eISSN: 2084-9869
ISSN: 1233-9687
Polish Journal of Pathology
Current issue Archive Manuscripts accepted About the journal Supplements Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
vol. 69
Review paper

Comprehensive histopathological diagnostics of aggressive B-cell lymphomas based on the updated criteria of the World Health Organisation’s 2017 classification

Anna Szumera-Ciećkiewicz, Grzegorz Rymkiewicz, Beata Grygalewicz, Dorota Jesionek-Kupnicka, Andrzej Gruchała, Bogna Ziarkiewicz-Wróblewska, Krystyna Gałązka, Joanna Reszeć, Katarzyna Borg, Monika Prochorec-Sobieszek

Pol J Pathol 2018; 69 (1): 1-19
Online publish date: 2018/05/07
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Revision of the fourth edition of the World Health Organisation (WHO) Classification of Haematopoietic and Lymphatic Tissues, which was published in 2017, introduced important changes updating the biology, pathology, genetics, and clinical presentation of aggressive B-cell lymphomas. High grade B-cell lymphomas (HGBLs) replaced B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma, the new provisional entity Burkitt-like lymphoma with 11q aberration was identified, and some categories were upgraded, e.g. EBV-positive diffuse large B-cell lymphoma, not otherwise specified. Still the histopathological diagnostics is based on morphology and immunoprofile, but to define the HGBLs evaluation of MYC, BCL2, and BCL6 gene statuses is required. According to the presented WHO criteria, in the comprehensive histopathological diagnostics of aggressive B-cell lymphomas a highly specialised diagnostic team including a pathologist, a molecular biologist, a geneticist, a haematologist, and immunophenotyping technicians is needed.

aggressive B-cell lymphomas, high grade B-cell lymphomas, Burkitt-like lymphoma,11q aberration

Swerdlow SH, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition). IARC Press, Lyon 2017.
Jaffe ES, Arber DA, Campo E, et al., Hematopathology E-Book. Second ed. Elservier Inc, Philadelphia 2017.
A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin’s lymphoma. The Non-Hodgkin’s Lymphoma Classification Project. Blood 1997; 89: 3909-39018.
Szumera-Cieckiewicz A, Gałązka K, Szpor J, et al., Distribution of lymphomas in Poland according to World Health Organization classification: analysis of 11718 cases from National Histopathological Lymphoma Register project – the Polish Lymphoma Research Group study. Int J Clin Exp Pathol 2014; 7: 3280-3286.
Taylor J, Xiao W, Abdel-Wahab O. Diagnosis and classification of hematologic malignancies on the basis of genetics. Blood 2017. 130: 410-423.
Pasqualucci L, Dalla-Favera R. The genetic landscape of diffuse large B-cell lymphoma. Semin Hematol 2015; 52: 67-76.
Schneider C, Pasqualucci L, Dalla-Favera R. Molecular pathogenesis of diffuse large B-cell lymphoma. Semin Diagn Pathol 2011; 28: 167-77.
Copie-Bergman C, Cuillière-Dartigues P, Baia M, et al. MYC-IG rearrangements are negative predictors of survival in DLBCL patients treated with immunochemotherapy: a GELA/LYSA study. Blood 2015; 126: 2466-2474.
Hwang HS, Park CS, Yoon DH, et al., High concordance of gene expression profiling-correlated immunohistochemistry algorithms in diffuse large B-cell lymphoma, not otherwise specified. Am J Surg Pathol 2014; 38: 1046-1057.
Landsburg DJ, Falkiewicz MK, Petrich AM, et al., Sole rearrangement but not amplification of MYC is associated with a poor prognosis in patients with diffuse large B cell lymphoma and B cell lymphoma unclassifiable. Br J Haematol 2016; 175: 631-640.
Moore EM, Aggarwal N, Surti U, et al., Further exploration of the complexities of large B-cell lymphomas with MYC abnormalities and the importance of a blastoid morphology. Am J Surg Pathol 2017; 41: 1155-1166.
