Diffuse Large B-cell Lymphoma (diffuse + large_b-cell_lymphoma)

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Diffuse Large B-cell Lymphoma

  • nodal diffuse large b-cell lymphoma


  • Selected Abstracts


    PREDICTIVE VALUE OF ENDOSCOPY AND ENDOSCOPIC ULTRASONOGRAPHY FOR REGRESSION OF GASTRIC DIFFUSE LARGE B-CELL LYMPHOMAS AFTER HELICOBACTER PYLORI ERADICATION

    DIGESTIVE ENDOSCOPY, Issue 4 2009
    Akira Tari
    Background:, Some gastric diffuse large B-cell lymphomas have been reported to regress completely after the successful eradication of Helicobacter pylori. The aim of this study was to investigate the clinical characteristics of gastric diffuse large B-cell lymphomas without any detectable mucosa-associated lymphoid tissue (MALT) lymphoma that went into complete remission after successful H. pylori eradication. Patients and Methods:, We examined the effect of H. pylori eradication in 15 H. pylori -positive gastric diffuse large B-cell lymphoma patients without any evidence of an associated MALT lymphoma (clinical stage I by the Lugano classification) by endoscopic examination including biopsies, endoscopic ultrasonography, computed tomography, and bone marrow aspiration. Results:,H. pylori eradication was successful in all the patients and complete remission was achieved in four patients whose clinical stage was I. By endoscopic examination, these gastric lesions appeared to be superficial. The depth by endoscopic ultrasonography was restricted to the mucosa in two patients and to the shallow portion of the submucosa in the other two patients. All four patients remained in complete remission for 7,100 months. Conclusion:, In gastric diffuse large B-cell lymphomas without a concomitant MALT lymphoma but associated with H. pylori infection, only superficial cases and lesions limited to the shallow portion of the submucosa regressed completely after successful H. pylori eradication. The endoscopic appearance and the rating of the depth of invasion by endosonography are both valuable for predicting the efficacy of H. pylori eradication in treating gastric diffuse large B-cell lymphomas. [source]


    Diffuse large B-cell lymphoma arising independently to lymphoplasmacytic lymphoma: a case of two lymphomas

    EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2007
    Tetsuaki Sekikawa
    Abstract Richter's syndrome occurs in 5,10% of patients with chronic lymphocytic leukemia, either by transformation of the primary neoplastic lymphocyte, or as a distinct B-cell neoplasm. We report a Japanese patient with lymphoplasmacytic lymphoma in whom a diffuse large B-cell lymphoma developed after treatment with rituximab. Molecular examination on immunoglobulin VH genes revealed that the lymphomas had arisen in two separate clones. We reviewed clinical case reports in literature, and found 30,40% of cases with Richter's syndrome and composite lymphoma had a second B-cell lymphoma of a different origin. [source]


    Pediatric diffuse large B-cell lymphoma demonstrates a high proliferation index, frequent c-Myc protein expression, and a high incidence of germinal center subtype: Report of the French,American,British (FAB) international study group,

    PEDIATRIC BLOOD & CANCER, Issue 3 2008
    Rodney R. Miles MD
    Abstract Background Diffuse large B-cell lymphoma (DLBCL) makes up 10,20% of pediatric non-Hodgkin lymphoma, and these patients have a significantly better prognosis than adults with DLBCL. The difference in prognosis may be related to clinical, phenotypic, and/or biological differences between adult and pediatric DLBCL. In adult DLBCL, the germinal center (GC) phenotype is associated with a better prognosis than the activated B-cell (ABC) phenotype. However, a high proliferative index and expression of Bcl2 and c-Myc protein have all been associated with worse outcomes. While multiple studies have addressed the phenotype and expression patterns of adult DLBCL, relatively little is known about these biological variables in pediatric DLBCL. The goal of this study was to investigate the proliferative index, the relative frequencies of the GC and non-GC subtypes, and the expression of Bcl2 and c-Myc protein in a cohort of children with DLBCL treated in a uniform manner. Procedure We performed immunohistochemistry (IHC) for MIB1, CD10, Bcl6, MUM1, Bcl2, and c-Myc on DLBCL tissue from children treated uniformly in the FAB LMB96 trial (SFOP LMB96/CCG5961/UKCCSG/NHL 9600). Results Compared to published adult DLBCL studies, pediatric DLBCL demonstrated moderate to high proliferation rates (83%), increased c-Myc protein expression (84%), decreased Bcl2 protein expression (28%), and an increased frequency of the GC phenotype (75%). Conclusions These findings suggest that there are significant biologic differences between pediatric and adult forms of DLBCL, which may contribute to the superior prognosis seen in the pediatric population relative to adult disease. Pediatr Blood Cancer 2008;51:369,374. © 2008 Wiley-Liss, Inc. [source]


    Molecular targeted therapies for diffuse large B-cell lymphoma based on apoptosis profiles,

