Biopsy ; CD79 Antigens ; metabolism ; Central Nervous System ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Inflammation ; Ki-67 Antigen ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; Magnetic Resonance Imaging ; Middle Aged ; Panniculitis ; diagnostic imaging ; Prognosis

OBJECTIVETo study the clinicopathologic features and significance of aberrant CD56 expression in diffuse large B-cell lymphoma (DLBCL).

METHODSThe clinical and pathologic profiles of 10 cases of DLBCL with aberrant expression of CD56 were investigated. Immunohistochemical staining, in-situ hybridization for Epstein-Barr virus encoded RNA and gene rearrangement for IgH and Igκ were carried out.

RESULTSThere were 6 male and 4 female patients. The medium age of patients was 46 years. All of them presented with extranodal lymphoma involvement, with gastrointestinal tract being the commonest site (5/10). Histologic examination showed that most of the atypical lymphoid cells were centroblast-like and demonstrated a diffuse growth pattern. Apoptosis and necrosis were identified in some cases. Immunohistochemical study showed that the tumor cells were positive for CD20 or CD79α and aberrantly expressed CD56. Five cases had the GCB phenotype while the remaining cases had the non-GCB phenotype, according to Hans classification. Bcl-6 was positive in most cases (9/10). All cases showed a high proliferation index by Ki-67. The tumor cells were negative for CD3ε, CD138 and granzyme B. In-situ hybridization for Epstein-Barr virus encoded RNA was performed in 7 cases and none of them showed positive signals. IgH gene rearranged bands were detected in 4 cases (4/6) and Igκ was detected in 3 cases (3/6). Follow-up data were available in 8 patients. Two patients died of disease progression within 5 to 13 months after diagnosis and the other 6 patients were alive 8 to 60 months after therapy.

CONCLUSIONSDLBCL with aberrant expression of CD56 is rare. Most of them present with extranodal involvement, show high frequency of bcl-6 expression and high proliferation index. The patients often have good response to chemotherapy.

Antigens, CD20 ; metabolism ; Apoptosis ; CD56 Antigen ; metabolism ; CD79 Antigens ; metabolism ; Disease Progression ; Female ; Gene Rearrangement ; Granzymes ; metabolism ; Herpesvirus 4, Human ; genetics ; Humans ; Immunophenotyping ; In Situ Hybridization ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Necrosis ; Phenotype ; Proto-Oncogene Proteins c-bcl-6 ; metabolism ; RNA, Viral ; analysis

Immunophenotype is critical for diagnosing common B-cell acute lymphoblastic leukemia (common ALL) and detecting minimal residual disease. We developed a protocol to explore the immunophenotypic profiles of common ALL based on the expression levels of the antigens associated with B lymphoid development, including IL-7Rα (CD127), cytoplasmic CD79a (cCD79a), CD19, VpreB (CD179a), and sIgM, which are successive and essential for progression of B cells along their developmental pathway. Analysis of the immunophenotypes of 48 common ALL cases showed that the immunophenotypic patterns were highly heterogeneous, with the leukemic cell population differing from case to case. Through the comprehensive analysis of immunophenotypic patterns, the profiles of patient-specific composite leukemia cell populations could provide detailed information helpful for the diagnosis, therapeutic monitoring, and individualized therapies for common ALL.
Adult ; Antigens, CD19 ; metabolism ; B-Lymphocytes ; immunology ; metabolism ; CD79 Antigens ; metabolism ; Female ; Humans ; Immunoglobulin Light Chains, Surrogate ; metabolism ; Immunophenotyping ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; immunology ; pathology ; Receptors, Interleukin-7 ; metabolism

Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Burkitt Lymphoma ; metabolism ; pathology ; CD79 Antigens ; metabolism ; Cyclophosphamide ; therapeutic use ; DNA-Binding Proteins ; metabolism ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Humans ; Lymphoma, B-Cell ; pathology ; Lymphoma, Follicular ; drug therapy ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Proto-Oncogene Proteins c-bcl-6 ; Skin Neoplasms ; drug therapy ; metabolism ; pathology ; Vincristine ; therapeutic use

