Primary bone diffuse large B-cell lymphoma: Clinicopathologic study of 21 cases and review of literature

Sharathkumar Bhagavathi, Mark A. Micale, Kimberly Les, Jon D. Wilson, Michele L. Wiggins, Kai Fu

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Primary bone diffuse large B-cell lymphomas (PB-DLBCL) are uncommon extranodal lymphomas. Herein, we report the clinical, pathologic, immunohistochemical, and molecular features of 21 cases of PB-DLBCL. The mean age of the patients was 54 years (range: 13 to 85y). The male and female ratio was 1.6:1. The tumors consisted of diffuse sheets of large atypical cells or a polymorphous mixture of small-to-large cells with large multilobated nuclei, fine chromatin, and inconspicuous to prominent nucleoli. Twelve (57%) cases were non-germinal center B (GCB) and 9 (43%) were GCB subtype based on immunohistochemical classification. B-cell lymphomas (BCL)-2 was positive in 17/21 (81%), TP53 in 11/21 (52%) positive and the mean MIB-1 index was 57%. Polymerase chain reaction showed 10 cases with immunoglobulin heavy-chain (IGH) and 4 cases with IGH/BCL-2 gene rearrangement. The fluorescence in-situ hybridization analyses showed 14% of cases with BCL-6, 19% of cases with BCL-2, and 9% of cases with C-MYC gene rearrangement. Age <60 years and complete response to initial treatment were significant predictors of survival outcome (P≤0.05). Even though no association was observed between the subtype of PB-DLBCL (GCB vs. non-GCB), BCL2, TP53, MIB1 index and overall survival (P>0.05), due to small sample size, and variability in treatment received, this analysis may be interpreted with caution.

Original languageEnglish (US)
Pages (from-to)1463-1469
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume33
Issue number10
DOIs
StatePublished - Oct 1 2009

Fingerprint

Lymphoma, Large B-Cell, Diffuse
B-Cell Lymphoma
Bone and Bones
Immunoglobulin Heavy Chains
Gene Rearrangement
Germinal Center
Fluorescence In Situ Hybridization
Sample Size
Chromatin
Lymphoma
Polymerase Chain Reaction
Neoplasms
Therapeutics

Keywords

  • BCL6
  • C-MYC
  • IGH
  • IGH-BCL2
  • Immunohistochemistry
  • Overall survival

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

Primary bone diffuse large B-cell lymphoma : Clinicopathologic study of 21 cases and review of literature. / Bhagavathi, Sharathkumar; Micale, Mark A.; Les, Kimberly; Wilson, Jon D.; Wiggins, Michele L.; Fu, Kai.

In: American Journal of Surgical Pathology, Vol. 33, No. 10, 01.10.2009, p. 1463-1469.

Research output: Contribution to journalArticle

Bhagavathi, Sharathkumar ; Micale, Mark A. ; Les, Kimberly ; Wilson, Jon D. ; Wiggins, Michele L. ; Fu, Kai. / Primary bone diffuse large B-cell lymphoma : Clinicopathologic study of 21 cases and review of literature. In: American Journal of Surgical Pathology. 2009 ; Vol. 33, No. 10. pp. 1463-1469.
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abstract = "Primary bone diffuse large B-cell lymphomas (PB-DLBCL) are uncommon extranodal lymphomas. Herein, we report the clinical, pathologic, immunohistochemical, and molecular features of 21 cases of PB-DLBCL. The mean age of the patients was 54 years (range: 13 to 85y). The male and female ratio was 1.6:1. The tumors consisted of diffuse sheets of large atypical cells or a polymorphous mixture of small-to-large cells with large multilobated nuclei, fine chromatin, and inconspicuous to prominent nucleoli. Twelve (57{\%}) cases were non-germinal center B (GCB) and 9 (43{\%}) were GCB subtype based on immunohistochemical classification. B-cell lymphomas (BCL)-2 was positive in 17/21 (81{\%}), TP53 in 11/21 (52{\%}) positive and the mean MIB-1 index was 57{\%}. Polymerase chain reaction showed 10 cases with immunoglobulin heavy-chain (IGH) and 4 cases with IGH/BCL-2 gene rearrangement. The fluorescence in-situ hybridization analyses showed 14{\%} of cases with BCL-6, 19{\%} of cases with BCL-2, and 9{\%} of cases with C-MYC gene rearrangement. Age <60 years and complete response to initial treatment were significant predictors of survival outcome (P≤0.05). Even though no association was observed between the subtype of PB-DLBCL (GCB vs. non-GCB), BCL2, TP53, MIB1 index and overall survival (P>0.05), due to small sample size, and variability in treatment received, this analysis may be interpreted with caution.",
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