    THE JOURNAL OF PATHOLOGY, Issue 5 2010
    Saskia AGM Cillessen
    Abstract Diffuse large B-cell lymphoma (DLBCL) is the most common type of adult non-Hodgkin lymphoma and is treated with chemotherapy in combination with rituximab. Despite this aggressive therapy, the disease is fatal in 30,40% of patients. Inhibition of the apoptosis signalling pathways is strongly related to response to chemotherapy and eventual clinical outcome. In order to survive, lymphoma cells depend on disruption of the apoptosis pathway by mutations in apoptosis inducing genes or by continuous expression of anti-apoptotic proteins. The development of molecules targeting these apoptosis inhibitors provides a very promising opportunity to specifically target tumour cells without toxicity to non-malignant cells in DLBCL patients. Sensitivity for most of these antagonists can be predicted based on biological markers, suggesting the possibility of pre-defining patients who will most likely benefit from these targeted therapies. Experimental therapies aimed at restoring the upstream apoptosis pathway or targeting apoptosis inhibitors are currently being tested in clinical trials and are expected to be effective particularly in chemotherapy-refractory DLBCL, providing hope for patients who are refractory to current therapies. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [source]


    Diffuse large B-cell lymphoma

    CANCER, Issue 21 2009
    Clinical characterization, prognosis of Waldeyer ring versus lymph node presentation
    Abstract BACKGROUND: The objective of this study was to compare the clinical features and prognosis of patients with diffuse large B-cell lymphoma (DLBCL) of Waldeyer ring (WR-DLBCL) and patients with lymph node DLBCL (N-DLBCL). METHODS: One hundred eighty-one patients with WR-DLBCL and N-DLBCL were reviewed. There were 57 patients with stage I disease, 83 patients with stage II disease, 26 patients with stage III disease, and 15 patients with stage IV disease. Among them, 101 patients had primary N-DLBCL, and 80 patients had primary WR-DLBCL. RESULTS: Patients with WR-DLBCL and N-DLBCL usually presented at an older age and had localized disease, a low frequency of B symptoms, a good performance status, and a low-risk International Prognostic Index (IPI) score. Compared with patients who had N-DLBCL, patients who had WR-DLBCL presented with more stage II disease and lower tumor burdens. The overall response rate after treatment was similar in both groups. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 76% and 61% in patients with WR-DLBCL, respectively, and 56% and 50% in patients with N-DLBCL, respectively (P = .119 for OS; P = .052 for PFS). IPI scores and elevated ,2-microglobulin and LDH levels were associated with a poor prognosis for patients who had WR-DLBCL; whereas bulky tumor, elevated ,2-microglobulin levels, and IPI scores were associated with poor OS for patients who had N-DLBCL. CONCLUSIONS: The current results supported the continued inclusion of WR-DLBCL as a lymph node group in the staging of DLBCL. Patients with WR-DLBCL had clinical features and prognosis similar to those of patients with N-DLBCL. Cancer 2009. © 2009 American Cancer Society. [source]


    Multiple fuzzy neural network system for outcome prediction and classification of 220 lymphoma patients on the basis of molecular profiling

    CANCER SCIENCE, Issue 10 2003
    Tatsuya Ando
    A fuzzy neural network (FNN) using gene expression profile data can select combinations of genes from thousands of genes, and is applicable to predict outcome for cancer patients after chemotherapy. However, wide clinical heterogeneity reduces the accuracy of prediction. To overcome this problem, we have proposed an FNN system based on majoritarian decision using multiple noninferior models. We used transcriptional profiling data, which were obtained from "Lymphochip" DNA microarrays (http://llmpp.nih.gov/DLBCL), reported by Rosenwald (N Engl J Med 2002; 346: 1937,47). When the data were analyzed by our FNN system, accuracy (73.4%) of outcome prediction using only 1 FNN model with 4 genes was higher than that (68.5%) of the Cox model using 17 genes. Higher accuracy (91%) was obtained when an FNN system with 9 noninferior models, consisting of 35 independent genes, was used. The genes selected by the system included genes that are informative in the prognosis of Diffuse large B-cell lymphoma (DLBCL), such as genes showing an expression pattern similar to that of CD10 and BCL-6 or similar to that of IRF-4 and BCL-4. We classified 220 DLBCL patients into 5 groups using the prediction results of 9 FNN models. These groups may correspond to DLBCL subtypes. In group A containing half of the 220 patients, patients with poor outcome were found to satisfy 2 rules, i.e., high expression of MAX dimerization with high expression of unknown A (LC_26146), or high expression of MAX dimerization with low expression of unknown B (LC_33144). The present paper is the first to describe the multiple noninferior FNN modeling system. This system is a powerful tool for predicting outcome and classifying patients, and is applicable to other heterogeneous diseases. [source]


    Diffuse large B-cell lymphoma in a patient with rheumatoid arthritis treated with infliximab and methotrexate

    CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 4 2008
    C. Nakashima
    Summary Infliximab is a tumour necrosis factor (TNF)-, blocking drug classified as a biological response modifier. It has been suggested that the risk of malignancies, especially lymphomas, is increased in patients with rheumatoid arthritis (RA) treated with anti-TNF-, antibody therapy. We present a case of malignant lymphoma during the treatment of RA with infliximab and methotrexate. [source]


    Cytologic features of recurrent lymphoma involving the urinary bladder

    DIAGNOSTIC CYTOPATHOLOGY, Issue 3 2004
    Adam M. Quinn D.O.
    Abstract Recurrent lymphoma of the bladder only occasionally presents with genitourinary symptoms, and there are very few cases in the literature reporting the cytologic findings of involvement of the urinary bladder by lymphoma. We report the findings from a case of diffuse large B-cell lymphoma with immunoblastic morphology that was identified in a bladder barbotage specimen of a 77-year-old man who presented with recurrent urinary tract infection and hematuria. We describe the cytomorphological features of lymphoma cells in the urine and discuss the differential diagnoses. Correlation of cytologic findings with immunohistochemical results is crucial in the diagnosis of lymphoma involving the urinary bladder. Diagn. Cytopathol. 2004;31:185,188. © 2004 Wiley-Liss, Inc. [source]


