title: Diagnosis and immunophenotype of 188 pediatric lymphoblastic lymphomas treated within a randomized prospective trial: experiences and preliminary recommendations from the European childhood lymphoma pathology panel.
abstract: The majority of lymphoblastic (precursor cell) neoplasms presents as leukemias. Consequently, the guidelines for lineage determination and subtyping of precursor cell neoplasms were primarily established for flow cytometry methods. Large-scale studies of nonleukemic lymphoblastic lymphomas are lacking so far. We analyzed a large series of pediatric patients with lymphoblastic lymphoma treated within a prospective randomized trial (the Euro-LB 02 study). Among 193 lymphomas, in which a detailed immunohistochemical analysis was carried out, there were several unusual and diagnostically challenging morphologic and immunophenotypical variants. These included 11 lymphomas with mixed phenotypes expressing markers of at least 2 hematopoietic lineages, 7 terminal deoxynucleotide transferase-negative lymphoblastic lymphomas, and 3 undifferentiated hematopoietic neoplasms that could not be assigned to any lineage with certainty. Our data indicate that World Health Organization guidelines for lineage determination and subtyping of precursor cell leukemia need to be adapted before they can be applied to immunohistochemical diagnosis of lymphoma. Using the experience from this cohort we suggest a resource-saving diagnostic staining panel for the immunohistochemical analysis of precursor cell neoplasms in formalin-fixed paraffin-embedded tissue.
authors: Department of Pathology, Hematopathology Section and Lymph Node Registry, Christian-Albrecht University, Arnold-Heller-Strasse 3, Kiel, Germany.
authors: Ilske
authors: I
authors: Oschlies
authors: Birgit
authors: B
authors: Burkhardt
authors: Catherine
authors: C
authors: Chassagne-Clement
authors: Emanuel S
authors: ES
authors: d'Amore
authors: Ulrika
authors: U
authors: Hansson
authors: Konnie
authors: K
authors: Hebeda
authors: Keith
authors: K
authors: Mc Carthy
authors: Roman
authors: R
authors: Kodet
authors: Jadwiga
authors: J
authors: Maldyk
authors: Leonhard
authors: L
authors: Müllauer
authors: Anna
authors: A
authors: Porwit
authors: Ana-Iris
authors: AI
authors: Schmatz
authors: Marianne
authors: M
authors: Tinguely
authors: Dimitry
authors: D
authors: Abramov
authors: Andrew
authors: A
authors: Wotherspoon
authors: Martin
authors: M
authors: Zimmermann
authors: Alfred
authors: A
authors: Reiter
authors: Wolfram
authors: W
authors: Klapper
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D019070:Cell Lineage; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005060:Europe; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping / Q000379:methods; D008297:Male; D017410:Practice Guidelines as Topic; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor