Primary and secondary cutaneous diffuse large B-cell lymphomas: A multiparameter analysis of 25 cases including fluorescence in situ hybridization for t(14;18) translocation

Bong K. Kim, Urvashi Surti, Amit G. Pandya, Steven H. Swerdlow

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

Although primary cutaneous diffuse large B-cell lymphomas (DLBCLs) except for those of the leg are grouped together with primary cutaneous follicle center cell lymphoma in the European Organization for Research and Treatment of Cancer classification of primary cutaneous lymphomas, they typically lack the usual phenotypic profile of follicular lymphoma. Whether they are truly of follicular center cell origin, have a molecular pathogenesis similar to nodal follicular lymphoma, or have any biologic features that distinguish them from secondary DLBCL involving skin remains uncertain. To address these issues, a retrospective multiparameter study of 25 patients including clinical, histologic, immunophenotypic, and cytogenetic analyses was performed. A classic CD10+, bcl-6+ follicular center cell profile was found in 10 (40%) cutaneous DLBCL (2 of 11 primary, 5 of 8 secondary, 3 of 6 unclassified) with bcl-2 expression seen only in the nonprimary cases. Of the remaining cases, 14 cases (56%) were CD10-, bcl-6+, bcl-2± (9 primary) and one case (4%) was CD10-, bcl-6-, bcl-2+ (0 primary). Fluorescence in situ hybridization analysis showed a t(14; 18) in 0 of 9 primary and 3 of 5 secondary cases. Primary cases were frequently found in the head/neck region, whereas secondary cases were more common on the trunk and extremities. Patients with primary disease were all alive, usually having received only local therapy, at a median follow-up of 19 months. Most secondary cases were treated with chemotherapy with only one untreated patient dead of disease at a median follow-up of 5 months. Primary cutaneous DLBCLs therefore appear to be distinctive as they have fewer features of follicular lymphoma than do secondary cases. Nevertheless, some appear to be of follicular center cell origin, even though they probably have a different molecular pathogenesis than most nodal follicular lymphomas.

Original languageEnglish (US)
Pages (from-to)356-364
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume27
Issue number3
DOIs
StatePublished - Mar 1 2003

Keywords

  • CD10
  • Cutaneous diffuse large B-cell lymphoma
  • Cutaneous follicle center cell lymphoma
  • Follicular center cells
  • T(14;18)

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

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