Anti-CD20 Monoclonal Antibody (Rituximab) for Therapy of T-Cell/Histiocyte-Rich Large B-Cell Non-Hodgkin Lymphoma.

Abstract T-cell/histiocyte-rich large B cell lymphoma (THR-BCL) is morphologic variants and subtypes of diffuse large B cell lymphoma (DLBCL). Four immunomorphologic criteria were applied to distinguish THR-BCL from DLBCL. a diffuse or vaguely nodular pattern of neoplastic infiltrate, the presence of scattered large atypical lymphoid cells that are of B-cell phenotype, predominance of a reactive background infiltrate, composed of both T-cell and non-epithelioid histiocytes, minimal presence of small B-cells in neoplastic areas. Bcl-6 protein expression, which was generally accepted markers of germinal center differentiation, was noted more than half of the THR-BCL cases. THR-BCL predominantly affected middle-aged men who present with advanced disease and an unusually high percentage of bone marrow (BM) involvement. Here we report a pediatric case of THR-BCL. 14-year-old boy was presented with both cervical mass which was observed 1 month ago. He complained generalized weakness and chest discomfort had fever. Cervical lymph node and BM biopsy were taken. Laboratory finding was as follows; Hemoglobin 10.4 mg/dL, hematocrit 31 %, leukocyte 6,730/μL, platelet 219,000/μL. Na 128 mmol/L, K 4.6 mmol/L, Cl 95.4 mmol/L, BUN 10 mg/dL, Cr 1.2 mg/dL, LDH 2,108 U/L. Lymph node specimen showed diffuse large B cell lymphoma and numerous histiocytes. Immnuohistochemical staining; CD 20(+), CD 10(−), CD 3(+), CD 68(+). Ann Arbor stage is IVB, international prognostic index is high-intermediate risk. He received induction chemotherapy with prednisolone, vincristine, cyclophosphamide, doxorubicin, rituximab and achieved remission and now he have continued chemotherapy for 7 months in state of complete remission. THR-BCL is a distinct clinicopathologic entity within DLBCL that is characterized by an aggressive behavior and high risk of treatment of failure. That is the reason why delineate this subgroup. Experimental therapeutic strategy was indicated in patients who relapsed after having obtained a complete remission or had partial response after initial chemotherapy.

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Nodular Lymphocyte Predominant Hodgkin Lymphoma: A Rare Case with Fan Pattern E

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.234 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S107-S107

Author(s):

E Ozluk ◽

E Wei

Keyword(s):

T Cells ◽

Lymph Node ◽

T Cell ◽

B Cell ◽

Hodgkin Lymphoma ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Large B Cell Lymphoma ◽

Atypical Cells ◽

Large B Cell

Abstract Introduction/Objective Growth patterns of nodular lymphocyte predominant Hogdkin lymphoma (NLPHL) has been further described by Fan et all. Pattern E is T cell/histiocyte rich large B-cell lymphoma-like and is quite rare. The treatment usually may follow large B cell lymphoma protocol instead of Hodgkin lymphoma regimen. Methods Here we report a patient with NLPHL pattern E. Patient was a 25 years-old African American man who initially presented with generalized lymphadenopathy. Results Biopsy of the axillary lymph node revealed effaced lymph node architecture by a malignant neoplasm in a diffuse and vaguely nodular pattern. In the background of a diffuse infiltrate, there were small to medium sized lymphocytes, numerous atypical large cells with irregular, basophilic nucleoli, and variable cytoplasm. The large cells focally sheeted out. Many histiocytes were also seen in the background. The large atypical cells were positive for CD20, BOB-1, OCT2, BCL-2 (focally), BCL-6, PAX5, and MUM-1, and IgD, whereas negative for BCL-1, CD10, CD15, CD30. CD2, CD3, CD4, CD5, CD7, CD8 highlighted numerous T cells with mild cytological atypia, forming rosettes around the large atypical cells. T cells were negative for ALK-1, CD1a, TdT with increased Ki-67 proliferation index around 35%. Although the surrounding T cells appear atypical in morphology, flow cytometric analysis showed predominantly reactive T-cells with no loss of T-cell associated antigens. PCR analysis showed a producible peak in a single IgH reaction. However, the fragment size of the peak observed did not meet the criteria. T-cell gene rearrangement by TCR gamma and TCR beta PCR was negative for monoclonal T-cells. BCL-1, BCL-2, and BCL-6 FISH panel were negative for gene rearrangements. Based on these findings the diagnosis was made at stage IV. Patient started treatment with R-CHOP therapy with subsequent relapse. Patient has been placed on RICE chemotherapy with partial response. Conclusion NLPHL Pattern E type should be differentiated from classical Hodgkin lymphoma, diffuse large B-cell lymphoma and peripheral T cell lymphoma because the treatment greatly differs from those with higher stage and tendency for recurrence. It is the pathologist role to lead the clinician and render a correct histopathologic diagnosis.

