sinus masses with invasion of the pterygopalatine fossa, infratemporal fossa, skull base, and orbit are more typical of DLBCL.
Humans
;
Retrospective Studies
;
Lymphoma, Extranodal NK-T-Cell/diagnosis*
;
Lymphoma, Large B-Cell, Diffuse/pathology*
;
Nasal Cavity/pathology*
;
Male
;
Diagnosis, Differential
;
Female
;
Middle Aged
;
Nose Neoplasms/diagnosis*
;
Adult
;
Aged
6.Clinicopathological characteristics and prognosis of non-Hodgkin lymphoma in oral and maxillofacial regions: An analysis of 369 cases.
Qian SU ; Xin PENG ; Chuan Xiang ZHOU ; Guang Yan YU
Journal of Peking University(Health Sciences) 2023;55(1):13-21
OBJECTIVE:
To investigate the clinicopathological characteristics and factors influencing the prognosis of non-Hodgkin lymphoma (NHL) in oral and maxillofacial regions.
METHODS:
Clinicopathological data of 369 patients with oral and maxillofacial NHL initially diagnosed in Peking University Hospital of Stomatology from 2008 to 2020 were collected and analyzed retrospectively.
RESULTS:
There were 180 males and 189 females. The median age of the patients was 56 years (3 months to 92 years), and the median duration was three months. Clinically, 283 cases manifested as mass, 38 cases as ulcerative necrotizing lesions, and 48 cases as diffuse soft tissue swelling. The lesions of 90 cases located in face and neck (75 cases neck, 20.3%), 99 cases were of major salivary glands (79 cases parotid glands, 20.9%), 103 cases of oral cavity, 50 cases of maxillofacial bones, 20 cases of Waldeyer's ring, and 7 cases of infratemporal fossa. In the study, 247 of the 369 patients had cervical lymphadenopathy, only 40 cases had B symptoms, and 23 cases had the bulky disease. Of the 369 NHLs, 299 (81%) were B-cell NHL, and 70(19%) were T-cell NHL. Diffuse large B-cell lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, follicular lymphoma, and extranodal natural killer (NK)/T-cell lymphoma nasal type were the most common pathological subtypes. According to Ann Arbor staging, 87, 138, 106, and 38 cases were classified as staged Ⅰ, Ⅱ, Ⅲ, Ⅳ, respectively. The me-dian follow-up time was 48 months, 164 patients died during the follow-up period. The overall survival rates for one year, two years, and five years were 90.1%, 82.4%, and 59.9%, respectively, and the median survival was (86.00±7.98) months. Multivariate analysis showed that age (P < 0.001), Ann Arbor staging (P < 0.001), elevated lactate dehydrogenase (P=0.014), and pathological subtype (P=0.049) were the independent factors influencing the overall survival rate of NHL patients.
CONCLUSION
Oral and maxillofacial NHL has unique clinical characteristics and distribution patterns of pathological subtypes. Fewer patients had systemic symptoms. Neck and parotid glands were the most common sites invaded by NHL. Advanced age, Ann Arbor stage Ⅲ-Ⅳ, B symptoms, and T-cell NHL may predict a poor prognosis in oral and maxillofacial NHL patients.
Male
;
Female
;
Humans
;
Middle Aged
;
Retrospective Studies
;
Prognosis
;
Lymphoma, Large B-Cell, Diffuse/diagnosis*
;
Lymphoma, B-Cell, Marginal Zone/pathology*
;
Neck/pathology*
;
Neoplasm Staging
7.Reverse effect of Semaphorin-3F on rituximab resistance in diffuse large B-cell lymphoma via the Hippo pathway.
Qiong LI ; Naya MA ; Xinlei LI ; Chao YANG ; Wei ZHANG ; Jingkang XIONG ; Lidan ZHU ; Jiali LI ; Qin WEN ; Lei GAO ; Cheng YANG ; Lingyi RAO ; Li GAO ; Xi ZHANG ; Jun RAO
Chinese Medical Journal 2023;136(12):1448-1458
BACKGROUND:
Exploring the underlying mechanism of rituximab resistance is critical to improve the outcomes of patients with diffuse large B-cell lymphoma (DLBCL). Here, we tried to identify the effects of the axon guidance factor semaphorin-3F (SEMA3F) on rituximab resistance as well as its therapeutic value in DLBCL.