    Central nervous system involvement in diffuse large B-cell lymphoma

    EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 1 2010
    Wataru Yamamoto
    Abstract Background:,Malignant lymphoma with central nervous system (CNS) involvement has an extremely poor prognosis. We retrospectively studied the risk factors for CNS involvement in patients with diffuse large B-cell lymphoma (DLBCL) treated by cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or rituximab (R) -CHOP chemotherapy. Patients and methods:,We studied 375 consecutive patients who were newly diagnosed with DLBCL between 1996 and 2006. Patients with primary CNS involvement and patients who received CNS prophylaxis were excluded. All the patients received CHOP (n = 172) or R-CHOP (n = 203) chemotherapy. The following variables were assessed for their potential to predict CNS involvement: gender, age, serum lactate dehydrogenase (LDH) level, performance status, clinical stage, number of extranodal involvements, International Prognostic Index (IPI), bone marrow involvement, presence of a bulky mass, presence of B symptom, and treatment. Results:,CNS involvement was observed in 13 cases (3.5%). In univariate analysis, LDH more than normal range, LDH more than twice as normal range, high IPI, bone marrow involvement, and systemic relapse were the predictors for CNS involvement. In multivariate analysis, no risk factors were detected for CNS involvement. The use of rituximab did not have an impact on CNS involvement. Conclusions:,The incidence of CNS involvement dose not decrease in rituximab-era. [source]


    Diffuse large B-cell lymphoma arising independently to lymphoplasmacytic lymphoma: a case of two lymphomas

    EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2007
    Tetsuaki Sekikawa
    Abstract Richter's syndrome occurs in 5,10% of patients with chronic lymphocytic leukemia, either by transformation of the primary neoplastic lymphocyte, or as a distinct B-cell neoplasm. We report a Japanese patient with lymphoplasmacytic lymphoma in whom a diffuse large B-cell lymphoma developed after treatment with rituximab. Molecular examination on immunoglobulin VH genes revealed that the lymphomas had arisen in two separate clones. We reviewed clinical case reports in literature, and found 30,40% of cases with Richter's syndrome and composite lymphoma had a second B-cell lymphoma of a different origin. [source]


    Improved treatment outcome in Chinese children and adolescents with Burkitt's lymphoma and large cell lymphoma by using the modified B-non-Hodgkin's lymphoma-Berlin-Frankfurt-Münster-90 protocol

    EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2006
    Xiao-Fei Sun
    Abstract:,Objectives:,This study was designed to evaluate the efficacy and toxicity of the modified B-Non-Hodgkin's Lymphoma (NHL)-Berlin-Frankfurt-Münster (BFM)-90-based protocol in Chinese children and adolescents with Burkitt's lymphoma and large cell lymphoma. Methods:,From September 1997 to August 2005, 55 untreated patients (age less than 20 yr) from a single institution were enrolled. The patients were stratified by risk factors (stage, LDH level and chemotherapy response). All patients were treated with a modified B-NHL-BFM 90 protocol. Results:,The median age of the patients was 8 yr (range 1.5,20 yr). Of these patients, 22 (40%) had Burkitt's lymphoma (BKL), 22 (40%) had diffuse large B-cell lymphoma (DLBL) and 11 (20%) had anaplastic large T-cell lymphoma (ALCL). Complete remission (CR) occurred in 45 patients (83%), partial remission (PR) in eight patients (14.5%), and progressive disease (PD) in one patient (1.8%). At a median follow up of 24 months, the event free survival (EFS) for all patients was 85% ± 5% with 100% for group R1, 84% ± 7% for group R2 and 72% ± 13% for group R3, and most notably, 80% ± 6% for stage III/IV at diagnosis. There was no statistically significant difference (P = 0.96) in EFS among BKL and DLBL and ALCL. The major toxicity complications were myelosuppression and mucositis, but these conditions were tolerated and manageable. Conclusions:,This modified NHL-BFM-90 protocol is very effective for Chinese children and adolescents with BKL and large cell lymphomas, and represented an increase in the cure rates in childhood NHL in China. [source]


    Fas and Fas ligand expression on germinal center type-diffuse large B-cell lymphoma is associated with the clinical outcome

    EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2006
    Yasushi Kojima
    Abstract:, In recent years, diffuse large B-cell lymphoma (DLBCL) has been classified by DNA microarray analysis into the germinal center B-cell-like (GC) type, the activated B-cell-like (ABC) type and type 3. The latter two types can be collectively categorized as the non-GC (NGC) type. From the prognostic perspective, the GC type has a favorable clinical outcome when compared with the NGC type. The protein Fas induces apoptosis of lymphocytes by binding with the Fas ligand (FasL), and escape from such apoptosis is considered to lead to malignant transformation of the cells and unrestricted growth of lymphoma. We proposed a hypothesis that Fas/FasL expression could be possibly related with a better survival of GC type DLBCL and evaluated 69 DLBCL cases immunohistochemically with CD10, Bcl-6, MUM1, Fas and FasL. These lymphomas were classified as GC type (positive for CD10 or Bcl-6 and negative for MUM1) or NGC type. The GC type had a better overall survival rate than the NGC type (P = 0.0723). Among markers as given above, positive CD10 was the most significant prognostic factor for overall survival in total DLBCL (P < 0.05). In the GC type, Fas and FasL expressions were significantly associated with a favorable overall survival (Fas: P < 0.005; FasL: P < 0.05). Hence, Fas or FasL expression might contribute to a better prognosis of this type of DLBCL. [source]


