title: Primary bone diffuse large B-cell lymphoma: clinicopathologic study of 21 cases and review of literature.
abstract: Primary bone diffuse large B-cell lymphomas (PB-DLBCL) are uncommon extranodal lymphomas. Herein, we report the clinical, pathologic, immunohistochemical, and molecular features of 21 cases of PB-DLBCL. The mean age of the patients was 54 years (range: 13 to 85 y). The male and female ratio was 1.6:1. The tumors consisted of diffuse sheets of large atypical cells or a polymorphous mixture of small-to-large cells with large multilobated nuclei, fine chromatin, and inconspicuous to prominent nucleoli. Twelve (57%) cases were non-germinal center B (GCB) and 9 (43%) were GCB subtype based on immunohistochemical classification. B-cell lymphomas (BCL)-2 was positive in 17/21 (81%), TP53 in 11/21 (52%) positive and the mean MIB-1 index was 57%. Polymerase chain reaction showed 10 cases with immunoglobulin heavy-chain (IGH) and 4 cases with IGH/BCL-2 gene rearrangement. The fluorescence in-situ hybridization analyses showed 14% of cases with BCL-6, 19% of cases with BCL-2, and 9% of cases with C-MYC gene rearrangement. Age <60 years and complete response to initial treatment were significant predictors of survival outcome (P< or =0.05). Even though no association was observed between the subtype of PB-DLBCL (GCB vs. non-GCB), BCL2, TP53, MIB1 index and overall survival (P>0.05), due to small sample size, and variability in treatment received, this analysis may be interpreted with caution.
authors.affiliation: Department of Pathology, Indiana University, Indianapolis, IN, USA.
authors.forename: Sharathkumar
authors.initials: S
authors.lastname: Bhagavathi
authors.forename: Mark A
authors.initials: MA
authors.lastname: Micale
authors.forename: Kimberly
authors.initials: K
authors.lastname: Les
authors.forename: Jon D
authors.initials: JD
authors.lastname: Wilson
authors.forename: Michele L
authors.initials: ML
authors.lastname: Wiggins
authors.forename: Kai
authors.initials: K
authors.lastname: Fu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D001859:Bone Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D004268:DNA-Binding Proteins / Q000235:genetics; D005260:Female; D019254:Genes, bcl-2; D016259:Genes, myc; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D019394:Ki-67 Antigen / Q000235:genetics; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011379:Prognosis; D051560:Proto-Oncogene Proteins c-bcl-6; D014178:Translocation, Genetic; D016159:Tumor Suppressor Protein p53 / Q000235:genetics; D055815:Young Adult
chemical_list: C084103:BCL6 protein, human; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D019394:Ki-67 Antigen; D051560:Proto-Oncogene Proteins c-bcl-6; D016159:Tumor Suppressor Protein p53