Centroblastic and centroblastic/centrocytic lymphoma associated with a prominent epithelioid granulomatous response: A clinicopathologic study of 50 cases

Masaru Kojima, Shigeo Nakamura, Koichi Ichimura, Ritsuro Suzuki, Yoshitoki Kagami, Eisei Kondo, Tadashi Motoori, Yasuo Hosomura, Tetsunari Oyama, Hideaki Itoh, Satoshi Ban, Katsue Yoshida, Yoshihiro Ohno, Kazuhiko Shimizu, Nobuhide Masawa, Shiro Sugihara

Research output: Contribution to journalArticle

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Abstract

A minority of centroblastic and centroblastic/centrocytic cell lymphomas are accompanied by a prominent epithelioid cell response and were suggested to be a distinct variant of B-cell lymphoma of germinal center cell origin. To confirm the clinicopathologic significance of these mainly large B-cell lymphomas with an epithelioid cell response (LBCL-ER), we reviewed 50 patients with LBCL-ER and compared the results with those of 167 other diffuse large B-cell lymphomas (DLBCL) and 94 follicular lymphomas (FL) without epithelioid response. The patients with LBCL-ER showed a higher age distribution (median 71, P = .03), a female predominance (M:F = 18:32, P = .001) and less frequent involvement of extranodal sites > 1 (P = .004) compared with those with DLBCL, and presented with a bulky mass of the affected lymph nodes in 54% of cases. They were also older (P = .0006) and more associated with the aggressive clinical factors such as serum LDH level and International Prognostic Index score than those with FL. Histologically, nine cases (18%) partially showed a follicular growth pattern, and the others (82%) were occupied by a diffuse growth pattern. The epithelioid cells were accumulated in large demarcated masses, partially imparting a lymphoepithelioid (Lennert) lymphoma-like appearance to some portions of the lesions in every case. Immunohistochemically, LBCR-ER was positive for CD20 in every case, CD10 in 43% of the cases, and BCL-2 in 56%. None of the tumor cells in the 40 cases tested expressed CD5 antigen. Immunostaining also often highlighted the remnants of the follicular dendritic cell network. The BCL-2 gene rearrangement was detected in only 19% of the cases examined. The survival curve of the cases of LBCL-ER was almost identical with that of DLBCL and was significantly inferior to that of FL. The centroblastic and centroblastic/centrocytic lymphoma with an epithelioid cell response may be regarded as the morphologic variant of DLBCL preferentially arising in the aged population and reflecting the disease progression of FL.

Original languageEnglish
Pages (from-to)750-758
Number of pages9
JournalModern Pathology
Volume15
Issue number7
DOIs
Publication statusPublished - 2002
Externally publishedYes

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Epithelioid Cells
Lymphoma
B-Cell Lymphoma
Follicular Lymphoma
Lymphoma, Large B-Cell, Diffuse
CD5 Antigens
Follicular Dendritic Cells
Germinal Center
Gene Rearrangement
Age Distribution
Growth
Disease Progression
Lymph Nodes
Survival
Serum
Population

Keywords

  • Centroblastic lymphoma
  • Centroblastic/centrocytic lymphoma
  • Diffuse large B-cell lymphoma
  • Epithelioid granulomatous response
  • Follicular large cell lymphoma
  • Lymphoma progression

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Centroblastic and centroblastic/centrocytic lymphoma associated with a prominent epithelioid granulomatous response : A clinicopathologic study of 50 cases. / Kojima, Masaru; Nakamura, Shigeo; Ichimura, Koichi; Suzuki, Ritsuro; Kagami, Yoshitoki; Kondo, Eisei; Motoori, Tadashi; Hosomura, Yasuo; Oyama, Tetsunari; Itoh, Hideaki; Ban, Satoshi; Yoshida, Katsue; Ohno, Yoshihiro; Shimizu, Kazuhiko; Masawa, Nobuhide; Sugihara, Shiro.

In: Modern Pathology, Vol. 15, No. 7, 2002, p. 750-758.

