The Experts below are selected from a list of 285 Experts worldwide ranked by ideXlab platform
L Jeffrey Medeiros - One of the best experts on this subject based on the ideXlab platform.
-
CD10-positive mantle cell lymphoma: clinicopathologic and prognostic study of 30 cases.
Oncotarget, 2017Co-Authors: Jie Xu, Michael Wang, L Jeffrey Medeiros, Annapurna Saksena, Jiehao Zhou, Jingyi Li, Guilin Tang, Lifu WangAbstract:// Jie Xu 1 , L. Jeffrey Medeiros 1 , Annapurna Saksena 1 , Michael Wang 2 , Jiehao Zhou 3 , Jingyi Li 1, 4 , C. Cameron Yin 1 , Guilin Tang 1 , Lifu Wang 1, 5 , Pei Lin 1 and Shaoying Li 1 1 Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA 2 Department of Lymphoma and Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA 3 Department of Pathology, Indiana University, Indianapolis, IN, USA 4 Department of Hematology, Tianjin First Center Hospital, China 5 Department of Pathology, Henan Provincial People's Hospital, Zhengzhou, Henan, China Correspondence to: Shaoying Li, email: sli6@mdanderson.org Keywords: CD10; mantle cell lymphoma; pathology; prognosis Received: August 18, 2017 Accepted: October 13, 2017 Published: December 15, 2017 ABSTRACT Mantle cell lymphoma is usually negative for CD10 which is useful in distinguishing MCL from other CD10 + B cell lymphomas. Here we assessed the clinicopathologic features of 30 cases of CD10+ MCL, the largest series to date in the English literature, and compared them with a group of 212 typical MCL cases (CD5+, CD10-negative, CD23-negative, cyclin D1+). The 30 patients with CD10+ MCL included 17 men and 13 women with a median age of 68 years. Compared with CD10-negative MCL, patients with CD10+ MCL showed a lower male predominance ( p = 0.01), more often had a diffuse growth pattern ( p = 0.04) and Blastoid/pleomorphic morphology ( p 60%), Blastoid/pleomorphic morphology, or high MCL International Prognostic Index (MIPI), CD10 expression was associated with a worse OS ( p = 0.003, 0.04, and 0.001, respectively). High Ki67 (> 60%), Blastoid/pleomorphic morphology, and high MIPI were also been identified as poor prognostic factors patients with in CD10+ MCL ( p = 0.001, 0.0003, and 0.01, respectively). In summary, CD10+ MCL more often has a diffuse growth pattern, Blastoid/pleomorphic morphology, and BCL6 expression. In MCL patients with a high Ki-67 (> 60%), Blastoid/pleomorphic morphology, or high MIPI, CD10 expression contributes to an even worse prognosis. MCL should be included in the differential diagnosis of CD10 + B cell lymphomas.
-
High‐grade B cell lymphoma, unclassifiable, with Blastoid features: an unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis
Histopathology, 2012Co-Authors: Rashmi Kanagal-shamanna, L Jeffrey Medeiros, Pei Lin, A. Wang, John T. Manning, Gerald M Penn, Ken H. Young, M. James You, Francisco VegaAbstract:Kanagal-Shamanna R, Medeiros L J, Lu G, Wang S A, Manning J T, Lin P, Penn G M, Young K H, You M J, Vega F, Bassett R & Miranda R N (2012) Histopathology 61, 945–954 High-grade B cell lymphoma, unclassifiable, with Blastoid features: an unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis Aims: A subset of B cell lymphomas with Blastoid features do not fit either as B lymphoblastic lymphoma/leukaemia or Blastoid mantle cell lymphoma. Their classification is challenging, even with complete clinicopathological and genetic information. At a haematopathology workshop, experts had suggested the term ‘high-grade B cell lymphoma, unclassifiable, with Blastoid features’, and recommended further studies. Methods and results: We describe the clinicopathological, immunophenotypic and cytogenetic findings of 24 high-grade B cell lymphomas, unclassifiable, with Blastoid features. Fifteen patients presented de novo and seven patients had a history of lymphoma. Twenty patients (83%) presented with nodal disease. All tumours expressed pan-B cell antigens and 17 (89%) of 19 tumours assessed had a germinal centre B cell immunophenotype. Ten (63%) of 16 tumours assessed by fluorescence in-situ hybridization (FISH) had MYC rearrangement, 13 of 18 (72%) carried IGH-BCL2 and nine of 15 (60%) had both (double-hit lymphoma). The median overall survival was 1.1 years. Using 2008 World Health Organization criteria, 15 cases were classified as B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma, and nine as DLBCL, small centroblastic variant. Conclusion: High-grade B cell lymphomas, unclassifiable, with Blastoid features are clinically aggressive with poor survival. Most neoplasms have a germinal centre B cell phenotype. MYC rearrangements and IGH-BCL2 are common, and ∼60% are double-hit lymphomas.
