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Sinusoidal pattern: precursor B lymphoblastic lymphoma (B-LBL) with a sinusoidal infiltrate of small blasts (a) with cytoplasmic expression of CD79a (b) and nuclear expression of terminal deoxynucleotidyl transferase (TdT; c). HSTCL with a sinusoidal infiltrate of monotonous neoplastic cells (d) with expression of CD3 (e) and the cytotoxic granule associated protein TIA-1 (f). Peripheral blood involvement (plasma cell leukemia) in a plasmacytoma with a sinusoidal infiltrate of plasma cells (g) with expression of CD138 (h) and IgG (i)
In contrast, in precursor B lymphoblastic leukemia/lymphoblastic
lymphoma (B-ALL/B-LBL; Fig. 4 a–c), HSTCL (Fig. 4 d–f),
leukemic plasmacytoma (Fig. 4 g–i), and hairy cell leukemia,
a sinusoidal infiltration pattern was observed in the majority of
Loddenkemper, Christoph; Longerich, Thomas; Hummel, Michael; Ernestus, Karen; Anagnostopoulos, Ioannis; Dienes, Hans-Peter; Schirmacher, Peter; Stein, HaraldJournal: Virchows Archiv
Issue 5DOI: 10.1007/s00428-007-0384-9Published: 2007-04-26Institution(s):
Charité-University Medicine Berlin, University of Heidelberg, University of Cologne
The recent World Health Organization (WHO) classification of hematopoietic and lymphoid tissue tumors represents the first worldwide consensus classification of these malignancies. However, the applicability of this classification to a representative number of hepatic lymphomas in liver biopsy specimens has not yet been investigated. The frequency and infiltration pattern of a series of 205 liver biopsies with lymphoma manifestations was analyzed with the aid of immunohistochemical and molecular pathological analyses. Diffuse large B-cell lymphoma (DLBCL) was by far the most frequent entity, comprising 45% of the cases analyzed. Using a previously published immunohistochemical algorithm, 35% of 80 DLBCL were assigned to a germinal center B-cell-like (GCB) and 65% to a non-GCB group. Most B-cell lymphoma entities involving the liver revealed a characteristic infiltration pattern. Diagnostically challenging entities were T-cell-rich B-cell lymphomas, anaplastic large cell lymphomas and peripheral T-cell lymphomas, which frequently required additional molecular clonality assessment. Overall, the percentage of T-cell lymphomas in the liver (12%) was higher as compared to other extranodal sites except for the skin and the small intestine. This study provides relevant data on the distribution of hepatic lymphomas and demonstrates the applicability of the WHO classification proposing a diagnostic algorithm for liver biopsies.
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