Nodular pattern of bone marrow infiltration: frequent finding in immunosuppression-related EBV-associated large B-cell lymphomas
| Autor: | Vundavalli V. Murty, Erin M. Weeden, Govind Bhagat, Suzy Alexander, Deborah W. Sevilla, Bachir Alobeid |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Herpesvirus 4 Human Pathology medicine.medical_specialty CD30 Gene Rearrangement B-Lymphocyte Heavy Chain Ki-1 Antigen Biology medicine.disease_cause Pathology and Forensic Medicine Bone Marrow immune system diseases hemic and lymphatic diseases medicine Humans Gammaherpesvirinae Molecular Biology Aged Aged 80 and over Immunosuppression Therapy Age Factors Large-cell lymphoma Cell Biology General Medicine Gene rearrangement Middle Aged medicine.disease biology.organism_classification Epstein–Barr virus Lymphoma medicine.anatomical_structure Child Preschool Female Lymphoma Large B-Cell Diffuse Bone marrow Diffuse large B-cell lymphoma |
| Zdroj: | Virchows Archiv. 455:323-336 |
| ISSN: | 1432-2307 0945-6317 |
| DOI: | 10.1007/s00428-009-0837-4 |
| Popis: | Different patterns of bone marrow (BM) infiltration by diffuse large B cell lymphomas (DLBCL) have been described. A pure nodular pattern is uncommon, and the pathologic features, as well as the clinical correlates of DLBCL manifesting this pattern in the BM have not been well characterized. We evaluated BM biopsies involved by large B cell lymphomas diagnosed at our institute over an 11-year period to assess the morphology, phenotype, cytogenetic abnormalities, and clinical features of cases associated with a nodular pattern. A distinct nodular pattern of BM involvement was noted in 14 out of 55 (25%) cases. Although both EBV+ and EBV− DLBCL with this pattern were identified, a pure nodular pattern was significantly more common in EBV+ DLBCL compared to EBV− DLBCL (8/9, 89% versus 6/46, 13%; P = 0.00002). The majority of EBV+ DLBCL associated with a nodular pattern had distinctive morphologic features (polymorphic cellular infiltrate and pleomorphic cytology), and CD30 expression was more commonly observed in this group (P = 0.0163). All EBV+ DLBCL and two out of six (33%) EBV− DLBCL had nongerminal center phenotypes. No recurrent cytogenetic abnormalities were detected in either group. Importantly, all EBV+ DLBCL occurred in individuals with immune dysfunction (organ transplant recipients, HIV infection) or in those >50 years of age. Our study indicates a much higher predilection for EBV+ DLBCL to involve the marrow in a nodular pattern compared to EBV− cases and highlights similarities in the morphologic pattern of BM involvement by previously recognized subsets of immunodeficiency-related EBV + lymphomas and the newer entity of “EBV+ DLBCL of the elderly.” |
| Databáze: | OpenAIRE |
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