Adult ; Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; CD79 Antigens ; metabolism ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; Male ; PAX5 Transcription Factor ; metabolism ; Young Adult

ADP-ribosyl Cyclase 1 ; metabolism ; Adult ; Brain Neoplasms ; metabolism ; pathology ; surgery ; CD79 Antigens ; metabolism ; Castleman Disease ; metabolism ; pathology ; Diagnosis, Differential ; Humans ; Leukocyte Common Antigens ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; surgery ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; Male ; Melanoma ; metabolism ; pathology ; Parietal Lobe ; Plasma Cells ; metabolism ; pathology

Antigens, CD20 ; metabolism ; CD79 Antigens ; metabolism ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; Carcinoma, Renal Cell ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; Leukocyte Common Antigens ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; Nephrectomy ; PAX5 Transcription Factor ; metabolism ; Wilms Tumor ; metabolism ; pathology

OBJECTIVETo investigate the clinicopathological features of EB virus positive diffuse large B-cell lymphomas (EBV + DLBCL) of the elderly.

METHODSFour hundred and ninety-six cases of DLBCLs were retrospectively studied by in situ hybridization (ISH) to detect the EBV in tumor cells, and by immunohistochemistry to evaluate the expression of CD10, CD20, CD30, CD79a, bcl-6, bcl-2, MUM-1, CD5, CD3, TIA-1 and Ki-67 protein. Their clinicopathological correlations were analyzed.

RESULTSOf the 59 cases of EBV + DLBCL, 48 cases were EBV positive. The median age of these EBV + DLBCLs was 73 years with male predominance (1.4:1). There were 11 cases with nodal presentation only, 18 cases with extra-nodal presentation and 19 cases with both lymph nodal and extra-nodal involvements, whereas about one third cases with more than one extra-nodal involvement. Thirty-five patients presented with advanced disease (Ann Arbor stage III/IV). A performance status was available in 36 cases and 5 cases had performance status of more than 1. Seven of 30 patients were found with high lactate dehydrogenase value (more than twice of the normal). An IPI-score was calculated in 30 cases and 18 cases had an intermediate/high IPI-score (3-5). The median survival for these patients was 35 months. Morphologically, EBV + DLBCLs of the elderly generally showed a diffuse and polymorphic proliferation of large lymphoid cells with varying degrees of reactive components including small lymphocytes, plasma cells, histiocytes, and epithelioid cells. These tumor cells were frequently characterized by a broad range of B-cell maturation, containing centroblasts, immunoblasts, and Hodgkin- and Reed-Sternberg (HRS)-like giant cells. The study cohort was further morphologically divided into large cell lymphoma subtypes (n = 33) and polymorphic lymphoma subtypes (n = 14) and one case with mixed subtype. Immunohistochemical studies showed that tumor cells were positive for CD20 (47/48) and/or CD79a (45/45) in almost cases. Tumor cells were MUM-1-positive in the majority of the cases (44/47) and were stained for CD10 or bcl-6 in a few cases. Expression of bcl-2 and CD30 was observed in 80.0% (28/35) and 28.9% (11/38) cases, respectively, and most of the cases (33/39) had a high proliferative index (by Ki-67 with a 50% cut-off point). Compared with other EBV + DLBCLs, except the older age and low frequency of bcl-6 staining, no other significant differences were observed in EBV + DLBCLs of the elderly.

CONCLUSIONSEBV + DLBCLs of the elderly constitute a distinct clinicopathologic subtype of DLBCL, although many clinical and histological features with EBV + lymphomas are similar with that of younger ages. Differential diagnosis from other types of lymphomas should also be considered.

Aged ; Aged, 80 and over ; Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; CD79 Antigens ; metabolism ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Epstein-Barr Virus Infections ; Female ; Follow-Up Studies ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Interferon Regulatory Factors ; metabolism ; Ki-1 Antigen ; metabolism ; L-Lactate Dehydrogenase ; blood ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; virology ; Male ; Middle Aged ; Neoplasm Staging ; Prednisone ; therapeutic use ; Retrospective Studies ; Survival Rate ; Vincristine ; therapeutic use

OBJECTIVETo study the clinicopathologic features and prognosis of primary lymphoma of breast.