Otto C, Scholtysik R, Schmitz R, et al., Novel IGH and MYC Translocation Partners in Diffuse Large B-Cell Lymphomas. Genes Chromosomes Cancer 2016; 55: 932-943.
Pedersen MØ, Gang AO, Brown P, et al., Real world data on young patients with high-risk diffuse large B-cell lymphoma treated with R-CHOP or R-CHOEP - MYC, BCL2 and BCL6 as prognostic biomarkers. PLoS One 2017; 12: e0186983.
Quesada AE, Medeiros LJ, Desai PA, et al., Increased MYC copy number is an independent prognostic factor in patients with diffuse large B-cell lymphoma. Mod Pathol 2017; 30: 1688-1697.
Schmidt-Hansen M, Berendse S, Marafioti T, et al. Does cell-of-origin or MYC, BCL2 or BCL6 translocation status provide prognostic information beyond the International Prognostic Index score in patients with diffuse large B-cell lymphoma treated with rituximab and chemotherapy? A systematic review. Leuk Lymphoma 2017; 58: 2403-2418.
Staiger AM, Ziepert M, Horn H, et al. Clinical Impact of the Cell-of-Origin Classification and the MYC/ BCL2 Dual Expresser Status in Diffuse Large B-Cell Lymphoma Treated Within Prospective Clinical Trials of the German High-Grade Non-Hodgkin’s Lymphoma Study Group. J Clin Oncol 2017; 35: 2515-2526.
Turakhia SK, Hill BT, Dufresne SD, et al. Aggressive B-cell lymphomas with translocations involving BCL6 and MYC have distinct clinical-pathologic characteristics. Am J Clin Pathol 2014; 142: 339-346.
Ye Q, Xu-Monette ZY, Tzankov A, et al. Prognostic impact of concurrent MYC and BCL6 rearrangements and expression in de novo diffuse large B-cell lymphoma. Oncotarget 2016; 7: 2401-2416.
Swerdlow SH. Diagnosis of ‘double hit’ diffuse large B-cell lymphoma and B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and Burkitt lymphoma: when and how, FISH versus IHC. Hematology Am Soc Hematol Educ Program 2014; 2014: 90-99.
Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016; 127: 2375-2390.
Campo E. MYC in DLBCL: partners matter. Blood 2015; 126: 2439-2440.
Camicia R, Winkler HC, Hassa PO. Novel drug targets for personalized precision medicine in relapsed/refractory diffuse large B-cell lymphoma: a comprehensive review. Mol Cancer, 2015; 14: 207.
Chiappella A, Santambrogio E, Castellino A, et al. Integrating novel drugs to chemoimmunotherapy in diffuse large B-cell lymphoma. Expert Rev Hematol 2017; 10: 697-705.
Choi WW, Weisenburger DD, Greiner TC, et al. A new immunostain algorithm classifies diffuse large B-cell lymphoma into molecular subtypes with high accuracy. Clin Cancer Res 2009; 15: 5494-5502.
Hong J, Park S, Park J, et al. Evaluation of prognostic values of clinical and histopathologic characteristics in diffuse large B-cell lymphoma treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy. Leuk Lymphoma 2011; 52: 1904-1912.
Nyman H, Jerkeman M, Karjalainen-Lindsberg ML, et al. Prognostic impact of activated B-cell focused classification in diffuse large B-cell lymphoma patients treated with R-CHOP. Mod Pathol 2009; 22: 1094-1101.
Sjo LD. Poulsen CB, Hansen M, et al. Profiling of diffuse large B-cell lymphoma by immunohistochemistry: identification of prognostic subgroups. Eur J Haematol 2007; 79: 501-507.
Li S, Young KH, Medeiros LJ. Diffuse large B-cell lymphoma. Pathology 2018; 50: 74-87.
