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LINKS
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Linfoma
B a grandi cellule Burkitt-like
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Blood 2001 Jun 15;97(12):3713-20- The Burkitt-like lymphomas: a Southwest Oncology Group
study delineating phenotypic, genotypic, and clinical features.
Braziel RM, Arber DA, Slovak ML, Gulley ML, Spier C, Kjeldsberg C, Unger
J, Miller TP, Tubbs R, Leith C, Fisher RI, Grogan TM.
Department of Pathology, L471, Oregon Health Sciences University, 3181 SW
Sam Jackson Park Road, Portland, OR 97201, USA. braziel@ohsu.edu
The Revised European-American Lymphoma classification gives Burkitt-like
lymphoma (BLL) provisional status, leaving unresolved the differential
diagnosis with Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL).
This study compared the biologic features of adult BLL and DLBCL. The
phenotypic distinction between BLL and DLBCL was determined by
immunohistochemical staining of frozen tissue from 13 patients with BLL and
55 patients with DLBCL by using an extensive antibody panel including Ki-67,
CD10, CD11a/lymphocyte function-associated antigen 1alpha (LFA-1alpha),
CD18/LFA-1beta, CD58/LFA-3, and CD54/intercellular adhesion molecule, CD8
for tumor-infiltrating cytotoxic T cells (T-TILs), CD44 homing receptor, and
p53 and Bcl-2 oncogenic proteins. Compared with DLBCL, BLL had a higher
proliferative rate (mean Ki-67, 88% versus 53%), greater expression of CD10
and p53 antigens, and decreased expression of Bcl-2. BLL cases had a
consistent absence of one or more cell adhesion molecules (92% versus 27%),
low T-TIL numbers, and absence of CD44 homing receptor (92% versus 14%). The
t(8;14) translocation was identified in 80% of BLL cases, but no patients
with BLL had the t(14;18) translocation. In a 10-year analysis, median
survival of patients with BLL was 1.2 years, and that of patients with DLBCL
was 2.5 years. Although the proportion of patients cured was similar in the
2 groups, BLL patients had an increased risk of early death. We conclude
that BLL can be recognized by its combined morphologic and phenotypic
features and that it represents a high-grade lymphoma much closer to BL than
DLBCL. Retention of the BLL category or inclusion of BLL as a variant of BL
is biologically and clinically more appropriate than absorbing the category
of BLL into DLBCL. (Blood. 2001;97:3713-3720)
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