-
Differential expression of CKS-1B in typical and Blastoid variants of mantle cell lymphoma☆
Human pathology, 2010Co-Authors: Nalan Akyurek, Lynne V Abruzzo, Elias Drakos, Konstantinos Giaslakiotis, Ronald J. Knoblock, Yi Ning, Georgios Z. Rassidakis, L Jeffrey MedeirosAbstract:Mantle cell lymphoma is a distinct type of B-cell lymphoma characterized by the t(11;14)(q13;q32). Mantle cell lymphomas exhibit a spectrum of morphologic findings, of which a subset of tumors is clinically aggressive with a high proliferation rate. These neoplasms are known as aggressive variants of which there are Blastoid and pleomorphic subsets. CKS-1B (CDC28 protein kinase regulatory subunit 1B) is essential for the ubiquitination and degradation of p27 and cell cycle progression. We analyzed CKS-1B expression in mantle cell lymphoma cell lines and tumors by Western blot and immunohistochemical analysis. In 4 mantle cell lymphoma cell lines, CKS-1B was expressed at variable levels and correlated inversely with p27 expression. In mantle cell lymphoma tumors, CKS-1B was positive in 10 (28.6%) of 35 typical versus 14 (87.5%) of 16 Blastoid/pleomorphic cases (Fisher exact test, P = .0002). Analyzed as a continuous variable, the percentage of CKS-1B-positive cells significantly correlated with Blastoid/pleomorphic morphology (Mann-Whitney U test, P = .001). Twelve (23.5%) of 51 mantle cell lymphoma tumors expressed p27. Proliferation rate (Ki-67) was higher in Blastoid/pleomorphic variants than in typical mantle cell lymphoma tumors and was inversely associated with p27 levels in typical mantle cell lymphoma. However, CKS-1B expression did not correlate with p27 expression, proliferation rate, or prognosis in the entire study group. Fluorescence in situ hybridization analysis of 10 CKS-1B-positive mantle cell lymphoma tumors showed no evidence of CKS-1B gene amplification. We conclude that CKS-1B is commonly expressed in mantle cell lymphoma, particularly in aggressive histologic variants, and may be involved in pathogenesis.
-
Sequence analysis proves clonal identity in five patients with typical and Blastoid mantle cell lymphoma
Modern Pathology, 2007Co-Authors: C Cameron Yin, L Jeffrey Medeiros, Candy C Cromwell, Ashwini P Mehta, Pei Lin, Rajyalakshmi Luthra, Lynne V AbruzzoAbstract:Mantle cell lymphoma (MCL) is typically composed of small irregular lymphoid cells. Blastoid variants, composed of lymphoblast-like (classic type) or large (pleomorphic type) cells, arise de novo or in patients with typical MCL. Although it has been assumed that Blastoid variant represents histologic transformation of typical MCL, the clonal relationship between the two tumors has rarely been assessed at the molecular level. We identified five patients with typical MCL who subsequently developed the Blastoid variant. There were two men and three women with a median age of 65 years (range, 34–70) at diagnosis of typical MCL involving lymph nodes. The median interval between typical and Blastoid MCL was 36 months (range, 11–103). Subsequent Blastoid variant MCL involved soft tissue (two), lymph node (one), ileum (one), or rectum (one). All typical and Blastoid neoplasms were positive for CD20, cyclin D1, and monotypic surface immunoglobulin light chain, and all typical cases were positive for CD5. Two Blastoid neoplasms lost CD5 expression, one of which aberrantly expressed CD10. Immunostaining for Ki-67 showed a median proliferative fraction of 20% in typical and 70% in Blastoid neoplasms. Sequence analysis of the VDJ regions of the rearranged IgH allele proved clonal identity in each set of paired samples in all five patients. These results support the concept that Blastoid MCL arising in patients with typical MCL represents histologic transformation of the original neoplastic clone.