Roschewski M, Staudt LM, Wilson WH. Diffuse large B-cell lymphoma-treatment approaches in the molecular era. Nat Rev Clin Oncol 2014; 11: 12-23.
Yoon N, Ahn S, Yong Yoo H, et al. Cell-of-origin of diffuse large B-cell lymphomas determined by the Lymph2Cx assay: better prognostic indicator than Hans algorithm. Oncotarget 2017; 8: 22014-22022.
Cascione L, Rinaldi A, Chiappella A, et al. Diffuse large B cell lymphoma cell of origin by digital expression profiling in the REAL07 Phase 1-2 study. Br J Haematol 2017; doi: 10.1111/bjh.14817.
Szczepanowski M, Lange J, Kohler CW, et al. Cell-of-origin classification by gene expression and MYC-rearrangements in diffuse large B-cell lymphoma of children and adolescents. Br J Haematol 2017; 179: 116-119.
Green TM, Young KH, Visco C, et al. Immunohistochemical double-hit score is a strong predictor of outcome in patients with diffuse large B-cell lymphoma treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone. J Clin Oncol 2012; 30: 3460-3467.
Klapper W, Stoecklein H, Zeynalova S, et al. Structural aberrations affecting the MYC locus indicate a poor prognosis independent of clinical risk factors in diffuse large B-cell lymphomas treated within randomized trials of the German High-Grade Non-Hodgkin’s Lymphoma Study Group (DSHNHL). Leukemia 2008; 22: 2226-2229.
Snuderl M, Kolman OK, Chen YB, et al. B-cell lymphomas with concurrent IGH-BCL2 and MYC rearrangements are aggressive neoplasms with clinical and pathologic features distinct from Burkitt lymphoma and diffuse large B-cell lymphoma. Am J Surg Pathol 2010; 34: 327-340.
Johnson NA, Savage KJ, Ludkovski O, et al. Lymphomas with concurrent BCL2 and MYC translocations: the critical factors associated with survival. Blood 2009; 114: 2273-2279.
Chen AI, Leonard JT, Okada CY, et al. Outcomes of DA-EPOCH-R induction plus autologous transplant consolidation for double hit lymphoma. Leuk Lymphoma 2017; doi: 10.1080/10428194.2017.
Reagan PM, Davies A. Current treatment of double hit and double expressor lymphoma. Hematology Am Soc Hematol Educ Program 2017; 2017: 295-297.
Zeng D, Desai A, Yan F, et al. Challenges and Opportunities for High-grade B-Cell Lymphoma With MYC and BCL2 and/or BCL6 Rearrangement (Double-hit Lymphoma). Am J Clin Oncol 2018; doi: 10.1097/COC.0000000000000427.
Aukema SM, Kreuz M, Kohler CW, et al. Biological characterization of adult MYC-translocation-positive mature B-cell lymphomas other than molecular Burkitt lymphoma. Haematologica 2014; 99: 726-735.
Wu D, Wood BL, Dorer R, et al. “Double-Hit” mature B-cell lymphomas show a common immunophenotype by flow cytometry that includes decreased CD20 expression. Am J Clin Pathol 2010; 134: 258-265.
Boerma EG, Siebert R, Kluin PM, et al. Translocations involving 8q24 in Burkitt lymphoma and other malignant lymphomas: a historical review of cytogenetics in the light of todays knowledge. Leukemia 2009; 23: 225-234.
Cheah CY, Oki Y, Westin JR, et al. A clinician’s guide to double hit lymphomas. Br J Haematol 2015; 168: 784-795.
Thangavelu M, Olopade O, Beckman E, et al. Clinical, morphologic, and cytogenetic characteristics of patients with lymphoid malignancies characterized by both t(14;18)(q32;q21) and t(8;14)(q24;q32) or t(8;22)(q24;q11). Genes Chromosomes Cancer 1990; 2: 147-158.
