title: Prognostic significance of immunophenotypes and a nodular pattern in primary mediastinal large B-cell lymphoma.
abstract: To investigate the clinicopathological and prognostic significance of a nodular pattern and immunophenotypes in primary mediastinal large B-cell lymphoma (PMBL), histopathological features, including a nodular pattern and immunophenotypes, were analyzed in 58 Japanese PMBL patients. The patients were 23 men and 35 women with a median age of 31 years. The 4-year progression free survival (PFS) rate was 78%, and the 4-year overall survival (OS) rate was 89%. Among the histopathological and immunohistochemical features, Bcl6(+) (P = 0.013), MUM1(+) (P = 0.091), and pale cytoplasm (P = 0.064) were favorable prognostic indicators of PFS, and Bcl6(+) (P = 0.051) and MUM1(+) (P = 0.07) were favorable prognostic indicators of OS. Patients with Bcl2 negativity (n = 11) had 4-year PFS and OS rates of 100%. Histologically, a nodular pattern, resembling nodular sclerosis classical Hodgkin lymphoma (CHL), was observed in 22 patients (38%). However, this was not a significant prognostic indicator. In conclusion, Bcl6(+) , MUM1(+) , Bcl2(-) , and pale cytoplasm are candidate favorable prognostic indicators for PMBL and should be further examined in larger studies. We suggest that PMBL with a nodular pattern may belong to the same histological spectrum as nodular sclerosis CHL.
authors.affiliation: Department of Pathology and Clinical Laboratory, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Akiko Miyagi
authors.initials: AM
authors.lastname: Maeshima
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Suguru
authors.initials: S
authors.lastname: Fukuhara
authors.forename: Wataru
authors.initials: W
authors.lastname: Munakata
authors.forename: Dai
authors.initials: D
authors.lastname: Maruyama
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Kensei
authors.initials: K
authors.lastname: Tobinai
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kushima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D016130:Immunophenotyping; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D055815:Young Adult
keywords: immunohistochemistry; large B-cell lymphoma; mediastinal neoplasms; nodular; prognosis