    PET-CT imaging of combined brachial and lumbosacral neurolymphomatosis

    EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 1 2005
    Pazit Kanter
    Abstract:, Neurolymphomatosis is a rare manifestation of progressive non-Hodgkin's lymphoma. A 44-yr-old man with diffuse large B-cell lymphoma presented with unilateral progressive peripheral sensorimotor neuropathy after the 7th cycle of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) therapy. No pathology in the nervous system was evident by computerized tomography (CT), magnetic resonance imaging (MRI) of the head, spinal axis and plexuses and by repeated analysis of cerebrospinal fluid. However, the hybrid modality of positron emission tomography (PET) of fluorinated deoxyglucose (FDG) combined with CT scan (PET-CT) showed unilateral involvement of both the brachial and lumbosacral nervous plexuses. A complete recovery of neurological manifestations and normalization of PET-CT followed intensive chemotherapy with autologous stem cell transplantation. The diagnosis and localization of neurolymphomatosis may be supported by PET-CT imaging. [source]


    Cytogenetic, FISH, and molecular studies in a case of B-cell chronic lymphocytic leukemia with karyotypic evolution

    EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5-6 2002
    Christian Chena
    Abstract:, We report the clinical, cytogenetic, fluorescence in situ hybridization (FISH) and molecular findings in a 54-yr-old male patient diagnosed with B-cell chronic lymphocytic leukemia (B-CLL), who showed progression to a diffuse large B-cell lymphoma (Richter's syndrome). Genetic studies were performed at diagnosis and during the Richter's transformation (RT). A clonal karyotype with two dicentric chromosomes, psu dic(12,21)(q24;q10) and dic(17,18)(p11.2;p11.2), was found. Both rearrangements were confirmed by FISH. Molecular cytogenetics analysis using p53 probe showed monoallelic loss of this tumor suppressor gene in 43.8% and 77.3% of cells for the first and the second studies, respectively). In both studies, deletions of D13S319 (18% and 12% of cells) and D13S25 loci (13% and 12% of cells) at 13q14 were found. Polymerase chain reaction analysis showed the MBR/JH rearrangement of the bcl-2 gene. FISH studies using LSI bcl-2/IgH probe allowed quantifying the clonal cell population with this rearrangement (4% and 6.6% of cells at diagnosis and RT, respectively). To our knowledge, this is the first case with a psu dic(12,21) described in B-CLL. The low percentage of cells with the 13q14 deletion and bcl-2/IgH rearrangement suggests that they were secondary events that resulted from clonal evolution. Our patient had a short survival (9 months) and a clear lack of response to several therapeutic agents, confirming the association of p53 gene deletion and karyotypic evolution with disease progression. [source]


    Burkitt lymphoma versus diffuse large B-cell lymphoma: a practical approach

    HEMATOLOGICAL ONCOLOGY, Issue 4 2009
    Cristiana Bellan
    Abstract Burkitt Lymphoma (BL) is listed in the World Health Organization (WHO) classification of lymphoid tumours as an "aggressive B-cell non-Hodgkin's lymphoma", characterized by a high degree of proliferation of the malignant cells and deregulation of the c- MYC gene. The main diagnostic challenge in BL is to distinguish it from diffuse large B-cell lymphoma (DLBCL). While in children BL and DLBCL types probably do not differ clinically, and the differential diagnosis between BL and DLBCL may theoretically appear clear-cut, in adults daily practice shows the existence of cases that have morphological features, immunophenotypic and cytogenetics intermediate between DLBCL and BL, and cannot be classified with certainty in these categories. Distinguishing between BL and DLBCL is critical, as the two diseases require different management. This review summarizes the current practical approach, including the use of a large panel of antibodies, and cytogenetic and molecular diagnostic techniques, to distinguish between BL, DLBCL and the provisional category of "B-cell lymphoma, unclassificable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma", now listed in the updated WHO classification. Copyright © 2009 John Wiley & Sons, Ltd. [source]


    Combination of rituximab with chemotherapy in diffuse large B-cell lymphoma.

    HEMATOLOGICAL ONCOLOGY, Issue 3 2008
    Evaluation in daily practice before, after approval of rituximab in this indication
    Abstract Randomized trials have demonstrated improved outcome from adding rituximab to CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) for patients with diffuse large B-cell lymphoma (DLBCL). This retrospective study compared the outcomes of 224 patients with DLBCL treated in our institution before (Period 1, 1996,2002) and after (Period 2, 2002,2005) approval of rituximab in this indication to evaluate the impact of the drug in daily practice in unselected patients receiving different types of chemotherapy. We treated 131 patients in Period 1 versus 93 in Period 2 (median follow-up, 75 and 29 months, respectively) with no difference in patient characteristics between the two periods. Event-free and overall survivals (EFS and OS) were significantly improved in Period 2 for elderly patients and a significant shift in the selection of regimens was observed at the time when rituximab became available. More patients received the CHOP regimen in Period 2 than in Period 1 (82 vs. 57%, p,<,0.007) with CHOP being substituted for epirubicin-based regimens. In younger patients treated mostly with the ACVBP regimen (doxorubicin, cyclophosphamide, vindesine, bleomycin, prednisone) these differences were not observed, suggesting that combination of rituximab with dose-dense chemotherapy may deserve further evaluation in this age group. Copyright © 2008 John Wiley & Sons, Ltd. [source]


