Fluid samples (e.g., ascitic or pleural fluid) do not require culture medium for collection, but should be collected and transported aseptically. Treatment recommendations and prognosis vary with different subtypes of the disease. Choi
and K.F.). Yamochi-Onizuka
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Expression of BCL2 protein was seen in 68.5% of the Chinese DLBCL cases (85/124) but in only 50.0% of the Western DLBCL cases (57/114; P = .0054). Anthracycline-based chemoimmunotherapy (with regimens recommended for first-line therapy for DLBCL, unless contraindicated) ± ISRT is recommended for TFL without double-hit cytogenetics (see FOLL-6 and FOLL-7, pages 652 and 653).
Variants described separately include: AIDS associated, Common in Western countries (25 - 30% of adult non-Hodgkin lymphoma), Affects all ages (most commonly elderly, median age 7th decade), Either germinal center B-like (BCL6+, CD10+, CD38+), activated B-like (IRF4+, FLIP+, BCL2+), or neither, Arises de novo (common) or due to progression / transformation of a less aggressive non-Hodgkin lymphoma, 1/3 arise from transformation of follicular lymphoma (germinal center-like), detectable by BCL2 rearrangement or BCL6 / CD10 coexpression with strong and uniform BCL6 expression, Often presents as single, rapidly growing nodal mass, 30 - 40% are extranodal (skin, GI, GU, CNS) at diagnosis; also liver, spleen, Often difficult to diagnose on flow cytometry, Overall 3 year survival ~ 78% in 2006 studies, Favorable: limited disease (no or < 10% marrow involvement), favorable international prognostic index, Favorable: germinal center gene expression (BCL6+, CD10+, negative for MUM1 / IRF4, negative for CD138) versus activated B cell-like profile (, Unfavorable: CD10+ and BCL2+ coexpression (, 23 year old female with an ovarian mass (, 55 year old male diagnosed with chronic hepatitis C and cirrhosis (, 56 year old male with small intestinal tumor (, Distinctive patterns of splenic and bone marrow involvement (, Fatal if untreated; remission in 70% after chemotherapy, 50% cure rate, Diffuse growth pattern with large cells (usually 5× normal lymphocytes) resembling immunoblasts (amphophilic cytoplasm, eccentric nuclei with one central nucleoli) or centroblasts (pale or basophilic cytoplasm, vesicular chromatin due to chromatin margination, 2 - 3 nucleoli, often near membrane), or rarely, anaplastic, associated with neutrophils (, May have plasmacytic differentiation or epithelioid granulomas (, IgH and IgL are clonally rearranged, but may be difficult to document in T cell rich cases, t(14;18)(q32;q21): affects IgH and BCL2; present in 30%, also in follicular lymphoma, t(3;14)(p27;q32): affects BCL6 and IgH; present in 30%, also in follicular lymphoma, Numerous other translocations involving BCL6 (3q27). If available, interphase fluorescence in situ hybridization (FISH) data were also collected from patients. Gomyo H, Shimoyama M, Minagawa K, Yakushijin K, Urahama N, Okamura A, Yamamoto K, Ito M, Chihara K, Hayashi Y, Matsui T. Dave BJ, Weisenburger DD, Higgins CM, Pickering DL, Hess MM, Chan WC, Sanger WG. NIH A well-characterized cohort of DLBCL cases from Western populations was used for comparative analysis.
Standard G-banded analysis was performed on unstimulated (1–2 day) and/or B-cell mitogen-stimulated (3-day) (lipopolysaccharide, Sigma, St Louis, MO) suspension cultures from minced tissue. Ann Lab Med. Korean Society of Hematology Lymphoma Working Party, See this image and copyright information in PMC.
On the other hand, the BCL2– subgroup had a significantly more frequent loss of 1p than the BCL2+ subgroup (P < .05; Fisher exact test) (Images 2A and 2B).
AC
Of the 4 positive cases, 3 were classified as GCB DLBCL and 1 as non-GCB DLBCL. Epub 2017 Aug 22. Lower incidences of the GCB subtype (P = .0001) and the t(14;18) translocation (P = .0001) were present in Chinese cases.