Research output: Contribution to journalArticle

Kojima, M, Nakamura, S, Ichimura, K, Suzuki, R, Kagami, Y, Kondo, E, Motoori, T, Hosomura, Y, Oyama, T, Itoh, H, Ban, S, Yoshida, K, Ohno, Y, Shimizu, K, Masawa, N & Sugihara, S 2002, 'Centroblastic and centroblastic/centrocytic lymphoma associated with a prominent epithelioid granulomatous response: A clinicopathologic study of 50 cases', Modern Pathology, vol. 15, no. 7, pp. 750-758. https://doi.org/10.1097/01.MP.0000018980.83088.D3
Kojima, Masaru ; Nakamura, Shigeo ; Ichimura, Koichi ; Suzuki, Ritsuro ; Kagami, Yoshitoki ; Kondo, Eisei ; Motoori, Tadashi ; Hosomura, Yasuo ; Oyama, Tetsunari ; Itoh, Hideaki ; Ban, Satoshi ; Yoshida, Katsue ; Ohno, Yoshihiro ; Shimizu, Kazuhiko ; Masawa, Nobuhide ; Sugihara, Shiro. / Centroblastic and centroblastic/centrocytic lymphoma associated with a prominent epithelioid granulomatous response : A clinicopathologic study of 50 cases. In: Modern Pathology. 2002 ; Vol. 15, No. 7. pp. 750-758.
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T1 - Centroblastic and centroblastic/centrocytic lymphoma associated with a prominent epithelioid granulomatous response

T2 - A clinicopathologic study of 50 cases

AU - Kojima, Masaru

AU - Nakamura, Shigeo

AU - Ichimura, Koichi

AU - Suzuki, Ritsuro

AU - Kagami, Yoshitoki

AU - Kondo, Eisei

AU - Motoori, Tadashi

AU - Hosomura, Yasuo

AU - Oyama, Tetsunari

AU - Itoh, Hideaki

AU - Ban, Satoshi

AU - Yoshida, Katsue

AU - Ohno, Yoshihiro

AU - Shimizu, Kazuhiko

AU - Masawa, Nobuhide

AU - Sugihara, Shiro

PY - 2002

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N2 - A minority of centroblastic and centroblastic/centrocytic cell lymphomas are accompanied by a prominent epithelioid cell response and were suggested to be a distinct variant of B-cell lymphoma of germinal center cell origin. To confirm the clinicopathologic significance of these mainly large B-cell lymphomas with an epithelioid cell response (LBCL-ER), we reviewed 50 patients with LBCL-ER and compared the results with those of 167 other diffuse large B-cell lymphomas (DLBCL) and 94 follicular lymphomas (FL) without epithelioid response. The patients with LBCL-ER showed a higher age distribution (median 71, P = .03), a female predominance (M:F = 18:32, P = .001) and less frequent involvement of extranodal sites > 1 (P = .004) compared with those with DLBCL, and presented with a bulky mass of the affected lymph nodes in 54% of cases. They were also older (P = .0006) and more associated with the aggressive clinical factors such as serum LDH level and International Prognostic Index score than those with FL. Histologically, nine cases (18%) partially showed a follicular growth pattern, and the others (82%) were occupied by a diffuse growth pattern. The epithelioid cells were accumulated in large demarcated masses, partially imparting a lymphoepithelioid (Lennert) lymphoma-like appearance to some portions of the lesions in every case. Immunohistochemically, LBCR-ER was positive for CD20 in every case, CD10 in 43% of the cases, and BCL-2 in 56%. None of the tumor cells in the 40 cases tested expressed CD5 antigen. Immunostaining also often highlighted the remnants of the follicular dendritic cell network. The BCL-2 gene rearrangement was detected in only 19% of the cases examined. The survival curve of the cases of LBCL-ER was almost identical with that of DLBCL and was significantly inferior to that of FL. The centroblastic and centroblastic/centrocytic lymphoma with an epithelioid cell response may be regarded as the morphologic variant of DLBCL preferentially arising in the aged population and reflecting the disease progression of FL.

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KW - Centroblastic/centrocytic lymphoma

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KW - Follicular large cell lymphoma

KW - Lymphoma progression

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