title: Diffuse large B-cell lymphoma in the spinal epidural space: A study of the Osaka Lymphoma Study Group.
abstract: Diffuse large B-cell lymphoma (DLBCL) involving spinal epidural space (SEDLBCL) is relatively rare, constituting 1.8% of DLBCLs in Osaka, Japan. The aim of this study was to analyze SEDLBCL cases for their clinical and histopathologic findings, including an association with Epstein-Barr virus (EBV) and immunohistochemical characteristics. We analyzed the clinicopathologic findings of 27 SEDLBCL cases. They consisted of 16 males and 11 females, their age ranging from 37-86 years (median 64 years). Eight patients had stage I disease, 3 had stage II, 5 had stage III, and 11 had stage IV. Based on the staining pattern for anti-CD10, bcl-6, and MUM-1, the cases were categorized into 17 cases of the germinal center B-cell (GCB) type and nine of the non-GCB type. There was a 4%-positive rate for EBV in the tumor cells. When compared to nodal DLBCL, the frequency of patients with a high performance status (PS) is higher in SEDLBCL. Compared to the DLBCL of the central nervous system (CNS), the frequency of cases with high stage, 2 or more extranodal lesions, high international prognostic index (IPI), and GCB-type is higher in SEDLBCL. There were no significant differences in the histologic features between SEDLBCL and nodal/CNS DLBCL. Univariate analysis revealed that advanced stage was an unfavorable factor for overall survival (P=0.060). SEDLBCL is different from nodal and CNS DLBCL, but an association with EBV is unlikely in every group.
authors.affiliation: Departments of Pathology, Osaka University Graduate School of Medicine, Suita, 2-2 Yamadaoka, Suita, Osaka 565-0871, Osaka, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Wada
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kohara
authors.forename: Junichiro
authors.initials: J
authors.lastname: Ikeda
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Hori
authors.forename: Shigeki
authors.initials: S
authors.lastname: Fujita
authors.forename: Masaya
authors.initials: M
authors.lastname: Okada
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ogawa
authors.forename: Haruo
authors.initials: H
authors.lastname: Sugiyama
authors.forename: Shirou
authors.initials: S
authors.lastname: Fukuhara
authors.forename: Akihisa
authors.initials: A
authors.lastname: Kanamaru
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hino
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kanakura
authors.forename: Eiichi
authors.initials: E
authors.lastname: Morii
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Aozasa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004824:Epidural Space / Q000473:pathology*; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005260:Female; D015321:Gene Rearrangement; D050438:Genes, Immunoglobulin Heavy Chain; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016133:Polymerase Chain Reaction