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T-Cell-Rich Diffuse Large B-cell Lymphoma Presenting as an Intraosseous Maxillary Neoplasm

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1054 ◽

2011 ◽

Vol 2 (1) ◽

pp. 53-55

Author(s):

Gururaj Patil Bheemanagouda ◽

Kaveri Satish Hallikeri ◽

Rekha Pillai Krishna

Keyword(s):

T Cell ◽

B Cell ◽

Hodgkin Lymphoma ◽

Cell Lymphoma ◽

Case Reports ◽

B Cell Lymphoma ◽

Lymphoid Cells ◽

Non Hodgkin Lymphoma ◽

Large B Cell Lymphoma ◽

Large B Cell

ABSTRACT Non-Hodgkin lymphomas are a group of highly diverse malignancies with great tendency to affect organs and tissues that do not ordinarily contain lymphoid cells. T-cell/histiocyte-rich large B-cell lymphoma (TCRBCL) is an uncommon histological variant of large B-cell non- Hodgkin lymphoma, morphologically characterized by a minor population of clonal B-cells distributed in a background of prominent reactive T lymphocytes. This is an interesting case of extranodal isolated TCRBCL in jaw bone and to our knowledge this is the first report of its kind in a nonimmune compromised 40-year-old female. An increase in the number of case reports of non-Hodgkin lymphoma in head and neck region definitely makes it to be included as differential diagnosis. The patient has completed 5 years of therapy with no evidence of recurrence.

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Nodular Lymphocyte Predominant Hodgkin Lymphoma versus T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: A Diagnostic Challenge

Case Reports in Pathology ◽

10.1155/2014/956217 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Anton V. Rets ◽

Susan R. S. Gottesman

Keyword(s):

Lymph Node ◽

T Cell ◽

B Cell ◽

Hodgkin Lymphoma ◽

De Novo ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Treatment Modalities ◽

Large B Cell Lymphoma ◽

Large B Cell

Lymphomas with overlapping histological features of two distinct entities cause difficulty in classification. Their classification is of particular significance when the two alternatives require different treatment modalities. We present a diagnostically challenging case of a nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) with features of T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL). Our patient is a 39-year-old woman who presented with painless subclavicular and axillary lymphadenopathy. The biopsied lymph node showed diffuse architectural effacement and scattered large neoplastic cells with large irregular nuclei and prominent nucleoli. These cells were positive for CD20 and Bcl-6 and negative for CD15, CD30, IgD, and Bcl-2. The background cells were predominantly T lymphocytes, whereas B cells were markedly depleted. The lymph node was interpreted as NLPHL, consistent with THRLBCL-like variant. NLPHL, especially THRLBC-like variant, and de novo THRLBCL are characterized by significant morphologic and immunophenotypic overlap. Our case demonstrates a rare predominance of background T-cells in NLPHL and emphasizes the importance of thorough evaluation of multiple morphologic and immunophenotypic features as an essential approach for arriving at the correct diagnosis.