Pienkowska-Grela B, Rymkiewicz G, Grygalewicz B, et al. Partial trisomy 11, dup(11)(q23q13), as a defect characterizing lymphomas with Burkitt pathomorphology without MYC gene rearrangement. Med Oncol 2011; 28: 1589-1595.
Salaverria I, Martin-Guerrero I, Wagener R, et al. A recurrent 11q aberration pattern characterizes a subset of MYC-negative high-grade B-cell lymphomas resembling Burkitt lymphoma. Blood 2014; 123: 1187-1198.
Grygalewicz B, Woroniecka R, Rymkiewicz G, et al. The 11q-Gain/Loss Aberration Occurs Recurrently in MYC-Negative Burkitt-like Lymphoma With 11q Aberration, as Well as MYC-Positive Burkitt Lymphoma and MYC-Positive High-Grade B-Cell Lymphoma, NOS. Am J Clin Pathol 2017; 149: 17-28.
Hoelzer D, Walewski J, Döhner H, et al. Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial. Blood 2014; 124: 3870-3879.
Rymkiewicz G, Grygalewicz B, Chechlinska M, et al. A comprehensive flow-cytometry-based immunophenotypic characterization of Burkitt-like lymphoma with 11q aberration. Mod Pathol 2018; doi: 10.1038/modpathol.2017.186.
Zajdel M, Rymkiewicz G, Chechlinska M, et al. miR expression in MYC-negative DLBCL/BL with partial trisomy 11 is similar to classical Burkitt lymphoma and different from diffuse large B-cell lymphoma. Tumour Biol 2015; 36: 5377-5388.
Castillo JJ, Beltran BE, Miranda RN, et al. EBV-positive diffuse large B-cell lymphoma of the elderly: 2016 update on diagnosis, risk-stratification, and management. Am J Hematol 2016; 91: 529-537.
Ghosh Roy S, Robertson ES, Saha A. Epigenetic Impact on EBV Associated B-Cell Lymphomagenesis. Biomolecules 2016; 6: pii: E46.
Martelli M, et al. Primary mediastinal lymphoma: diagnosis and treatment options. Expert Rev Hematol 2015; 8: 173-86.
Goodman A, Patel SP, Kurzrock R. PD-1-PD-L1 immune-checkpoint blockade in B-cell lymphomas. Nat Rev Clin Oncol 2017; 14: 203-220.
Yu L, Li L, Medeiros LJ, et al. NF-kappaB signaling pathway and its potential as a target for therapy in lymphoid neoplasms. Blood Rev 2017; 31: 77-92.
Patrick LB, Mohile NA. Advances in Primary Central Nervous System Lymphoma. Curr Oncol Rep 2015; 17: 60.
Deckert M, Brunn A, Montesinos-Rongen M, et al. Primary lymphoma of the central nervous system – a diagnostic challenge. Hematol Oncol 2014; 32: 57-67.
Deckert M, Montesinos-Rongen M, Brunn A, et al. Systems biology of primary CNS lymphoma: from genetic aberrations to modeling in mice. Acta Neuropathol 2014; 127: 175-188.
Castillo J, Pantanowitz L, Dezube BJ. HIV-associated plasmablastic lymphoma: lessons learned from 112 published cases. Am J Hematol 2008; 83: p. 804-9.
Harmon CM, Smith LB. Plasmablastic lymphoma: a review of clinicopathologic features and differential diagnosis. Arch Pathol Lab Med 2016; 140: 1074-1078.
Liu, JJ, Zhang L, Ayala E et al. Human immunodeficiency virus (HIV)-negative plasmablastic lymphoma: a single institutional experience and literature review. Leuk Res 2011; 35: 1571-1577.
Colomo L, Loong F, Rives S, et al. Diffuse large B-cell lymphomas with plasmablastic differentiation represent a heterogeneous group of disease entities. Am J Surg Pathol 2004; 28: 736-747.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe