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Perforation predicts poor prognosis in patients with primary intestinal diffuse large B‐cell lymphoma
Author(s) -
Chuang SS,
Ye H,
Yang SF,
Huang WT,
Chen HK,
Hsieh PP,
Hwang WS,
Chang KY,
Lu CL,
Du MQ
Publication year - 2008
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2008.03140.x
Subject(s) - lymphoma , pathology , chromosomal translocation , perforation , fluorescence in situ hybridization , diffuse large b cell lymphoma , tissue microarray , hazard ratio , biology , international prognostic index , bcl6 , immunohistochemistry , medicine , gastroenterology , germinal center , b cell , immunology , chromosome , confidence interval , materials science , metallurgy , punching , gene , biochemistry , antibody
Aims: To elucidate the clinicopathological features and prognostic factors of primary intestinal diffuse large B‐cell lymphoma (PI‐DLBL). Methods and results: Archival tissues from 30 tumours were used for tissue microarray construction, immunohistochemistry and interphase fluorescence in situ hybridization for chromosomal translocation. The M:F ratio was 1.7:1, with a median age of 60 years. The ileum and ileocaecum were most frequently involved (40% each). Fourteen (47%) were at stage I E disease, 15 (50%) at stage II E . Five (17%) tumours were perforated at presentation. The tumours expressed Bcl‐6 (73%), MUM1 (70%), Bcl‐2 (67%) and CD10 (23%). Nine (30%) were classified as germinal centre B‐cell (GCB) phenotype and 21 non‐GCB. Eight of 30 (27%), 7/30 (23%) and 2/29 (7%) cases were positive for rearrangements involving IGH , BCL6 , and C‐MYC loci, respectively, whereas all cases were negative for BCL2 and CCND1 translocation. Perforation was a poor prognostic indicator, with a hazard ratio of tumour‐related death at 8.75 ( P = 0.001). The differentiation antigens, GCB versus non‐GCB phenotype, or lymphoma‐associated translocations were of no prognostic significance. Conclusions: We found a higher rate of perforation and lower frequency of GCB phenotype in PI‐DLBL in Taiwan compared with other geographical areas; perforation is a poor prognostic indicator.