    Pyothorax-associated lymphoma (PAL): a western case with marked angiocentricity and review of the literature

    HISTOPATHOLOGY, Issue 1 2004
    A Androulaki
    Aims :,To report a case of pyothorax-associated lymphoma in a non-immunocompromised 78-year-old man with a 45-year history of tuberculous pleuritis and left pleural effusion. Pyothorax-associated lymphoma is a high-grade non-Hodgkin's lymphoma occurring in 2% of patients with long-standing tuberculous pleuritis and pyothorax. Pyothorax-associated lymphoma is frequently Epstein,Barr virus (EBV)-associated, mainly reported in Japan but exceedingly rare in western countries. Methods and results :,Histology revealed a high-grade, diffuse large B-cell lymphoma with immunoblastic and plasmacytoid features and marked angiocentricity with focal destruction of the vessel walls. Immunohistochemistry revealed a post germinal B-cell phenotype. RNA in-situ hybridization and molecular analysis showed a latent EBV infection and absence of human herpes virus-8 (HHV-8). Conclusions :,Pyothorax-associated lymphoma represents a rare but distinctive type of diffuse large B-cell lymphoma, with characteristic clinico-epidemiological, immunohistological, and biological features. [source]


    Obesity and risk of non-Hodgkin's lymphoma: A meta-analysis

    INTERNATIONAL JOURNAL OF CANCER, Issue 7 2007
    Susanna C. Larsson
    Abstract Obesity is associated with altered immune and inflammatory responses and it may therefore influence the risk of non-Hodgkin's lymphoma. However, epidemiologic findings on obesity in relation to non-Hodgkin's lymphoma have been inconsistent. We conducted a meta-analysis to summarize the epidemiologic evidence on the association between excess body weight and risk of non-Hodgkin's lymphoma. Relevant studies were identified by searching MEDLINE (1966 to February 2007) and the reference lists of retrieved publications. We included cohort and case,control studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the association of body mass index (BMI) with non-Hodgkin's lymphoma incidence or mortality. A random-effects model was used to combine results from individual studies. Sixteen studies (10 cohorts and 6 case,control studies), with 21,720 cases, met the inclusion criteria. Compared to individuals of normal weight (BMI < 25.0 kg/m2), the summary RRs of non-Hodgkin's lymphoma were 1.07 (95% CI, 1.01,1.14) for overweight individuals (BMI between 25 and 30 kg/m2) and 1.20 (95% CI, 1.07,1.34) for those who were obese (BMI ,,,, 30.0 kg/m2). Meta-analysis stratified by histologic subtypes showed that obesity was associated with a statistically significant increased risk of diffuse large B-cell lymphoma (RR, 1.40; 95% CI, 1.18,1.66; n = 6 studies) but not of follicular lymphoma (RR, 1.10; 95% CI, 0.82,1.47; n = 6 studies) or small lymphocytic lymphoma/chronic lymphocytic leukemia (RR, 0.95; 95% CI, 0.76,1.20; n = 3 studies). These findings indicate that excess body weight is associated with an increased risk of non-Hodgkin's lymphoma, especially of diffuse large B-cell lymphoma. © 2007 Wiley-Liss, Inc. [source]


    Clinicopathological features of gastric mucosa-associated lymphoid tissue lymphoma: A comparison with diffuse large B-cell lymphoma without a mucosa-associated lymphoid tissue lymphoma component

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7 2001
    Toru Hiyama
    Abstract Background and Aims: The aim of this study was to clinicopathologically distinguish the pathogenesis of gastric mucosa-associated lymphoid tissue (MALT) lymphoma and diffuse large B-cell lymphoma without a MALT lymphoma component (DLL). Methods: We investigated clinicopathological features of these gastric lymphomas including age, sex ratio, tumor location and depth, macroscopic appearance, and infection with Helicobacter pylori of these gastric lymphomas and hepatitis viruses in 24 patients with gastric low-grade MALT lymphoma, 10 patients with high-grade MALT lymphoma, and 19 patients with DLL. The frequency of H. pylori infection in lymphoma patients was compared with that in age- and sex-matched control subjects. Results: There was a predominance of females with MALT lymphoma (male to female ratio, 8/16 for low-grade MALT lymphomas and 1/9 for high-grade MALT lymphomas), and there was a predominance of males with DLL (male to female ratio, 13/6); the ratios differed significantly (P < 0.05). Ninety-two percent of low-grade MALT lymphomas and 80% of high-grade MALT lymphomas were confined to the mucosal and submucosal layers, but lymphoma cells invaded the muscular layer or more deeply in 74% of DLL. Helicobacter pylori infection occurred significantly more often in patients with low-grade MALT lymphoma than in age- and sex-matched controls (96 vs 67%, P < 0.01). Conversely, the frequency of H. pylori infection in DLL patients did not differ from that in controls. Conclusions: These data suggest that H. pylori infection may be associated with the development of gastric MALT lymphoma, but not DLL, and that MALT lymphoma and DLL may have a different pathogenesis. [source]


