title: A unique subtype of diffuse large B-cell lymphoma primarily involving the bone marrow, spleen, and liver, defined by fluorodeoxyglucose-positron emission tomography combined with computed tomography.
abstract: We describe 10 cases of diffuse large B-cell lymphoma (DLBCL) confined to the bone marrow (BM), spleen, and liver, as evidenced by the uniformly increased uptake of fluorodeoxyglucose (FDG) on positron emission tomography combined with computed tomography (PET/CT). Ages ranged from 56 to 87. All, but one patient presented with 'B' symptoms, a poor performance status, and hepatosplenomegaly. All patients showed cytopenia and elevated lactate dehydrogenase levels and were classified into the high-risk category of the International Prognostic Index scoring. BM infiltration was diffuse, interstitial/intrasinusoidal, or mixed, and all showed the nongerminal center B immunophenotype. Five patients had a rearrangement involving 3q27/BCL6, while six had increased copies of MYC, BCL2, or BCL6. All patients were initially treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone, leading to complete responses in six out of eight evaluable patients. We propose BM, spleen, and liver-type DLBCL, which is defined by the findings of FDG-PET/CT.
authors.affiliation: a Departments of Hematology, Tenri Hospital , Mishima, Tenri , Japan ;
authors.forename: Futoshi
authors.initials: F
authors.lastname: Iioka
authors.affiliation: b Department of Diagnostic Pathology, Tenri Hospital , Mishima, Tenri , Japan ;
authors.forename: Gen
authors.initials: G
authors.lastname: Honjo
authors.affiliation: c Department of Radioisotope Center, Tenri Hospital , Mishima, Tenri , Japan ;
authors.forename: Takashi
authors.initials: T
authors.lastname: Misaki
authors.affiliation: a Departments of Hematology, Tenri Hospital , Mishima, Tenri , Japan ;
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Toda
authors.affiliation: a Departments of Hematology, Tenri Hospital , Mishima, Tenri , Japan ;
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Izumi
authors.affiliation: a Departments of Hematology, Tenri Hospital , Mishima, Tenri , Japan ;
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kamoda
authors.affiliation: a Departments of Hematology, Tenri Hospital , Mishima, Tenri , Japan ;
authors.forename: Yuya
authors.initials: Y
authors.lastname: Nagai
authors.affiliation: a Departments of Hematology, Tenri Hospital , Mishima, Tenri , Japan ;
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
authors.affiliation: c Department of Radioisotope Center, Tenri Hospital , Mishima, Tenri , Japan ;
authors.forename: Kazushi
authors.initials: K
authors.lastname: Kitamura
authors.affiliation: d Laboratory of Cytogenetics, Tenri Institute of Medical Research , Tenri , Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Nakagwa
authors.affiliation: d Laboratory of Cytogenetics, Tenri Institute of Medical Research , Tenri , Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Fukutsuka
authors.affiliation: d Laboratory of Cytogenetics, Tenri Institute of Medical Research , Tenri , Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Okumura
authors.affiliation: a Departments of Hematology, Tenri Hospital , Mishima, Tenri , Japan ;|d Laboratory of Cytogenetics, Tenri Institute of Medical Research , Tenri , Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ohno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging* / Q000473:pathology*; D016896:Treatment Outcome; D051598:Whole Body Imaging
chemical_list: D015415:Biomarkers; D019788:Fluorodeoxyglucose F18
keywords: BCL6 gene; BM; FDG-PET/CT; R-CHOP; diffuse large B-cell lymphoma; liver type; spleen