METHODS:
The effects of SEMA3F on the treatment response to rituximab were investigated by gain- or loss-of-function experiments. The role of the Hippo pathway in SEMA3F-mediated activity was explored. A xenograft mouse model generated by SEMA3F knockdown in cells was used to evaluate rituximab sensitivity and combined therapeutic effects. The prognostic value of SEMA3F and TAZ (WW domain-containing transcription regulator protein 1) was examined in the Gene Expression Omnibus (GEO) database and human DLBCL specimens.
RESULTS:
We found that loss of SEMA3F was related to a poor prognosis in patients who received rituximab-based immunochemotherapy instead of chemotherapy regimen. Knockdown of SEMA3F significantly repressed the expression of CD20 and reduced the proapoptotic activity and complement-dependent cytotoxicity (CDC) activity induced by rituximab. We further demonstrated that the Hippo pathway was involved in the SEMA3F-mediated regulation of CD20. Knockdown of SEMA3F expression induced the nuclear accumulation of TAZ and inhibited CD20 transcriptional levels via direct binding of the transcription factor TEAD2 and the CD20 promoter. Moreover, in patients with DLBCL, SEMA3F expression was negatively correlated with TAZ, and patients with SEMA3F low TAZ high had a limited benefit from a rituximab-based strategy. Specifically, treatment of DLBCL cells with rituximab and a YAP/TAZ inhibitor showed promising therapeutic effects in vitro and in vivo .
CONCLUSION
Our study thus defined a previously unknown mechanism of SEMA3F-mediated rituximab resistance through TAZ activation in DLBCL and identified potential therapeutic targets in patients.
Humans
;
Animals
;
Mice
;
Rituximab/therapeutic use*
;
Hippo Signaling Pathway
;
Lymphoma, Large B-Cell, Diffuse/pathology*
;
Prognosis
;
Semaphorins/therapeutic use*
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
;
Membrane Proteins/genetics*
;
Nerve Tissue Proteins/genetics*
8.Diagnostic Efficacy of 18F-FDG PET/CT in Detecting Bone Marrow Infiltration in Patients with Newly Diagnosed Diffuse Large B-Cell Lymphoma.
Bo GUO ; Ran QIN ; Zhen Yang GU ; Yan Fen LI ; Lei GAO ; Wen Rong HUANG
Biomedical and Environmental Sciences 2023;36(6):510-516
OBJECTIVE:
Diffuse large B-cell lymphoma (DLBCL) is often associated with bone marrow infiltration, and 2-deoxy-2-(18F) fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) has potential diagnostic significance for bone marrow infiltration in DLBCL.
METHODS:
A total of 102 patients diagnosed with DLBCL between September 2019 and August 2022 were included. Bone marrow biopsy and 18F-FDG PET/CT examinations were performed at the time of initial diagnosis. Kappa tests were used to evaluate the agreement of 18F-FDG PET/CT with the gold standard, and the imaging features of DLBCL bone marrow infiltration on PET/CT were described.
RESULTS:
The total detection rate of bone marrow infiltration was not significantly different between PET/CT and primary bone marrow biopsy ( P = 0.302) or between the two bone marrow biopsies ( P = 0.826). The sensitivity, specificity, and Youden index of PET/CT for the diagnosis of DLBCL bone marrow infiltration were 0.923 (95% CI, 0.759-0.979), 0.934 (95% CI, 0.855-0.972), and 0.857, respectively.
CONCLUSION
18F-FDG PET/CT has a comparable efficiency in the diagnosis of DLBCL bone marrow infiltration. PET/CT-guided bone marrow biopsy can reduce the misdiagnosis of DLBCL bone marrow infiltration.
Humans
;
Positron Emission Tomography Computed Tomography/methods*
;
Fluorodeoxyglucose F18
;
Bone Marrow/pathology*
;
Retrospective Studies
;
Positron-Emission Tomography/methods*
;
Lymphoma, Large B-Cell, Diffuse/pathology*
9.Expressions and Clinical Significance of Notch1 and Hes1 in Diffuse Large B-Cell Lymphoma.
Yan LIU ; Sha-Sha XU ; Xiao-Ning WANG ; Na ZHENG ; Meng-Yao XU ; Jie LI
Journal of Experimental Hematology 2023;31(3):714-721
OBJECTIVE:
To investigate the expressions of Notch1 and Hes1 in diffuse large B-cell lymphoma (DLBCL), and their correlations with clinical features.
