1 / 11

T-cell/histiocyte-rich large B cell lymphoma

T-cell/histiocyte-rich large B cell lymphoma. Monirath Hav, MD, PhD fellow Pathology Department Ghent University Hospital.    Diffuse large B-cell lymphoma (DLBCL), NOS. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues 2008 edition. Introduction.

zev
Download Presentation

T-cell/histiocyte-rich large B cell lymphoma

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. T-cell/histiocyte-rich large B cell lymphoma Monirath Hav, MD, PhD fellow Pathology Department Ghent University Hospital

  2.    Diffuse large B-cell lymphoma (DLBCL), NOS WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues 2008 edition

  3. Introduction • Characterized by a limited number of scatterd, large, atypical B cells embedded in a background of abundant small T cells and frequently Histiocytes • Age: mainly middle-aged men (12-61 yo, 75% cases are male) • Refractory to present chemotherapy • Postulated normal counterpart: germinal center B cell

  4. Morphology • Diffuse or less commonly vaguley nodular growth pattern • Scattered, single, large B cells (<10%) embedded in the background of small T lymphocytes and variable numbers of histiocytes • Tumour cells do not form aggregrates or sheets and mimic popcorn cells in NLPHL but usually show a more pronouced variation in size • Cases in which tumour cells form sheets or nests should be classified as a subtype of DLBCL, NOS • Eosinophils and plasma cells are not found

  5. Immunophenotype • The large atypical cells are: • Positive for pan B cell markers, BCL6 & some for BCL2 & EMA • Negative for CD15, CD30, & CD138 • The background is composed of CD68+ histiocytes and CD3, CD5 & CD8 + T cells • Unlike in NLPHL, rosettes of T-cells around the tumour cells are not found in THRLBCL

  6. Differential diagnosis  Main DD: NLPHL  rosettes of T cells around tumour cells, usually no BM involvement, CD57+, small B cells in the background

  7. Prognosis • Aggressive lymphoma • Refractory to presently available therapy • IPI score is the only parameter of prognostic significance

  8. LHRLBCL Vs NLPHL - similarities • Predilection for middle-aged men • Both derived from germinal center B cells • Diffuse or vague nodularity growth pattern • Eosinophils and plasma cells are seldom seen • Large atypical tumour cells are (+) for CD20, CD79a, PAX5, CD45, CBL6, & BCL2 in the background of small CD3 + cells • Large atypical tumour cells are (–) for CD30* & CD15 • Large atypical tumour cells are usually EBV (–)

  9. LHRLBCL Vs NLPHL - differences

  10. References 1. WHO classification of Tumours of Haematopoietic and Lymphoid Tissues, 2008 edition 2. Frank X. Zhao. Nodular Lymphocyte-Predominant Hodgkin Lymphoma or T cell/Histiocyte Rich Large B-cell Lymphoma: The Problem in “Grey Zone” Lymphomas. Int J Clin Exp Pathol (2008) 1, 300-305 3. Ludmila Boudova et al. Nodular lymphocyte–predominant Hodgkin lymphoma with nodules resembling T-cell/histiocyte-rich B-cell lymphoma: differential diagnosis between nodular lymphocyte–predominant Hodgkin lymphoma and T-cell/histiocyte-rich B-cell lymphoma. Blood. 2003;102:3753-3758. 4. Megan S. Lim et al. T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: A Heterogeneous Entity With Derivation From Germinal Center B Cells. Am J Surg Pathol 26(11): 1458- 1466, 2002. 5. Á. Illés et al. Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) Clinicopathological Features Based on the Data of Two Hungarian Lymphoma Centres. Pathol. Oncol. Res. (2008) 14:411–421

More Related