Clinicopathological analysis of primary splenic diffuse large B-cell lymphoma

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Splenic infiltration is common in diffuse large B-cell lymphoma (DLBCL).
• Primary splenic DLBCL is a rare subtype with limited clinicopathological data.
• Understanding its unique characteristics is crucial for diagnosis and treatment.

Purpose of the Study:

• To investigate the clinicopathological features of primary splenic DLBCL.
• To compare primary splenic DLBCL with other DLBCL subtypes.
• To evaluate prognostic factors and survival outcomes in primary splenic DLBCL.

Main Methods:

• Retrospective analysis of 66 primary splenic DLBCL cases and 309 control DLBCL cases.
• Histopathological classification into white pulp and red pulp patterns.
• Analysis of clinical data, including Hepatitis C virus antibody prevalence, B symptoms, performance status, and CD5 positivity.
• Survival analysis (overall survival and progression-free survival).

Main Results:

• Primary splenic DLBCL showed significant differences in Hepatitis C virus antibody prevalence, B symptoms, performance status, and CD5 positivity compared to controls.
• White pulp pattern associated with lower performance status and CD5 positivity; red pulp pattern showed poorer overall survival.
• No difference in overall survival between primary splenic DLBCL and controls, but more favorable progression-free survival for splenic DLBCL.
• CD5 positivity identified as a poor prognostic indicator in multivariate analysis for primary splenic DLBCL.

Conclusions:

• Classifying primary splenic DLBCL into white and red pulp patterns is valuable for understanding clinicopathological features and survival.
• Primary splenic DLBCL exhibits unique characteristics and a distinct survival profile.
• CD5 positivity is a significant negative prognostic factor in primary splenic DLBCL.