    Autoimmune and inflammatory disorders and risk of malignant lymphomas , an update

    JOURNAL OF INTERNAL MEDICINE, Issue 6 2008
    K. E. Smedby
    Abstract. As specific autoimmune disorders now constitute established risk factors for malignant lymphomas, we describe this association. We review reported risk levels, risk determinants, lymphoma subtypes and biological mechanisms in autoimmunity/inflammation, emphasizing on recent findings. Whilst numerous reports describe average lymphoma risks in large patient groups, there's a recent shift of focus to risk determinants and the role of inflammatory activity. Studies highlight associations with diffuse large B-cell lymphoma, apart from lymphoma development in target organs of inflammation. Future studies of high-risk patient subsets using detailed assessments of autoimmunity/inflammation and lymphoma may give important clues to lymphomagenesis. [source]


    Comparison of apoptosis and apoptosis-related gene products between extranodal oral B-cell lymphoma and maxillofacial nodal B,-,cell lymphoma

    JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 3 2001
    Hong-fang Yin
    Abstract: Twenty-seven cases of primary extranodal oral B-cell lymphoma and 22 cases of primary maxillofacial nodal B-cell lymphoma were investigated for the presence of apoptotic cells and the expression of apoptosis-related gene products by terminal deoxynucleotidyl-mediated dUTP nick end labeling (TUNEL) and immunohistochemistry. The majority of extranodal oral diffuse large B-cell lymphomas (17/25, 68%) and maxillofacial nodal diffuse large B-cell lymphomas (14/16, 88%) contained no or less than 10% apoptotic cells. Whereas the majority of extranodal oral diffuse large B-cell lymphomas (18/25, 72%) and maxillofacial nodal diffuse large B-cell lymphomas (13/16, 81%) contained more than 10% of Ki-67-positive cells. Bcl-2-, Bax-, p53- and Ki-67-positive rates were higher in maxillofacial nodal diffuse large B-cell lymphomas than in extranodal oral diffuse large B-cell lymphomas, but only Bax (,2 test, 0.01diffuse large B-cell lymphomas had a higher frequency of TUNEL expression than maxillofacial nodal diffuse large B-cell lymphomas. In maxillofacial nodal diffuse large B-cell lymphomas, stage III and stage IV tumors had a significantly higher frequency of Bcl-2 expression than stage I and stage II tumors (Fisher's exact test, P<0.01). These findings indicated that in the majority of both extranodal oral and maxillofacial nodal diffuse large B-cell lymphomas, apoptosis was inhibited , whereas proliferative activity was accelerated. Impairment of apoptosis and apoptotic related gene products may have a more important relation to maxillofacial nodal diffuse large B-cell lymphoma than extranodal oral diffuse large B-cell lymphoma. [source]


    Scalp tumour as a sign of systemic B-cell lymphoma

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2004
    S Magina
    ABSTRACT An 86-year-old man presented with a painful reddish tumour on the scalp with a 3-month history, mental confusion with recent onset and lymphadenopathies. Histological examination of the lymph node and cutaneous lesion revealed a dense infiltrate of atypical and large B cells. There was no evidence of bone marrow invasion. According to REAL (Revised European,American Classification of Lymphoid Neoplasms), this lymphoma was considered as a diffuse large B-cell lymphoma with concurrent cutaneous and nodal involvement. Cerebral computerized tomography (CT) scan showed bone and dura mater invasion in the right parieto-occipital region with collapse of lateral ventricle. The patient was submitted to systemic chemotherapy with cyclophosphamide, vincristine and prednisolone (CVP). There was a good response with regression of the cutaneous lesion, but the patient died after the third cycle. We point out the unusual clinical presentation and aggressive behaviour of this lymphoma. [source]


    Early detection of radiation therapy response in non-Hodgkin's lymphoma xenografts by in vivo1H magnetic resonance spectroscopy and imaging

    NMR IN BIOMEDICINE, Issue 6 2010
    Seung-Cheol Lee
    Abstract The purpose of the study was to investigate the capability of 1H MRS and MRI methods for detecting early response to radiation therapy in non-Hodgkin's lymphoma (NHL). Studies were performed on the WSU-DLCL2 xenograft model in nude mice of human diffuse large B-cell lymphoma, the most common form of NHL. Radiation treatment was applied as a single 15,Gy dose to the tumor. Tumor lactate, lipids, total choline, T2 and apparent diffusion coefficients (ADC) were measured before treatment and at 24,h and 72,h after radiation. A Hadamard-encoded slice-selective multiple quantum coherence spectroscopy sequence was used for detecting lactate (Lac) while a stimulated echo acquisition mode sequence was used for detection of total choline (tCho) and lipids. T2 - and diffusion-weighted imaging sequences were used for measuring T2 and ADC. Within 24,h after radiation, significant changes were observed in the normalized integrated resonance intensities of Lac and the methylenes of lipids. Lac/H2O decreased by 38,±,15% (p,=,0.03), and lipid (1.3,ppm, CH2)/H2O increased by 57,±,14% (p,=,0.01). At 72,h after radiation, tCho/H2O decreased by 45,±,14% (p,=,0.01), and lipid (2.8,ppm, polyunsaturated fatty acid)/H2O increased by 970,±,36% (p,=,0.001). ADC increased by 14,±,2% (p,=,0.003), and T2 did not change significantly. Tumor growth delay and regression were observed thereafter. This study enabled comparison of the relative sensitivities of various 1H MRS and MRI indices to radiation and suggests that 1H MRS/MRI measurements detect early responses to radiation that precede tumor volume changes. Copyright © 2010 John Wiley & Sons, Ltd. [source]


