[Nodal versus extranodal diffuse large B-cell lymphoma: comparison of clinicopathologic features, immunophenotype and prognosis].
OBJECTIVE
To study the clinicopathologic features and outcome of patients with diffuse large B-cell lymphoma (DLBCL), and to compare the differences between DLBCL of nodal and extranodal origins.


METHODS
One hundred and forty-two cases of de novo DLBCL collected during a 10-year period were reviewed. The clinicopathologic features and follow-up (2 - 108 months) data were analyzed. Tissue microarray blocks were performed and immunohistochemical studies using antibodies against CD10, bcl-6 and MUM1 were carried out. The cases were then further categorized into germinal center B cell-like (GCB) and non-GCB subtypes.


RESULTS
Primary gastrointestinal DLBCL often presented as early-stage disease (stage I or II) and was associated with low international prognostic index. They showed better prognosis than DLBCL of nodal and other extranodal origins. The positivity rates of CD10, bcl-6 and MUM1 were 19%, 51% and 58%, respectively. 36% of the cases belonged to GCB, while the remaining 64% were non-GCB. In general, DLBCL of extranodal origin showed more frequent bcl-6 expression than nodal DLBCL. As for extranodal DLBCL, GCB immunophenotype was often seen in thyroid and breast tumors, while testicular DLBCL usually carried a non-GCB immunophenotype.


CONCLUSIONS
DLBCL of various origins show a diversified GCB and non-GCB differentiation. Nodal and extranodal DLBCL, as well as extranodal DLBCL from different primary sites, carry different biologic characteristics and prognostic implications.
Lu
Jin-biao
JB
Department of Pathology, Cancer Hospital, Fudan University, Shanghai 200032, China.
Li
Xiao-qiu
XQ
Zhang
Pei-hong
PH
Zhou
Xiao-yan
XY
Zhang
Tai-ming
TM
Li
Xiao-mei
XM
Zhu
Xiong-zeng
XZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000378:metabolism / Q000473:pathology; D018858:Germinal Center / Q000473:pathology*; D006801:Humans; D050835:Interferon Regulatory Factors / Q000378:metabolism; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015260:Neprilysin / Q000378:metabolism; D011379:Prognosis; D051560:Proto-Oncogene Proteins c-bcl-6 / Q000378:metabolism*; D013736:Testicular Neoplasms / Q000378:metabolism / Q000473:pathology; D013964:Thyroid Neoplasms / Q000378:metabolism / Q000473:pathology; D055815:Young Adult; D000099218:Interferon Regulatory Factor-4
D050835:Interferon Regulatory Factors; D015260:Neprilysin; D051560:Proto-Oncogene Proteins c-bcl-6; D000099218:Interferon Regulatory Factor-4