-
Cytogenetic findings in Blastoid mantle cell lymphoma.
Human pathology, 2003Co-Authors: Joseph D. Khoury, Lynne V Abruzzo, Filiz Şen, Kimberly Hayes, Armand B. Glassman, L Jeffrey MedeirosAbstract:A subset of mantle cell lymphoma (MCL) tumors has Blastoid morphology, and a number of morphologic variants of Blastoid MCL have been described in the literature. In this report, we document the cytogenetic findings in 27 cases of Blastoid MCL. Conventional cytogenetic analyses were performed on bone marrow aspirates involved by MCL from 27 patients. There were 14 men and 13 women with a median age of 63 years (range, 40-79 years). Diagnostic tissue biopsy and bone marrow specimens were reviewed, and cases were divided into 2 morphologic groups: classic (12 cases) and pleomorphic (15 cases), as defined in the World Health Organization classification. All tumors had an immunophenotype compatible with MCL, were positive for cyclin D1, and carried the t(11;14). Twenty-four cases had complex karyotypes with 3 or more chromosomal abnormalities in addition to the t(11;14). In classic Blastoid MCL, abnormalities of chromosomes 13, 18, and 8 were most common. In pleomorphic Blastoid MCL, abnormalities of chromosomes 13, 17, and 3 were most frequent. Chromosome 22 abnormalities were detected exclusively in the pleomorphic group. Tumors in which the neoplastic cells showed prominent nucleoli had a significantly higher frequency of chromosome 17 abnormalities (P = 0.03). We conclude that Blastoid MCL tumors often show complex cytogenetic aberrations. Some abnormalities correlate with morphologic features, suggesting that morphologic variants of Blastoid MCL may arise via different molecular pathways.
Johnny A. Waters - One of the best experts on this subject based on the ideXlab platform.
-
Devonian (Emsian, Givetian) Blastoids and crinoids from the Tafilalt, Morocco
Neues Jahrbuch Fur Geologie Und Palaontologie-abhandlungen, 2018Co-Authors: Johnny A. Waters, Christian KlugAbstract:Two Emsian species of crinoids, Kroppocrinus garamdouaraensis n. sp. and Elicrinus? weyeri, and two species of Blastoids, Pentremitidea pailleti (Emsian) and Hyperoblastus clavatus (Givetian), are described herein from the Tafilalt of Morocco. The crinoid records expand the sparse record of Devonian crinoids within Morocco; the Blastoids represent the first report of this class from the Anti-Atlas and probably northern Africa. Key words: Crinoidea, Blastoidea, Emsian, Givetian, Anti-Atlas, Tafilalt.
-
A new model of respiration in Blastoid (Echinodermata) hydrospires based on computational fluid dynamic simulations of virtual 3D models
Journal of Paleontology, 2017Co-Authors: Johnny A. Waters, Lyndsie Elizabeth White, Colin D. Sumrall, Bonnie K. NguyenAbstract:Hydrospires are internal structures in Blastoids that primarily served a respiratory function. Historically, hydrospires have been modeled as passive-flow respiratory structures with a vertical orientation. This project constructed virtual 3D models of Blastoids from legacy acetate peel collections at the Naturalis Museum in the Netherlands. Computational fluid dynamic (CFD) simulations of the Blastoid models reconstructed in living position indicated that hydrospires likely were oriented horizontally when the Blastoid was in feeding mode in current velocities>0.5 cm/s to 10 cm/s. In this range of current velocities, passive water flow through the hydrospires did not produce conditions optimized for efficient gas exchange. However, optimal water flow through the hydrospires could be achieved if the excurrent velocity of water exiting the hydrospire through the spiracle was approximately one-half the velocity of ambient environmental currents. Maintaining such a ratio in the dynamic current systems in which Blastoids lived suggests that cilia-driven active water flow through the hydrospires is a better model for optimizing respiratory effectiveness.