METHODS:
Immunohistochemistry (IHC) was performed on DLBCL samples (54 cases) and lymphadenitis tissues (20 cases) to evaluate the expressions of Notch1 and Hes1, and analyze their correlations with clinical characteristics of patients. Based on Oncomine database, the expressions of Notch1 and Hes1 mRNA and DNA were also explored.
RESULTS:
IHC result showed that the positive expression rates of Notch1 and Hes1 in DLBCL patients were significantly higher than those in the control group (P <0.05). In DLBCL patients, the expression of Notch1 was closely associated with B symptoms, Ann Arbor stage, lymphocyte count and the level of lactate dehydrogenase (P <0.05), while the expression level of Hes1 was significantly higher in patients with B symptoms (P <0.05). Notch+/Hes1+ expression was found in 21 DLBCL tissues (38.9%), and there was a correlation between Notch1 and Hes1 expression (r =0.296, P <0.05). Bioinformatics analysis (Oncomine database) showed that the mRNA expressions of Notch1 and Hes1 in the Brune dataset were significantly higher than those in the control tissues (P <0.05).
CONCLUSION
The expressions of Notch1 and Hes1 in DLBCL are significantly higher than those in lymphadenitis, and correlated with B symptoms and Ann Arbor stage, suggesting that Notch1 and Hes1 play important roles in the occurrence and development of DLBCL.
Humans
;
Cell Line
;
Clinical Relevance
;
Lymphadenitis
;
Lymphoma, Large B-Cell, Diffuse/pathology*
;
Prognosis
;
RNA, Messenger
10.Effect of MELK Inhibitor OTSSP167 on Diffuse Large B-Cell Lymphoma.
Jun-Yi ZHOU ; Hao HUANG ; Yan ZHUANG ; Xiao-Min ZHONG
Journal of Experimental Hematology 2023;31(3):739-745
OBJECTIVE:
To investigate the effect of MELK inhibitor OTSSP167 against diffuse large B-cell lymphoma (DLBCL).
METHODS:
The effect of OTSSP167 on activity, proliferation, and apoptosis of DLBCL cell line (SUDHL2 and HBL1) was detected by CCK-8 assay, 5-ethynyl-2'-deoxyuridine (EdU) staining, and Annexin V-FITC/PI double staining, respectively. DLBCL cells were inoculated into nude mice, after 4 weeks of OTSSP167 treatment, the effect of OTSSP167 on DLBCL growth in vivo was detected. Caspase-GloTM 3/7 enzyme activity assay kit was used to detect the effect of OTSSP167 on Caspase 3/7 enzyme activity of DLBCL cells. The expression levels of apoptosis and cycle-related proteins were detected by Western blot.
RESULTS:
OTSSP167 significantly inhibited the activity of SUDHL2 and HBL1 cells in a dose-dependent manner (r =-0.61, r =-0.52). EdU staining showed that OTSSP167 could significantly inhibit the proliferation of SUDHL2 and HBL1 cells. Annexin V-FITC/PI result showed that OTSSP167 could significantly promote the apoptosis of SUDHL2 and HBL1 cells (P <0.001). The result of in vivo experiment showed that OTSSP167 could inhibit the growth of SUDHL2 cells in nude mice. The result of TUNEL staining of tumor further confirmed that OTSSP167 could promote the apoptosis of SUDHL2 cells. Caspase 3/7 enzyme activity test demonstrated that OTSSP167 could significantly increase caspase activity in SUDHL2 and HBL1 cells (r =0.98, r =0.87). Western blot showed that OTSSP167 could dose-dependently inhibit the expression of PARP, Bcl-xL, and Bcl-2 in apoptosis signaling pathway (r =-0.93, r =-0.66, r =-0.87), while p53 protein was significantly up-regulated (r =0.82). The expression of cell cycle-related proteins cdc2, Cyclin E1, Cyclin A2, and Cyclin B1 also showed a dose-dependent down-regulation (r =-0.89, r =-0.83, r =-0.61, r =-0.93).
CONCLUSION
The MELK inhibitor OTSSP167 can inhibit the proliferation and promote the apoptosis of DLBCL cells by inhibiting the expression of cycle-related proteins and anti-apoptosis-related proteins.
Mice
;
Animals
;
Mice, Nude
;
Cell Line, Tumor
;
Cell Proliferation
;
Caspase 3
;
Apoptosis Regulatory Proteins
;
Caspases
;
Lymphoma, Large B-Cell, Diffuse/pathology*

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