    Distribution of lymphoid neoplasms in the Republic of Korea: Analysis of 5318 cases according to the World Health Organization classification,

    AMERICAN JOURNAL OF HEMATOLOGY, Issue 10 2010
    Sun Och Yoon
    Compared with the West, the overall incidence of lymphoid neoplasms is lower, and the subtype distribution is distinct in Asia. To comprehensively investigate the subtype distribution with the age and sex factors, and temporal changes of subtype proportions, we re-assessed all patients with lymphoid neoplasms diagnosed at a large oncology service in the Republic of Korea from 1989 to 2008 using the World Health Organization classifications. Of the total 5,318 patients, 66.9% had mature B-cell neoplasms, 12.5% had mature T/natural killer (NK)-cell neoplasms, 16.4% had precursor lymphoblastic leukemia/lymphoma (ALL/LBL), and 4.1% had Hodgkin's lymphoma. The most common subtypes were diffuse large B-cell lymphoma (30.5%), plasma cell myeloma (14.0%), extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type (MALT lymphoma; 12.4%), B-cell ALL/LBL (11.3%), Hodgkin's lymphoma (4.1%), peripheral T-cell lymphoma unspecified (4.0%), T-cell ALL/LBL (3.9%), and extranodal NK/T-cell lymphoma of nasal type (3.9%). Most subtypes showed male predominance, with an average M/F ratio of 1.3. Most mature lymphoid neoplasms were diseases of adults (mean age, 53.5 yr), whereas ALL/LBLs were of young individuals (mean age, 20.3 yr). When the relative proportion of subtypes were compared between two decades (1989,1998 vs. 1999,2008), especially MALT lymphoma has increased in proportion, whereas T/NK-cell neoplasms and ALL/LBL have slightly decreased. In summary, the lymphoid neoplasms of Koreans shared some epidemiologic features similar to those of other countries, whereas some subtypes showed distinct features. Although the increase in incidence of lymphoid neoplasms is relatively modest in Korea, recent increase of MALT lymphoma and decrease of T/NK-cell neoplasms and ALL/LBL are interesting findings. Am. J. Hematol., 2010. © 2010 Wiley-Liss, Inc. [source]


    Identification of uniquely expressed transcription factors in highly purified B-cell lymphoma samples,,§

    AMERICAN JOURNAL OF HEMATOLOGY, Issue 6 2010
    Ulrika Andréasson
    Transcription factors (TFs) are critical for B-cell differentiation, affecting gene expression both by repression and transcriptional activation. Still, this information is not used for classification of B-cell lymphomas (BCLs). Traditionally, BCLs are diagnosed based on a phenotypic resemblance to normal B-cells; assessed by immunohistochemistry or flow cytometry, by using a handful of phenotypic markers. In the last decade, diagnostic and prognostic evaluation has been facilitated by global gene expression profiling (GEP), providing a new powerful means for the classification, prediction of survival, and response to treatment of lymphomas. However, most GEP studies have typically been performed on whole tissue samples, containing varying degrees of tumor cell content, which results in uncertainties in data analysis. In this study, global GEP analyses were performed on highly purified, flow-cytometry sorted tumor-cells from eight subgroups of BCLs. This enabled identification of TFs that can be uniquely associated to the tumor cells of chronic lymphocytic leukemia (CLL), diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), hairy cell leukemia (HCL), and mantle cell lymphoma (MCL). The identified transcription factors influence both the global and specific gene expression of the BCLs and have possible implications for diagnosis and treatment. Am. J. Hematol., 2010. © 2010 Wiley-Liss, Inc. [source]


    Dose-intensified treatment of Burkitt lymphoma and B-cell lymphoma unclassifiable, (with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma) in young adults (<50 years): A comparison of two adapted BFM protocols,

    AMERICAN JOURNAL OF HEMATOLOGY, Issue 4 2010
    Sudhir Tauro
    The chemotherapy dose-intensity in two adapted German BFM paediatric protocols (BFM 90 and NHL 86) was compared in contemporaneously treated adults <50 years with Burkitt lymphoma and B-cell lymphoma unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma (collectively referred to as BL). In BFM 90, primary prophylaxis with Granulocyte-colony-stimulating factor was used, postinduction treatment was started at granulocytes ,0.5 × 109/L (,1.0 × 109/L in NHL 86) with a higher mean methotrexate dose (2.9 g/m2/cycle, n = 23; 1.6 g/m2/cycle in NHL 86, n = 22, P < 0.001). Intervals between consecutive treatment-cycles were shorter in BFM 90 (P < 0.001) with no additional toxicity. However, the two-year failure-free survival with BFM 90 (82%) was similar to that achieved with NHL 86 (72%, P = 0.33). We conclude that BFM 90 enables safe intensification of therapy in young adults with BL compared to NHL 86, but registry-based studies are required to further evaluate the antineoplastic effects and cost-effectiveness of the two therapeutic approaches. Am. J. Hematol., 2010. © 2010 Wiley-Liss, Inc. [source]


    Age-related EBV-associated B-cell lymphoproliferative disorders: Diagnostic approach to a newly recognized clinicopathological entity