-
Video S1
2016Co-Authors: Imran A. Rahman, Johnny A. Waters, Colin D. Sumrall, Alberto AstolfoAbstract:Video showing a three-dimensional digital reconstruction of the early post-metamorphic, Carboniferous Blastoid (NIGP 163236)
-
stratigraphy and facies development of the marine late devonian near the boulongour reservoir northwest xinjiang china
Journal of Asian Earth Sciences, 2014Co-Authors: Thomas J Suttner, Johnny A. Waters, Erika Kido, Xiuqin Chen, Ruth Mawson, Jiři Frýda, David Mathieson, Peter D Molloy, John Pickett, Gary D WebsterAbstract:Late Devonian to Early Carboniferous stratigraphic units within the ‘Zhulumute’ Formation, HonggulelengFormation (stratotype), ‘Hebukehe’ Formation and the Heishantou Formation near the BoulongourReservoir in northwestern Xinjiang are fossil-rich. The Hongguleleng and ‘Hebukehe’ formations are biostratigraphicallywell constrained by microfossils from the latest Frasnian linguiformis to mid-Famenniantrachytera conodont biozones. The Hongguleleng Formation (96.8 m) is characterized by bioclastic argillaceouslimestones and marls (the dominant facies) intercalated with green spiculitic calcareous shales. Ityields abundant and highly diverse faunas of bryozoans, brachiopods and crinoids with subordinatesolitary rugose corals, ostracods, trilobites, conodonts and other fish teeth. The succeeding ‘Hebukehe’Formation (95.7 m) consists of siltstones, mudstones, arenites and intervals of bioclastic limestone (e.g.‘Blastoid Hill’) and cherts with radiolarians. A diverse ichnofauna, phacopid trilobites, echinoderms(crinoids and Blastoids) together with brachiopods, ostracods, bryozoans and rare cephalopods have beencollected from this interval. Analysis of geochemical data, microfacies and especially the distribution ofmarine organisms, which are not described in detail here, but used for facies analysis, indicate a deepeningof the depositional environment at the Boulongour Reservoir section. Results presented here concernmainly the sedimentological and stratigraphical context of the investigated section. Additionally, oneLate Devonian palaeo-oceanic and biotic event, the Upper Kellwasser Event is recognized near the sectionbase.
-
Stratigraphy and facies development of the marine Late Devonian near the Boulongour Reservoir, northwest Xinjiang, China
Journal of Asian Earth Sciences, 2014Co-Authors: Thomas J Suttner, Johnny A. Waters, Erika Kido, Xiuqin Chen, Ruth Mawson, Jiři Frýda, David Mathieson, Peter D Molloy, John Pickett, Gary D WebsterAbstract:Late Devonian to Early Carboniferous stratigraphic units within the 'Zhulumute' Formation, Hongguleleng Formation (stratotype), 'Hebukehe' Formation and the Heishantou Formation near the Boulongour Reservoir in northwestern Xinjiang are fossil-rich. The Hongguleleng and 'Hebukehe' formations are biostratigraphically well constrained by microfossils from the latest Frasnian linguiformis to mid-Famennian trachytera conodont biozones. The Hongguleleng Formation (96.8 m) is characterized by bioclastic argillaceous limestones and marls (the dominant facies) intercalated with green spiculitic calcareous shales. It yields abundant and highly diverse faunas of bryozoans, brachiopods and crinoids with subordinate solitary rugose corals, ostracods, trilobites, conodonts and other fish teeth. The succeeding 'Hebukehe' Formation (95.7 m) consists of siltstones, mudstones, arenites and intervals of bioclastic limestone (e.g. 'Blastoid Hill') and cherts with radiolarians. A diverse ichnofauna, phacopid trilobites, echinoderms (crinoids and Blastoids) together with brachiopods, ostracods, bryozoans and rare cephalopods have been collected from this interval. Analysis of geochemical data, microfacies and especially the distribution of marine organisms, which are not described in detail here, but used for facies analysis, indicate a deepening of the depositional environment at the Boulongour Reservoir section. Results presented here concern mainly the sedimentological and stratigraphical context of the investigated section. Additionally, one Late Devonian palaeo-oceanic and biotic event, the Upper Kellwasser Event is recognized near the section base.18 page(s
Koichi Ohshima - One of the best experts on this subject based on the ideXlab platform.
