T-cell/histiocyte-rich large B-cell lymphoma: a distinct clinicopathologic entity.
OBJECTIVE
Although it has proven difficult to delineate diagnostically reproducible and clinically relevant subgroups, the heterogeneity of diffuse large B-cell lymphomas (DLBCL) is widely acknowledged. In 1992, we reported on six cases that suggested that large B-cell lymphoma rich in stromal histiocytes and T cells may be identified as a distinct clinicopathologic entity within DLBCL.


METHODS
An integrated clinicopathologic study of 40 cases of this DLBCL subtype is presented.


RESULTS
Distinguishing a DLBCL rich in histiocytes and reactive T cells, designated T-cell/histiocyte--rich large B-cell lymphoma (THR-BCL), may be justified from a clinical point of view. The disease typically affects middle-aged male patients who usually present with advanced-stage disease that is not adequately managed with current therapeutic strategies. Whereas proliferation fraction and p53 overexpression, in addition to the clinical variables incorporated in the International Prognostic Index (IPI), significantly correlate with response to treatment and survival in a univariate analysis, only the IPI score identifies relevant prognostic THR-BCL subpopulations in a multivariate model. The morphologic and immunophenotypic profile of the neoplastic B cells in THR-BCL suggests that they may originate from a germinal center ancestor.


CONCLUSIONS
THR-BCL constitutes a distinct clinicopathologic entity that is characterized by an aggressive behavior. Experimental therapeutic strategies may be indicated to obtain a more favorable response to treatment in this disease.
Achten
R
R
Department of Morphology and Molecular Pathology, University Hospitals K.U. Leuven, Leuven, Belgium. Ruth.Achten@uz.kuleuven.ac.be
Verhoef
G
G
Vanuytsel
L
L
De Wolf-Peeters
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006644:Histiocytes / Q000473:pathology*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000145:classification* / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000145:classification* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000473:pathology*