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Interferon alfa 2b as maintenance therapy in poor risk diffuse large B-cell lymphoma in complete remission after intensive CHOP-BLEO regimens

European Journal Of Haematology ◽

10.1034/j.1600-0609.2001.00272.x ◽

2001 ◽

Vol 66 (2) ◽

pp. 94-99 ◽

Cited By ~ 12

Author(s):

Agustin Aviles ◽

Sergio Cleto ◽

Judith Huerta-Guzman ◽

Natividad Neri

Keyword(s):

Complete Remission ◽

Maintenance Therapy ◽

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Interferon Alfa ◽

Poor Risk ◽

Large B Cell Lymphoma ◽

Large B Cell

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Tumor staging in a Beagle dog with concomitant large B-cell lymphoma and T-cell acute lymphoblastic leukemia

Journal of Veterinary Diagnostic Investigation ◽

10.1177/10406387211011024 ◽

2021 ◽

pp. 104063872110110

Author(s):

Alessandro Ferrari ◽

Marzia Cozzi ◽

Luca Aresu ◽

Valeria Martini

Keyword(s):

Bone Marrow ◽

Lymph Node ◽

T Cell ◽

B Cell ◽

Cell Lymphoma ◽

Tumor Staging ◽

Lymphoblastic Leukemia ◽

B Cell Lymphoma ◽

Large B Cell Lymphoma ◽

Cell Acute Lymphoblastic Leukemia

An 8-y-old spayed female Beagle dog was presented with peripheral lymphadenomegaly. Lymph node cytology and flow cytometry led to the diagnosis of large B-cell lymphoma (LBCL). We detected minimal percentages of LBCL cells in peripheral blood and bone marrow samples. However, a monomorphic population of neoplastic cells different from those found in the lymph node was found in the bone marrow. T-cell acute lymphoblastic leukemia was suspected based on flow cytometric immunophenotyping. PCR for antigen receptor rearrangement (PARR) revealed clonal rearrangement of both B-cell and T-cell receptors, and the presence of both neoplastic clones in the lymph node, peripheral blood, and bone marrow. The dog was treated with multi-agent chemotherapy but died 46 d following diagnosis. Tumor staging and patient classification are needed to accurately establish a prognosis and select the most appropriate therapeutic protocol.

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Use of immune repertoire sequencing to resolve discordant microscopic and immunochemical findings in a case of T cell-rich large B cell lymphoma in a young dog

BMC Veterinary Research ◽

10.1186/s12917-021-02783-3 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Gary Kwok Cheong Lee ◽

Dorothee Bienzle ◽

Stefan Matthias Keller ◽

Mei-Hua Hwang ◽

Nikos Darzentas ◽

...

Keyword(s):

T Cells ◽

T Cell ◽

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Immune Repertoire ◽

Large B Cell Lymphoma ◽

Repertoire Sequencing ◽

Reactive Lymphocytes ◽

Large B Cell

Abstract Background Lymphocytic neoplasms with frequent reactive lymphocytes are uncommonly reported in dogs, and can pose a diagnostic challenge. Different diagnostic modalities such as cytology, flow cytometry, histopathology, immunohistochemistry, and clonality testing, are sometimes required for a diagnosis. This report illustrates the value of using a multi-modal diagnostic approach to decipher a complex lymphocytic tumor, and introduces immune repertoire sequencing as a diagnostic adjunct. Case presentation A 10-month-old Great Dane was referred for marked ascites. Cytologic analysis of abdominal fluid and hepatic aspirates revealed a mixed lymphocyte population including numerous large lymphocytes, yielding a diagnosis of lymphoma. Flow cytometrically, abdominal fluid lymphocytes were highly positive for CD4, CD5, CD18, CD45, and MHC II, consistent with T cell lymphoma. Due to a rapidly deteriorating clinical condition, the dog was euthanized. Post mortem histologic evaluation showed effacement of the liver by aggregates of B cells surrounded by T cells, suggestive of hepatic T cell-rich large B cell lymphoma. Immune repertoire sequencing confirmed the presence of clonal B cells in the liver but not the abdominal fluid, whereas reactive T cells with shared, polyclonal immune repertoires were found in both locations. Conclusions T cell-rich large B cell lymphoma is a rare neoplasm in dogs that may be challenging to diagnose and classify due to mixed lymphocyte populations. In this case, the results of histopathology, immunohistochemistry and immune repertoire sequencing were most consistent with a hepatic B cell neoplasm and reactive T cells exfoliating into the abdominal fluid. Immune repertoire sequencing was helpful in delineating neoplastic from reactive lymphocytes and characterizing repertoire overlap in both compartments. The potential pitfalls of equating atypical cytomorphology and monotypic marker expression in neoplasia are highlighted.