-
Epstein-Barr Virus-Positive Blastoid Variant of Mantle Cell Lymphoma in an Adult with Recurrent Infectious Mononucleosis-Like Symptoms: A Case Report
International journal of hematology, 2007Co-Authors: Masakazu Higuchi, Tsuyoshi Muta, Kennosuke Karube, Tetsuya Eto, Yujiro Yamano, Koichi OhshimaAbstract:Epstein-Barr virus (EBV) is closely associated with several lymphomas, such as Burkitt lymphoma, natural killer/T-cell lymphoma, peripheral T-cell lymphoma, and Hodgkin’s lymphoma; however, whether EBV is implicated in mantle cell lymphoma (MCL) has not been established. We report the case of an adult with recurrent infectious mononucleosis (IM)-like symptoms who developed an EBV-positive Blastoid variant of MCL. A 54-year-old Japanese man presented with fever, swelling of the oral mucosa and tongue, dispersed pulmonary infiltrations, systemic lymphadenopathy, and splenomegaly. He had a history of recurrent IM-like symptoms (prolonged fever and cervical lymphadenopathy) for at least 1 year. MCL was diagnosed by biopsy of the cervical lymph node. The anti-EBV antibody titer indicated a reactivation of chronic infection with this virus. EBV was detected in most of the lymphoma cells and in the peripheral blood. EBV might have played some role in the tumorigenesis of Blastoid MCL.
-
Blastoid Variant of Mantle Cell Lymphoma with Lactic Acidosis: A Case Report
International Journal of Hematology, 2004Co-Authors: Korenori Ohtsubo, Rie Imamura, Ritsuko Seki, Koichi Ohshima, Michitoshi Hashiguchi, Kazuaki Yakushiji, Koji Yoshimoto, Hideaki Ogata, Takashi Okamura, Michio SataAbstract:Approximately 20% of mantle cell lymphomas (MCL) present with the Blastoid variant associated with poor prognosis. Lactic acidosis complicated with hematologic malignancies is seen infrequently and is associated with a poor outcome. Here we report the case of a patient with the Blastoid variant of MCL complicated by lactic acidosis and who achieved complete remission through chemotherapy combined with rituximab therapy. A 77-year-old man presented with peripheral blood lymphoma cells, huge splenomegaly, abdominal and mediastinal lymphadenopathy, and pleural effusion. A bone marrow smear showed an increase in large, abnormal lymphoid cells with oval or round nuclei, distinct nucleoli, and abundant basophilic cytoplasm with vacuolization. Splenic sections also showed massive and diffuse infiltration by these cells. Flow cytometry analysis showed these cells to be positive for CD5, CD19, CD20, and k chain and negative for CD10 and CD23. A Blastoid variant of MCL was diagnosed from the results of histologic, immunohistochemical (cyclin D1), and cytogenetic (chimeric bcl-1/IgH fusion gene) analyses. The patient recovered from the 2 episodes of severe lactic acidosis for which he had been given chemotherapy, and he achieved complete remission after subsequent chemotherapy combined with rituximab treatment.
Pei Lin - One of the best experts on this subject based on the ideXlab platform.
-
high grade b cell lymphoma unclassifiable with Blastoid features an unusual morphological subgroup associated frequently with bcl2 and or myc gene rearrangements and a poor prognosis
Histopathology, 2012Co-Authors: Rashmi Kanagalshamanna, Pei Lin, John T. Manning, Gerald M Penn, Ken H. Young, Francisco Vega, Jeffrey L Medeiros, Sa A Wang, James M You, Roland L BassettAbstract:Kanagal-Shamanna R, Medeiros L J, Lu G, Wang S A, Manning J T, Lin P, Penn G M, Young K H, You M J, Vega F, Bassett R & Miranda R N (2012) Histopathology 61, 945–954 High-grade B cell lymphoma, unclassifiable, with Blastoid features: an unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis Aims: A subset of B cell lymphomas with Blastoid features do not fit either as B lymphoblastic lymphoma/leukaemia or Blastoid mantle cell lymphoma. Their classification is challenging, even with complete clinicopathological and genetic information. At a haematopathology workshop, experts had suggested the term ‘high-grade B cell lymphoma, unclassifiable, with Blastoid features’, and recommended further studies. Methods and results: We describe the clinicopathological, immunophenotypic and cytogenetic findings of 24 high-grade B cell lymphomas, unclassifiable, with Blastoid features. Fifteen patients presented de novo and seven patients had a history of lymphoma. Twenty patients (83%) presented with nodal disease. All tumours expressed pan-B cell antigens and 17 (89%) of 19 tumours assessed had a germinal centre B cell immunophenotype. Ten (63%) of 16 tumours assessed by fluorescence in-situ hybridization (FISH) had MYC rearrangement, 13 of 18 (72%) carried IGH-BCL2 and nine of 15 (60%) had both (double-hit lymphoma). The median overall survival was 1.1 years. Using 2008 World Health Organization criteria, 15 cases were classified as B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma, and nine as DLBCL, small centroblastic variant. Conclusion: High-grade B cell lymphomas, unclassifiable, with Blastoid features are clinically aggressive with poor survival. Most neoplasms have a germinal centre B cell phenotype. MYC rearrangements and IGH-BCL2 are common, and ∼60% are double-hit lymphomas.
