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Low-grade B-cell lymphoma presenting primarily in the bone marrow
Kayoko Iwatani1, Katsuyoshi Takata1, Yasuharu Sato1
1Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, 700-8558, Japan.
Human Pathology
|April 29, 2014
Summary
Low-grade B-cell lymphomas primarily in bone marrow are rare and diverse. This study found varied subtypes, with some "not otherwise specified" cases resembling lymphoplasmacytic or marginal zone lymphomas.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Low-grade B-cell lymphoma (LBCL) primarily in bone marrow is uncommon.
- Clinicopathological features of these rare presentations are not well-defined.
Purpose of the Study:
- To retrospectively analyze the clinicopathology of LBCL presenting primarily in the bone marrow.
- To characterize the subtypes, immunophenotypic features, and genetic mutations in these rare lymphomas.
Main Methods:
- Retrospective review of 14 patients with LBCL primarily in the bone marrow.
- Immunohistochemistry (CD20, CD138, CD10, BCL-2) and fluorescence in situ hybridization (IgH/BCL-2 rearrangement).
- Analysis of myeloid differentiation primary response gene (88) (MYD88) L265P mutation and paraproteinemia.
Main Results:
- Included lymphoplasmacytic lymphoma (LPL), chronic lymphocytic leukemia/small lymphocytic lymphoma, follicular lymphoma (FL), and LBCL-not otherwise specified (LGBCL-NOS).
- MYD88 L265P mutation found in LPL, FL, and LGBCL-NOS.
- Paraproteinemia observed in 10 patients (6 IgM, 3 IgG).
- One LPL patient died from lymphoma progression.
Conclusions:
- LBCL primarily in bone marrow comprises diverse subtypes.
- Approximately one-third of cases were LGBCL-NOS.
- LGBCL-NOS immunophenotype and MYD88 mutation suggest overlap with LPL or marginal zone lymphoma.
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