Primary central nervous system lymphoma: Comprehension of cell-of-origin subtypes
Primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is an uncommon extranodal lymphoma that accounts for more than 95% of all the CNS lymphomas. Unlike its systemic/nodal counterpart, which is currently subtyped into cell-of origin (COO) subtypes, its feasibility and utility ar...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-07-01
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| Series: | Indian Journal of Pathology and Microbiology |
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| Online Access: | https://journals.lww.com/10.4103/ijpm.ijpm_343_21 |
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| author | Shruti Rao Sridhar Epari Tanuja M. Shet Sumeet Gujral Hasmukh Jain Bhausaheb Bagal Manju Senagar Prakash Shetty Aliasgar Moiyadi Jayant Sastri Goda Tejpal Gupta |
| author_facet | Shruti Rao Sridhar Epari Tanuja M. Shet Sumeet Gujral Hasmukh Jain Bhausaheb Bagal Manju Senagar Prakash Shetty Aliasgar Moiyadi Jayant Sastri Goda Tejpal Gupta |
| author_sort | Shruti Rao |
| collection | DOAJ |
| description | Primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is an uncommon extranodal lymphoma that accounts for more than 95% of all the CNS lymphomas. Unlike its systemic/nodal counterpart, which is currently subtyped into cell-of origin (COO) subtypes, its feasibility and utility are largely debatable in PCNS-DLBCL.
Objectives:
To classify PCNS-DLBCL into COO-subtypes based on immunohistochemical algorithms by Hans and Choi and evaluate concordance between the two. A further aim is to investigate the clinicoradiological and histomorphological parameters of the subtypes thus obtained.
Materials and Methods:
As many as 143 cases of primary CNS lymphoma were evaluated by immunohistochemistry for CD10, BCL6, MUM1, GCET, and FOXP1 and based on which the said 143 cases were further classified into COO subtypes using Hans and Choi algorithms.
Results:
Mean age was 53.8 years with marginal male preponderance and predominantly centroblastic morphology (75.5%). CD 10 was positive in 8.9% of the cases, BCL6 in 58.6%, MUM1 in 89.9%, GCET in 32.9%, and FOXP1 in 79.5%. As much as 84.9% cases were of non-germinal center B-cell (GCB) subtype and 15.1% cases were of GCB subtype as determined based on Hans algorithm. Furthermore, 90.7% cases were of activated B-cell (ABC) subtype and 9.3% cases were of GCB subtype according to Choi algorithm. A 91.8% concordance was observed between Hans and Choi algorithms. Among the 6 discordant cases, 5 cases were subtyped as GCB by Hans and ABC by Choi and 1 case as ABC by Hans and GCB by Choi.
Conclusion:
Most of PCNS-DLBCLs are of non-GCB/ABC COO subtype, but inconsistences abound in the utility of IHC algorithms in PCNS-DLBCL COO subtypes. |
| format | Article |
| id | doaj-art-aae91ae4c73143baacee0f691e7c3706 |
| institution | Kabale University |
| issn | 0377-4929 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Pathology and Microbiology |
| spelling | doaj-art-aae91ae4c73143baacee0f691e7c37062025-02-07T13:31:45ZengWolters Kluwer Medknow PublicationsIndian Journal of Pathology and Microbiology0377-49292023-07-0166354955510.4103/ijpm.ijpm_343_21Primary central nervous system lymphoma: Comprehension of cell-of-origin subtypesShruti RaoSridhar EpariTanuja M. ShetSumeet GujralHasmukh JainBhausaheb BagalManju SenagarPrakash ShettyAliasgar MoiyadiJayant Sastri GodaTejpal GuptaPrimary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is an uncommon extranodal lymphoma that accounts for more than 95% of all the CNS lymphomas. Unlike its systemic/nodal counterpart, which is currently subtyped into cell-of origin (COO) subtypes, its feasibility and utility are largely debatable in PCNS-DLBCL. Objectives: To classify PCNS-DLBCL into COO-subtypes based on immunohistochemical algorithms by Hans and Choi and evaluate concordance between the two. A further aim is to investigate the clinicoradiological and histomorphological parameters of the subtypes thus obtained. Materials and Methods: As many as 143 cases of primary CNS lymphoma were evaluated by immunohistochemistry for CD10, BCL6, MUM1, GCET, and FOXP1 and based on which the said 143 cases were further classified into COO subtypes using Hans and Choi algorithms. Results: Mean age was 53.8 years with marginal male preponderance and predominantly centroblastic morphology (75.5%). CD 10 was positive in 8.9% of the cases, BCL6 in 58.6%, MUM1 in 89.9%, GCET in 32.9%, and FOXP1 in 79.5%. As much as 84.9% cases were of non-germinal center B-cell (GCB) subtype and 15.1% cases were of GCB subtype as determined based on Hans algorithm. Furthermore, 90.7% cases were of activated B-cell (ABC) subtype and 9.3% cases were of GCB subtype according to Choi algorithm. A 91.8% concordance was observed between Hans and Choi algorithms. Among the 6 discordant cases, 5 cases were subtyped as GCB by Hans and ABC by Choi and 1 case as ABC by Hans and GCB by Choi. Conclusion: Most of PCNS-DLBCLs are of non-GCB/ABC COO subtype, but inconsistences abound in the utility of IHC algorithms in PCNS-DLBCL COO subtypes.https://journals.lww.com/10.4103/ijpm.ijpm_343_21activated b-cellcell-of-origindiffuse large b-cell lymphomagerminal center b-cellprimary central nervous system lymphoma |
| spellingShingle | Shruti Rao Sridhar Epari Tanuja M. Shet Sumeet Gujral Hasmukh Jain Bhausaheb Bagal Manju Senagar Prakash Shetty Aliasgar Moiyadi Jayant Sastri Goda Tejpal Gupta Primary central nervous system lymphoma: Comprehension of cell-of-origin subtypes Indian Journal of Pathology and Microbiology activated b-cell cell-of-origin diffuse large b-cell lymphoma germinal center b-cell primary central nervous system lymphoma |
| title | Primary central nervous system lymphoma: Comprehension of cell-of-origin subtypes |
| title_full | Primary central nervous system lymphoma: Comprehension of cell-of-origin subtypes |
| title_fullStr | Primary central nervous system lymphoma: Comprehension of cell-of-origin subtypes |
| title_full_unstemmed | Primary central nervous system lymphoma: Comprehension of cell-of-origin subtypes |
| title_short | Primary central nervous system lymphoma: Comprehension of cell-of-origin subtypes |
| title_sort | primary central nervous system lymphoma comprehension of cell of origin subtypes |
| topic | activated b-cell cell-of-origin diffuse large b-cell lymphoma germinal center b-cell primary central nervous system lymphoma |
| url | https://journals.lww.com/10.4103/ijpm.ijpm_343_21 |
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