-
High‐grade B cell lymphoma, unclassifiable, with Blastoid features: an unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis
Histopathology, 2012Co-Authors: Rashmi Kanagal-shamanna, L Jeffrey Medeiros, Pei Lin, A. Wang, John T. Manning, Gerald M Penn, Ken H. Young, M. James You, Francisco VegaAbstract:Kanagal-Shamanna R, Medeiros L J, Lu G, Wang S A, Manning J T, Lin P, Penn G M, Young K H, You M J, Vega F, Bassett R & Miranda R N (2012) Histopathology 61, 945–954 High-grade B cell lymphoma, unclassifiable, with Blastoid features: an unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis Aims: A subset of B cell lymphomas with Blastoid features do not fit either as B lymphoblastic lymphoma/leukaemia or Blastoid mantle cell lymphoma. Their classification is challenging, even with complete clinicopathological and genetic information. At a haematopathology workshop, experts had suggested the term ‘high-grade B cell lymphoma, unclassifiable, with Blastoid features’, and recommended further studies. Methods and results: We describe the clinicopathological, immunophenotypic and cytogenetic findings of 24 high-grade B cell lymphomas, unclassifiable, with Blastoid features. Fifteen patients presented de novo and seven patients had a history of lymphoma. Twenty patients (83%) presented with nodal disease. All tumours expressed pan-B cell antigens and 17 (89%) of 19 tumours assessed had a germinal centre B cell immunophenotype. Ten (63%) of 16 tumours assessed by fluorescence in-situ hybridization (FISH) had MYC rearrangement, 13 of 18 (72%) carried IGH-BCL2 and nine of 15 (60%) had both (double-hit lymphoma). The median overall survival was 1.1 years. Using 2008 World Health Organization criteria, 15 cases were classified as B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma, and nine as DLBCL, small centroblastic variant. Conclusion: High-grade B cell lymphomas, unclassifiable, with Blastoid features are clinically aggressive with poor survival. Most neoplasms have a germinal centre B cell phenotype. MYC rearrangements and IGH-BCL2 are common, and ∼60% are double-hit lymphomas.
-
Sequence analysis proves clonal identity in five patients with typical and Blastoid mantle cell lymphoma
Modern Pathology, 2007Co-Authors: C Cameron Yin, L Jeffrey Medeiros, Candy C Cromwell, Ashwini P Mehta, Pei Lin, Rajyalakshmi Luthra, Lynne V AbruzzoAbstract:Mantle cell lymphoma (MCL) is typically composed of small irregular lymphoid cells. Blastoid variants, composed of lymphoblast-like (classic type) or large (pleomorphic type) cells, arise de novo or in patients with typical MCL. Although it has been assumed that Blastoid variant represents histologic transformation of typical MCL, the clonal relationship between the two tumors has rarely been assessed at the molecular level. We identified five patients with typical MCL who subsequently developed the Blastoid variant. There were two men and three women with a median age of 65 years (range, 34–70) at diagnosis of typical MCL involving lymph nodes. The median interval between typical and Blastoid MCL was 36 months (range, 11–103). Subsequent Blastoid variant MCL involved soft tissue (two), lymph node (one), ileum (one), or rectum (one). All typical and Blastoid neoplasms were positive for CD20, cyclin D1, and monotypic surface immunoglobulin light chain, and all typical cases were positive for CD5. Two Blastoid neoplasms lost CD5 expression, one of which aberrantly expressed CD10. Immunostaining for Ki-67 showed a median proliferative fraction of 20% in typical and 70% in Blastoid neoplasms. Sequence analysis of the VDJ regions of the rearranged IgH allele proved clonal identity in each set of paired samples in all five patients. These results support the concept that Blastoid MCL arising in patients with typical MCL represents histologic transformation of the original neoplastic clone.
