title: Perforation predicts poor prognosis in patients with primary intestinal diffuse large B-cell lymphoma.
abstract: OBJECTIVE
  To elucidate the clinicopathological features and prognostic factors of primary intestinal diffuse large B-cell lymphoma (PI-DLBL).
  
  
  RESULTS
  Archival tissues from 30 tumours were used for tissue microarray construction, immunohistochemistry and interphase fluorescence in situ hybridization for chromosomal translocation. The M:F ratio was 1.7:1, with a median age of 60 years. The ileum and ileocaecum were most frequently involved (40% each). Fourteen (47%) were at stage I(E) disease, 15 (50%) at stage II(E). Five (17%) tumours were perforated at presentation. The tumours expressed Bcl-6 (73%), MUM1 (70%), Bcl-2 (67%) and CD10 (23%). Nine (30%) were classified as germinal centre B-cell (GCB) phenotype and 21 non-GCB. Eight of 30 (27%), 7/30 (23%) and 2/29 (7%) cases were positive for rearrangements involving IGH, BCL6, and C-MYC loci, respectively, whereas all cases were negative for BCL2 and CCND1 translocation. Perforation was a poor prognostic indicator, with a hazard ratio of tumour-related death at 8.75 (P = 0.001). The differentiation antigens, GCB versus non-GCB phenotype, or lymphoma-associated translocations were of no prognostic significance.
  
  
  CONCLUSIONS
  We found a higher rate of perforation and lower frequency of GCB phenotype in PI-DLBL in Taiwan compared with other geographical areas; perforation is a poor prognostic indicator.
authors.affiliation: Department of Pathology, Chi-Mei Medical Centre, Tainan and Taipei Medical University, Taipei, Taiwan. cmh5301@mail.chimei.org.tw
authors.forename: S-S
authors.initials: SS
authors.lastname: Chuang
authors.forename: H
authors.initials: H
authors.lastname: Ye
authors.forename: S-F
authors.initials: SF
authors.lastname: Yang
authors.forename: W-T
authors.initials: WT
authors.lastname: Huang
authors.forename: H-K
authors.initials: HK
authors.lastname: Chen
authors.forename: P-P
authors.initials: PP
authors.lastname: Hsieh
authors.forename: W-S
authors.initials: WS
authors.lastname: Hwang
authors.forename: K-Y
authors.initials: KY
authors.lastname: Chang
authors.forename: C-L
authors.initials: CL
authors.lastname: Lu
authors.forename: M-Q
authors.initials: MQ
authors.lastname: Du
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018858:Germinal Center / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011379:Prognosis; D016019:Survival Analysis; D014178:Translocation, Genetic