De novo CD5+ diffuse large B-cell lymphoma: results of a detailed clinicopathological review in 120 patients.
BACKGROUND
De novo CD5-positive diffuse large B-cell lymphoma (CD5(+) DLBCL) is clinicopathologically and genetically distinct from CD5-negative (CD5(-)) DLBCL and mantle cell lymphoma. The aim of this retrospective study was to clarify the histopathological spectrum and obtain new information on the therapeutic implications of CD5(+) DLBCL.


METHODS
From 1984 to 2002, 120 patients with CD5(+) DLBCL were selected from 13 collaborating institutes. We analyzed the relationship between their morphological features and long-term survival. The current series includes 101 patients described in our previous study.


RESULTS
Four morphological variants were identified: common (monomorphic) (n=91), giant cell-rich (n=13), polymorphic (n=14), and immunoblastic (n=2). Intravascular or sinusoidal infiltration was seen in 38% of the cases. BCL2 protein expression in CD5(+) DLBCL was more frequent than in CD5(-) DLBCL (p=0.0003). Immunohistochemical analysis in 44 consecutive cases of CD5(+) DLBCL revealed that 82% of these cases (36/44) were non-germinal center B-cell type DLBCL. The 5-year overall survival rate of the patients with CD5(+) DLBCL was 38% after a median observation time of 81 months. Patients with the common variant showed a better prognosis than those with the other three variants (p=0.011), and this was confirmed on multivariate analysis. Overall, 16 patients (13%) developed central nervous system recurrence.


CONCLUSIONS
Our study revealed the morphological spectrum of CD5(+) DLBCL, found that the incidence of central nervous system recurrence in this form of lymphoma in high, confirmed that CD5(+) DLBCL frequently expresses BCL2 protein and showed that it is mainly included in the non-germinal center B-cell type of DLBCL.
Yamaguchi
Motoko
M
Department of Hematology and Oncology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. waniwani@clin.medic.mie-u.ac.jp
Nakamura
Naoya
N
Suzuki
Ritsuro
R
Kagami
Yoshitoyo
Y
Okamoto
Masataka
M
Ichinohasama
Ryo
R
Yoshino
Tadashi
T
Suzumiya
Junji
J
Murase
Takuhei
T
Miura
Ikuo
I
Ohshima
Koichi
K
Nishikori
Momoko
M
Tamaru
Jun-ichi
J
Taniwaki
Masafumi
M
Hirano
Masami
M
Morishima
Yasuo
Y
Ueda
Ryuzo
R
Shiku
Hiroshi
H
Nakamura
Shigeo
S
D000368:Aged; D015703:Antigens, CD / Q000235:genetics; D001402:B-Lymphocytes / Q000276:immunology* / Q000473:pathology*; D018956:CD5 Antigens / Q000235:genetics*; D005260:Female; D014644:Genetic Variation; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D016403:Lymphoma, Large B-Cell, Diffuse / Q000276:immunology* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics; D012189:Retrospective Studies; D016019:Survival Analysis
D015703:Antigens, CD; D018956:CD5 Antigens; D019253:Proto-Oncogene Proteins c-bcl-2