Diffuse Large B-Cell Lymphoma Involving the Central Nervous System

作者：Gualco Gabriela; Weiss Lawrence M; Barber Glen N; Bacchi Carlos E^*

来源：International Journal of Surgical Pathology, 2011, 19(1): 44-50.

DOI：10.1177/1066896910386476

• primary central nervous system lymphoma
• central nervous system lymphoma
• diffuse large B-cell lymphoma
• WHO classification
• human immunodeficiency virus
• immunocompromised
• immunocompetent
• immunohistochemistry
• EBV

Lymphomas involving the central nervous system are recognized increasingly in immunocompetent as well as immunosuppressed individuals, and the majority of the cases are diffuse large B-cell lymphoma (DLBCL). The aim of this study was to compare the immunophenotype, clinicopathological features, and association with Epstein-Barr virus (EBV) of DLBCL of the central nervous system (CNS) in 3 different clinical situations: primary, in immunocompetent patients; "primary," in immunosuppressed patients; and in patients with secondary involvement by systemic lymphoma. The authors reviewed the clinicopathological features, morphology, immunophenotype (according to germinal-center B-cell like and nongerminal B-cell like subtypes), and association with EBV in 36 cases of DLBCL of the CNS, including 25 primary cases, 5 associated with immunosuppression, and 6 cases with secondary involvement. Survival was evaluated in 15 cases of primary CNS lymphomas. Of the 36 patients, 19 were male and 18 female. Only 2 cases of lymphomas were EBV-positive; both occurred in immunosuppressed patients. Separation into germinal-center and non-germinal center subtypes by an immunohistochemistry panel showed that 68% of primary, 80% of secondary, and 83% of the cases associated with immunosuppression were of non-germinal-center subtype, respectively. Patients with non-germinal-center immunophenotype showed significantly worse survival than those with CNS lymphomas of the germinal-center subtype.

• 出版日期2011-2