title: C-MYC rearrangements are frequent in aggressive mature B-Cell lymphoma with atypical morphology.
abstract: Diagnosis and classification of aggressive mature B-cell lymphoma with atypical morphology remains a challenge. To identify factors that may contribute to the atypical morphology, we selected eight such cases and evaluated their morphologic, immunophenotypic and cytogenetic features and clinical outcomes. The neoplastic cells showed a diffuse monotonous infiltrating pattern with a spectrum of morphology including: 1) L1 lymphoblastic; 2) centroblastic; 3) immunoblastic; and 4) mixed centroblastic and immunoblastic. The lymphoma cells in most cases were positive for CD10 and/or BCL6, and showed BCL2 expression. 6 of 8 cases showed C-MYC rearrangements, and interestingly, all 6 cases demonstrated a proliferation index of < or =90%. 3 of the 6 cases also demonstrated t(14;18). Clinical follow-up indicated that aggressive mature B-cell lymphoma may benefit from more intensified chemotherapeutic regimens used for BL. Our study suggests that aggressive mature B-cell lymphoma with atypical morphology may be another "grey zone lymphoma" lying in the spectrum between Burkitt lymphoma and diffuse large B-cell lymphoma.
authors.affiliation: . Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA. xzhao@umm.edu.
authors.forename: Xianfeng F
authors.initials: XF
authors.lastname: Zhao
authors.forename: Anjum
authors.initials: A
authors.lastname: Hassan
authors.forename: Arie
authors.initials: A
authors.lastname: Perry
authors.forename: Yi
authors.initials: Y
authors.lastname: Ning
authors.forename: Sanford A
authors.initials: SA
authors.lastname: Stass
authors.forename: Louis P
authors.initials: LP
authors.lastname: Dehner
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