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Diffuse intermediate lymphocytic lymphoma. A clinicopathologic study and comparison with small lymphocytic lymphoma
D A Perry1, M A Bast, J O Armitage
1Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68198.
Cancer
|November 1, 1990
Summary
Diffuse intermediate lymphocytic lymphoma (ILL) with pseudofollicular proliferation centers (PC) indicates a better prognosis, suggesting its classification as low-grade. Diffuse ILL without PC is considered intermediate-grade non-Hodgkin's lymphoma.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- The clinical classification of diffuse intermediate lymphocytic lymphoma (ILL) remains controversial.
- Distinguishing between low-grade and intermediate-grade non-Hodgkin's lymphoma is crucial for treatment decisions.
Purpose of the Study:
- To investigate the clinicopathologic features and biologic course of diffuse ILL.
- To compare diffuse ILL with small lymphocytic lymphoma (SLL) and diffuse small cleaved cell lymphoma (DSCCL).
- To clarify the appropriate clinical grading of diffuse ILL based on prognostic factors.
Main Methods:
- Clinicopathologic study of 40 cases of diffuse ILL.
- Comparison with 51 cases of SLL and 14 cases of DSCCL.
- Analysis of survival data based on the presence or absence of pseudofollicular proliferation centers (PC) in diffuse ILL.
Main Results:
- Patients with diffuse ILL and PC demonstrated significantly longer median survival (84 months) compared to those without PC (46.5 months).
- Median survival for SLL was 72 months, and for DSCCL was 18 months.
- Diffuse ILL without PC showed a poorer prognosis, aligning with intermediate-grade lymphomas.
Conclusions:
- Diffuse ILL with PC should be clinically categorized with low-grade SLL.
- Diffuse ILL without PC (true diffuse ILL) should be classified as an intermediate-grade non-Hodgkin's lymphoma.
- True diffuse ILL warrants a similar clinical status to centrocytic lymphoma in the Kiel classification.