METHODSForty cases of primary breast lymphoma, diagnosed according to the 2008 World Health Organization classification of hematopoietic and lymphoid tumors, were retrospectively studied. Immunohistochemistry was performed by SP method. The follow-up data were analyzed.

RESULTS(1) All the patients were females and the median age was 47 years. Unilateral and bilateral breast involvement were noted in 36 and 4 patients, respectively. The number of tumor were 31 cases (77.5%, 31/40) less than 3, and 9 cases (22.5%, 9/40) were 3 and more than 3. According to Ann Arbor staging system, 33 cases (82.5%) were in stage I to II and 7 cases (17.5%) in stage III to IV. The level of LDH in 9 cases (24.3%, 9/37) went up. For ECOG scores, 34 cases (85.0%) were 0 to 1 score and 6 cases (15.0%) were more than 2 scores. With respect to international prognostic index, 83.8% (31/37) were of score 0 to 2 and 16.2% (6/37) were of score 3 and more than 3. The axillary lymph nodes of 21 patients (53.8%, 21/39) were involved by the malignancy. (2) Histologically, 38 cases (95.0%, 38/40) were classified as B-cell lymphoma [including 27 cases (67.5%) of diffuse large B-cell lymphoma, 8 cases (20.0%) of mucosa-associated lymphoid tissue lymphoma, 2 cases of follicular lymphoma and 1 case of lymphoplasmacytic lymphoma]. The remaining cases included one case of peripheral T-cell lymphoma and one case of lymphoblastic lymphoma. Immunohistochemically, expression of CD20+/- CD79a were demonstrated in the 38 cases (95.0%) of B-cell lymphoma. The staining for CK was negative in all cases. In 33 cases, the positive rates of MUM-1, bcl-6 and bcl-2 were 57.6% (19/33), 30.3% (10/33) and 72.7% (24/33), respectively. Three cases were germinal center B cell phenotype and 21 cases were non-germinal center B cell phenotype. (3) Follow-up information was available in 37 patients (92.5%, 37/40). Twenty-three patients (62.2%, 23/37) were still alive and fourteen ones (37.8%, 14/37) died. For the 27 cases with diffuse large B-cell lymphoma, the five-year and disease-free survival rates were 48.0% and 36.0%, respectively.

CONCLUSIONSPrimary breast lymphoma is a rare disease entity. Diffuse large B-cell lymphoma is the commonest histologic type and the majority show a non-germinal center B cell phenotype. The level of LDH, number of tumor and international prognostic index are of prognostic significance.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; CD79 Antigens ; metabolism ; Cyclophosphamide ; therapeutic use ; Disease-Free Survival ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Interferon Regulatory Factors ; metabolism ; L-Lactate Dehydrogenase ; blood ; Lymphatic Metastasis ; Lymphoma ; drug therapy ; metabolism ; pathology ; surgery ; Lymphoma, B-Cell, Marginal Zone ; drug therapy ; metabolism ; pathology ; surgery ; Lymphoma, Follicular ; drug therapy ; metabolism ; pathology ; surgery ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; surgery ; Lymphoma, T-Cell, Peripheral ; drug therapy ; metabolism ; pathology ; surgery ; Mastectomy ; methods ; Middle Aged ; Neoplasm Staging ; Prednisone ; therapeutic use ; Retrospective Studies ; Survival Rate ; Vincristine ; therapeutic use ; Young Adult

Aged, 80 and over ; Antigens, CD20 ; metabolism ; CD79 Antigens ; metabolism ; Diagnosis, Differential ; Humans ; Interferon Regulatory Factors ; metabolism ; Ki-67 Antigen ; metabolism ; Leukosialin ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; surgery ; Male ; Neoplasms, Muscle Tissue ; metabolism ; pathology ; Prostatic Neoplasms ; metabolism ; pathology ; surgery ; Prostatitis ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Receptor Protein-Tyrosine Kinases ; metabolism