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A morphologic study of childhood lymphoma of the diffuse “histiocytic” type the pediatric oncology group experience
Author(s) -
Nathwani Bharat N.,
Griffith Rogers C.,
Kelly David R.,
Shuster Jonathan J.,
Hvizdala Eva,
Sullivan Margaret P.,
Murphy Sharon B.,
Berard Costan W.
Publication year - 1987
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19870315)59:6<1138::aid-cncr2820590617>3.0.co;2-8
Subject(s) - medicine , lymphoma , histiocyte , large cell , pathology , histology , cancer , adenocarcinoma
Of 227 cases of pediatric non‐Hodgkin's lymphoma with adequate histopathologic material for review, 72 (32%) were classified as diffuse “histiocytic” lymphoma (DHL). These cases were further divided into different morphologic subtypes according to the Lukes—Collins classification, and the National Cancer Institute Working Formulation, to ascertain whether there were any significant prognostic differences among the different subtypes. The results of our study showed that 40 patients were classified as immunoblastic lymphomas, and 32 were called large follicular center cell (FCC) tumors. Of the 40 patients with immunoblastic histology, 19 had morphologic features of the clear cell type and were interpreted as consistent with T‐immunoblastic lymphomas; an additional two had polymorphous features also consistent with T‐cell type: 17 had plasmacytoid features, and were morphologically classified as B‐immunoblastic lymphomas; two could not be subtyped. Of the 32 patients with morphologic features of FCC lymphomas, 29 were classified as large noncleaved type, and three as large cleaved type. A clinicopathologic analysis showed that 90% of the patients obtained complete remission, and there were no significant differences in complete remission rate among the different morphologic subtypes of DHL. The estimated five year disease‐free survival for all patients was over 70%, with no failure after the second year; and there were no significant differences in the disease‐free survival among the different subtypes. The only clinical differences that we found, were that patients with lymphomas of FCC (large noncleaved) type (1) were younger ( P = 0.01); (2) had less nodal involvement ( P = 0.03); and (3) had more organ involvement ( P < 0.01). We conclude that the morphologic subclassification of DHL in children currently has limited clinical prognostic significance. Cancer 59:1138‐1142, 1987.