Francisco Vega - One of the best experts on this subject based on the ideXlab platform.
-
high grade b cell lymphoma unclassifiable with Blastoid features an unusual morphological subgroup associated frequently with bcl2 and or myc gene rearrangements and a poor prognosis
Histopathology, 2012Co-Authors: Rashmi Kanagalshamanna, Pei Lin, John T. Manning, Gerald M Penn, Ken H. Young, Francisco Vega, Jeffrey L Medeiros, Sa A Wang, James M You, Roland L BassettAbstract:Kanagal-Shamanna R, Medeiros L J, Lu G, Wang S A, Manning J T, Lin P, Penn G M, Young K H, You M J, Vega F, Bassett R & Miranda R N (2012) Histopathology 61, 945–954 High-grade B cell lymphoma, unclassifiable, with Blastoid features: an unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis Aims: A subset of B cell lymphomas with Blastoid features do not fit either as B lymphoblastic lymphoma/leukaemia or Blastoid mantle cell lymphoma. Their classification is challenging, even with complete clinicopathological and genetic information. At a haematopathology workshop, experts had suggested the term ‘high-grade B cell lymphoma, unclassifiable, with Blastoid features’, and recommended further studies. Methods and results: We describe the clinicopathological, immunophenotypic and cytogenetic findings of 24 high-grade B cell lymphomas, unclassifiable, with Blastoid features. Fifteen patients presented de novo and seven patients had a history of lymphoma. Twenty patients (83%) presented with nodal disease. All tumours expressed pan-B cell antigens and 17 (89%) of 19 tumours assessed had a germinal centre B cell immunophenotype. Ten (63%) of 16 tumours assessed by fluorescence in-situ hybridization (FISH) had MYC rearrangement, 13 of 18 (72%) carried IGH-BCL2 and nine of 15 (60%) had both (double-hit lymphoma). The median overall survival was 1.1 years. Using 2008 World Health Organization criteria, 15 cases were classified as B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma, and nine as DLBCL, small centroblastic variant. Conclusion: High-grade B cell lymphomas, unclassifiable, with Blastoid features are clinically aggressive with poor survival. Most neoplasms have a germinal centre B cell phenotype. MYC rearrangements and IGH-BCL2 are common, and ∼60% are double-hit lymphomas.
-
High‐grade B cell lymphoma, unclassifiable, with Blastoid features: an unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis
Histopathology, 2012Co-Authors: Rashmi Kanagal-shamanna, L Jeffrey Medeiros, Pei Lin, A. Wang, John T. Manning, Gerald M Penn, Ken H. Young, M. James You, Francisco VegaAbstract:Kanagal-Shamanna R, Medeiros L J, Lu G, Wang S A, Manning J T, Lin P, Penn G M, Young K H, You M J, Vega F, Bassett R & Miranda R N (2012) Histopathology 61, 945–954 High-grade B cell lymphoma, unclassifiable, with Blastoid features: an unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis Aims: A subset of B cell lymphomas with Blastoid features do not fit either as B lymphoblastic lymphoma/leukaemia or Blastoid mantle cell lymphoma. Their classification is challenging, even with complete clinicopathological and genetic information. At a haematopathology workshop, experts had suggested the term ‘high-grade B cell lymphoma, unclassifiable, with Blastoid features’, and recommended further studies. Methods and results: We describe the clinicopathological, immunophenotypic and cytogenetic findings of 24 high-grade B cell lymphomas, unclassifiable, with Blastoid features. Fifteen patients presented de novo and seven patients had a history of lymphoma. Twenty patients (83%) presented with nodal disease. All tumours expressed pan-B cell antigens and 17 (89%) of 19 tumours assessed had a germinal centre B cell immunophenotype. Ten (63%) of 16 tumours assessed by fluorescence in-situ hybridization (FISH) had MYC rearrangement, 13 of 18 (72%) carried IGH-BCL2 and nine of 15 (60%) had both (double-hit lymphoma). The median overall survival was 1.1 years. Using 2008 World Health Organization criteria, 15 cases were classified as B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma, and nine as DLBCL, small centroblastic variant. Conclusion: High-grade B cell lymphomas, unclassifiable, with Blastoid features are clinically aggressive with poor survival. Most neoplasms have a germinal centre B cell phenotype. MYC rearrangements and IGH-BCL2 are common, and ∼60% are double-hit lymphomas.