    PATHOLOGY INTERNATIONAL, Issue 12 2009
    Yoshie Shimoyama
    EBV is prevalent among healthy individuals, and is implicated in numerous reactive and neoplastic processes in the immune system. The authors originally identified a series of senile or age-related EBV-associated B-cell lymphoproliferative disorders (LPD) bearing a resemblance to immunodeficiency-associated ones, which may be associated with immune senescence in the elderly and which are now incorporated into the 2008 World Health Organization lymphoma classification as EBV-positive diffuse large B-cell lymphoma (DLBCL) of the elderly. This newly described disease is pathologically characterized by a proliferation of atypical large B cells including Reed,Sternberg-like cells with reactive components, which pose a diagnostic problem for pathologists. Clinically, this disease may present with lymphadenopathy, and is often extranodal, frequently involving the skin, gastrointestinal tract, or lung. Onset is usually after the age of 50; the median patient age is 70,79 years, and incidence continues to increase with age, providing additional support to the nosological term of EBV+ DLBCL of the elderly. These patients have a worse prognosis than those with EBV-negative DLBCL or EBV+ classical Hodgkin lymphoma (CHL). The aim of the present review was to summarize the clinicopathological profile of age-related EBV+ LPD and EBV+ Hodgkin lymphoma to facilitate diagnostic approach. [source]


    Sclerosing encapsulating peritonitis (abdominal cocoon) associated with liver cirrhosis and diffuse large B-cell lymphoma: Autopsy case

    PATHOLOGY INTERNATIONAL, Issue 9 2009
    Sohsuke Yamada
    A case of sclerosing encapsulating peritonitis (SEP) associated with liver cirrhosis (LC) and complicated by diffuse large B-cell lymphoma (DLBCL) is reported herein. A 49-year-old Japanese man had undergone peritoneo-venous shunt against refractory ascites due to hepatitis C virus-positive uncompensated LC for 2 years. After he received a diagnosis of DLBCL of the left neck lymph node 3 months before his death, palliative care was given because of his poor general condition. He developed severe abdominal distention and pain over 1 week and was found to have marked ascites and whole bowel lumped together on abdominal CT. At autopsy, the peritoneum was covered with a thick white membrane and the bowel could not be distinguished, which was macroscopically characterized by a cocoon-like appearance. Histology indicated a proliferation of diffusely thickened or hyalinized fibrocollagenous tissue in the entire peritoneum with a slight chronic inflammatory infiltrate and without remarkable change of mucosa. A diagnosis of SEP, also known as abdominal cocoon, was established based on these features. Additionally, in the abdominal cavity, a large amount of serous ascites and multiple peritoneal nodules or masses involved by DLBCL were recognized. To the authors' knowledge this is the first case report of SEP associated with LC and complicated by the invasion of DLBCL in the abdominal cavity. [source]


    FOXP1 expression in monoclonal gammopathy of undetermined significance and multiple myeloma

    PATHOLOGY INTERNATIONAL, Issue 5 2009
    Petra Kora
    Multiple myeloma (MM) is a clonal disorder of terminally differentiated B cells. In some cases the premalignant state is monoclonal gammopathy of undetermined significance (MGUS). Neoplastic plasma cells in both entities carry multiple and complex chromosomal abnormalities that make understanding of the disease development difficult. New insight into malignant mechanisms that underlie multiple myeloma may come from forkhead box P1 transcription factor (FOXP1) analysis in neoplastic plasma cells. FOXP1 is known to be important for B-cell maturation and differentiation and could play a significant role in plasma cell tumors. The purpose of the present study was therefore to analyze FOXP1 protein presence and FOXP1 gene abnormalities in 13 cases of MGUS and 60 cases of MM. It was found that FOXP1 protein was expressed in neoplastic plasma cells, unlike in their normal counterparts, and that additional FOXP1 gene copies could be found in both MGUS and MM. Based on FOXP1 presence in MM and its role in diffuse large B-cell lymphoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue, FOXP1 might play an important role in plasma cell neoplasm. [source]


    Expression of CD68+ tumor-associated macrophages in patients with diffuse large B-cell lymphoma and its relation to prognosis

    PATHOLOGY INTERNATIONAL, Issue 8 2008
    Sverker Hasselblom
    Tumor-associated macrophages (TAM) have been ascribed both pro- and anti-tumor properties, but the majority of clinical cancer studies have shown that the presence of a high number of TAM is related to poor prognosis, suggesting that TAM predominantly exert pro-tumoral activity. The prognostic role of TAM in patients with diffuse large B-cell lymphoma (DLBCL), however, is so far unknown. Therefore, TAM were immunohistochemically stained with a CD68 antibody in a retrospective, population-based study including 176 DLBCL patients treated with curative intent. With the exception that patients >60 years of age had a larger number of CD68+ cells (1143 vs 1018 cells/mm2; P = 0.05), no significant differences were found between the number of CD68+ cells and other clinical factors. Similarly, germinal center B-cell (GCB)/non-GCB immunophenotype or low/high Ki-67 percentage were not associated with CD68 expression. Finally, no significant correlation was found between the number of CD68+ cells and progression-free survival (P = 0.34) or overall survival (P = 0.94). These data indicate that the pro-tumor effect of TAM has limited clinical relevance in DLBCL patients, which could imply that therapeutic strategies aimed at enhancing their anti-tumor activity are of continuous clinical interest. [source]