TY - JOUR
T1 - High-grade B cell lymphoma, unclassifiable, with blastoid features
T2 - An unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis
AU - Kanagal-Shamanna, Rashmi
AU - Medeiros, L. Jeffrey
AU - Lu, Gary
AU - Wang, Sa A.
AU - Manning, John T.
AU - Lin, Pei
AU - Penn, Gerald M.
AU - Young, Ken H.
AU - You, M. James
AU - Vega, Francisco
AU - Bassett, Roland
AU - Miranda, Roberto N.
PY - 2012/11
Y1 - 2012/11
N2 - Aims: A subset of B cell lymphomas with blastoid features do not fit either as B lymphoblastic lymphoma/leukaemia or blastoid mantle cell lymphoma. Their classification is challenging, even with complete clinicopathological and genetic information. At a haematopathology workshop, experts had suggested the term 'high-grade B cell lymphoma, unclassifiable, with blastoid features', and recommended further studies. Methods and results: We describe the clinicopathological, immunophenotypic and cytogenetic findings of 24 high-grade B cell lymphomas, unclassifiable, with blastoid features. Fifteen patients presented de novo and seven patients had a history of lymphoma. Twenty patients (83%) presented with nodal disease. All tumours expressed pan-B cell antigens and 17 (89%) of 19 tumours assessed had a germinal centre B cell immunophenotype. Ten (63%) of 16 tumours assessed by fluorescence in-situ hybridization (FISH) had MYC rearrangement, 13 of 18 (72%) carried IGH-BCL2 and nine of 15 (60%) had both (double-hit lymphoma). The median overall survival was 1.1years. Using 2008 World Health Organization criteria, 15 cases were classified as B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma, and nine as DLBCL, small centroblastic variant. Conclusion: High-grade B cell lymphomas, unclassifiable, with blastoid features are clinically aggressive with poor survival. Most neoplasms have a germinal centre B cell phenotype. MYC rearrangements and IGH-BCL2 are common, and ∼60% are double-hit lymphomas.
AB - Aims: A subset of B cell lymphomas with blastoid features do not fit either as B lymphoblastic lymphoma/leukaemia or blastoid mantle cell lymphoma. Their classification is challenging, even with complete clinicopathological and genetic information. At a haematopathology workshop, experts had suggested the term 'high-grade B cell lymphoma, unclassifiable, with blastoid features', and recommended further studies. Methods and results: We describe the clinicopathological, immunophenotypic and cytogenetic findings of 24 high-grade B cell lymphomas, unclassifiable, with blastoid features. Fifteen patients presented de novo and seven patients had a history of lymphoma. Twenty patients (83%) presented with nodal disease. All tumours expressed pan-B cell antigens and 17 (89%) of 19 tumours assessed had a germinal centre B cell immunophenotype. Ten (63%) of 16 tumours assessed by fluorescence in-situ hybridization (FISH) had MYC rearrangement, 13 of 18 (72%) carried IGH-BCL2 and nine of 15 (60%) had both (double-hit lymphoma). The median overall survival was 1.1years. Using 2008 World Health Organization criteria, 15 cases were classified as B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma, and nine as DLBCL, small centroblastic variant. Conclusion: High-grade B cell lymphomas, unclassifiable, with blastoid features are clinically aggressive with poor survival. Most neoplasms have a germinal centre B cell phenotype. MYC rearrangements and IGH-BCL2 are common, and ∼60% are double-hit lymphomas.
KW - BCL2 rearrangement
KW - Blastoid
KW - Double-hit
KW - High-grade B cell lymphoma unclassifiable
KW - MYC rearrangement
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U2 - 10.1111/j.1365-2559.2012.04301.x
DO - 10.1111/j.1365-2559.2012.04301.x
M3 - Article
C2 - 22804688
AN - SCOPUS:84868008393
SN - 0309-0167
VL - 61
SP - 945
EP - 954
JO - Histopathology
JF - Histopathology
IS - 5
ER -