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T-Cell/Histiocyte-Rich Large B-Cell Lymphoma Presenting as a Primary Central Nervous System Lymphoma

Rare Tumors ◽

10.4081/rt.2015.6084 ◽

2015 ◽

Vol 7 (4) ◽

pp. 160-162 ◽

Cited By ~ 1

Author(s):

Pooja Advani ◽

Jason Starr ◽

Abhisek Swaika ◽

Liuyan Jiang ◽

Yushi Qiu ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

T Cell ◽

B Cell ◽

Cell Lymphoma ◽

Central Nervous System Lymphoma ◽

B Cell Lymphoma ◽

Large B Cell Lymphoma ◽

Large B Cell

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Plastin-3 is a diagnostic and prognostic marker for pancreatic adenocarcinoma and distinguishes from diffuse large B-cell lymphoma

Cancer Cell International ◽

10.1186/s12935-021-02117-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fei Xiong ◽

Guan-Hua Wu ◽

Bing Wang ◽

Yong-Jun Chen

Keyword(s):

Lymph Node ◽

B Cell ◽

Cell Lymphoma ◽

Quantitative Polymerase Chain Reaction ◽

B Cell Lymphoma ◽

Actin Binding ◽

Rank Test ◽

Large B Cell Lymphoma ◽

Tissue Specimens ◽

Large B Cell

Abstract Background Altered Plastin-3 (PLS3; an actin-binding protein) expression was associated with human carcinogenesis, including pancreatic ductal adenocarcinoma (PDA). This study first assessed differentially expressed genes (DEGs) and then bioinformatically and experimentally confirmed PLS3 to be able to predict PDA prognosis and distinguish PDA from diffuse large B-cell lymphoma. Methods This study screened multiple online databases and revealed DEGs among PDA, normal pancreas, diffuse large B-cell lymphoma (DLBCL), and normal lymph node tissues and then focused on PLS3. These DEGs were analyzed for Gene Ontology (GO) terms, Kaplan–Meier curves, and the log-rank test to characterize their association with PDA prognosis. The receiver operating characteristic curve (ROC) was plotted, and Spearman’s tests were performed. Differential PLS3 expression in different tissue specimens (n = 30) was evaluated by reverse transcription quantitative polymerase chain reaction (RT-qPCR). Results There were a great number of DEGs between PDA and lymph node, between PDA and DLBCL, and between PDA and normal pancreatic tissues. Five DEGs (NET1, KCNK1, MAL2, PLS1, and PLS3) were associated with poor overall survival of PDA patients, but only PLS3 was further verified by the R2 and ICGC datasets. The ROC analysis showed a high PLS3 AUC (area under the curve) value for PDA diagnosis, while PLS3 was able to distinguish PDA from DLBCL. The results of Spearman's analysis showed that PLS3 expression was associated with levels of KRT7, SPP1, and SPARC. Differential PLS3 expression in different tissue specimens was further validated by RT-qPCR. Conclusions Altered PLS3 expression was useful in diagnosis and prognosis of PDA as well as to distinguish PDA from DLBCL.

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