A unique subtype of diffuse large B-cell lymphoma primarily involving the bone marrow, spleen, and liver, defined by fluorodeoxyglucose-positron emission tomography combined with computed tomography

We describe 10 cases of diffuse large B-cell lymphoma (DLBCL) confined to the bone marrow (BM), spleen, and liver, as evidenced by the uniformly increased uptake of fluorodeoxyglucose (FDG) on positron emission tomography combined with computed tomography (PET/CT). Ages ranged from 56 to 87. All, bu...

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Bibliographic Details
Published in:Leukemia & lymphoma 2016-11, Vol.57 (11), p.2593-2602
Main Authors: Iioka, Futoshi, Honjo, Gen, Misaki, Takashi, Toda, Yusuke, Izumi, Kiyotaka, Kamoda, Yoshimasa, Nagai, Yuya, Akasaka, Takashi, Kitamura, Kazushi, Nakagwa, Miho, Fukutsuka, Katsuhiro, Okumura, Atsuko, Ohno, Hitoshi
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
BCL6 gene
Biomarkers
Bone Marrow - diagnostic imaging
Bone Marrow - pathology
diffuse large B-cell lymphoma
FDG-PET/CT
Female
Fluorodeoxyglucose F18
Humans
In Situ Hybridization, Fluorescence
Karyotyping
Liver - diagnostic imaging
Liver - pathology
liver type
Lymphoma, Large B-Cell, Diffuse - diagnosis
Lymphoma, Large B-Cell, Diffuse - mortality
Lymphoma, Large B-Cell, Diffuse - therapy
Male
Middle Aged
Positron Emission Tomography Computed Tomography - methods
R-CHOP
Retrospective Studies
spleen
Spleen - diagnostic imaging
Spleen - pathology
Treatment Outcome
Whole Body Imaging
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Description
Summary:We describe 10 cases of diffuse large B-cell lymphoma (DLBCL) confined to the bone marrow (BM), spleen, and liver, as evidenced by the uniformly increased uptake of fluorodeoxyglucose (FDG) on positron emission tomography combined with computed tomography (PET/CT). Ages ranged from 56 to 87. All, but one patient presented with 'B' symptoms, a poor performance status, and hepatosplenomegaly. All patients showed cytopenia and elevated lactate dehydrogenase levels and were classified into the high-risk category of the International Prognostic Index scoring. BM infiltration was diffuse, interstitial/intrasinusoidal, or mixed, and all showed the nongerminal center B immunophenotype. Five patients had a rearrangement involving 3q27/BCL6, while six had increased copies of MYC, BCL2, or BCL6. All patients were initially treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone, leading to complete responses in six out of eight evaluable patients. We propose BM, spleen, and liver-type DLBCL, which is defined by the findings of FDG-PET/CT.
ISSN:1042-8194
1029-2403
DOI:10.3109/10428194.2016.1154959