High-grade B cell lymphoma, unclassifiable, with blastoid features: An unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis

Rashmi Kanagal-Shamanna, L. Jeffrey Medeiros, Gary Lu, Sa A. Wang, John T. Manning, Pei Lin, Gerald M. Penn, Ken H. Young, M. James You, Francisco Vega, Roland Bassett, Roberto N. Miranda

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Aims: A subset of B cell lymphomas with blastoid features do not fit either as B lymphoblastic lymphoma/leukaemia or blastoid mantle cell lymphoma. Their classification is challenging, even with complete clinicopathological and genetic information. At a haematopathology workshop, experts had suggested the term 'high-grade B cell lymphoma, unclassifiable, with blastoid features', and recommended further studies. Methods and results: We describe the clinicopathological, immunophenotypic and cytogenetic findings of 24 high-grade B cell lymphomas, unclassifiable, with blastoid features. Fifteen patients presented de novo and seven patients had a history of lymphoma. Twenty patients (83%) presented with nodal disease. All tumours expressed pan-B cell antigens and 17 (89%) of 19 tumours assessed had a germinal centre B cell immunophenotype. Ten (63%) of 16 tumours assessed by fluorescence in-situ hybridization (FISH) had MYC rearrangement, 13 of 18 (72%) carried IGH-BCL2 and nine of 15 (60%) had both (double-hit lymphoma). The median overall survival was 1.1years. Using 2008 World Health Organization criteria, 15 cases were classified as B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma, and nine as DLBCL, small centroblastic variant. Conclusion: High-grade B cell lymphomas, unclassifiable, with blastoid features are clinically aggressive with poor survival. Most neoplasms have a germinal centre B cell phenotype. MYC rearrangements and IGH-BCL2 are common, and ∼60% are double-hit lymphomas.

Original languageEnglish (US)
Pages (from-to)945-954
Number of pages10
JournalHistopathology
Volume61
Issue number5
DOIs
StatePublished - Nov 1 2012
Externally publishedYes

Keywords

  • BCL2 rearrangement
  • Blastoid
  • Double-hit
  • High-grade B cell lymphoma unclassifiable
  • MYC rearrangement

ASJC Scopus subject areas

  • Histology
  • Pathology and Forensic Medicine

Fingerprint Dive into the research topics of 'High-grade B cell lymphoma, unclassifiable, with blastoid features: An unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis'. Together they form a unique fingerprint.

  • Cite this

    Kanagal-Shamanna, R., Medeiros, L. J., Lu, G., Wang, S. A., Manning, J. T., Lin, P., Penn, G. M., Young, K. H., You, M. J., Vega, F., Bassett, R., & Miranda, R. N. (2012). High-grade B cell lymphoma, unclassifiable, with blastoid features: An unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis. Histopathology, 61(5), 945-954. https://doi.org/10.1111/j.1365-2559.2012.04301.x