High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements with diffuse large B-cell lymphoma morphology.

Blood
D W ScottA Rosenwald

Abstract

High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements (HGBL-DH/TH) is a newly defined entity in the latest World Health Organization Classification. Accurate diagnosis would appear to mandate fluorescence in situ hybridization (FISH) for all tumors with diffuse large B-cell lymphoma (DLBCL) morphology. We present the results of FISH, cell-of-origin, and immunohistochemistry (IHC) testing from 1228 DLBCL biopsies from 3 clinical trials and a population-based registry. HGBL-DH/TH made up 7.9% of the DLBCL, confined primarily to the germinal center B-cell-like (GCB; 13.3%) compared with activated B-cell-like (ABC; 1.7%) subtype (P < .001). HGBL-DH/TH with BCL2 rearrangement is a GCB phenomenon with no cases observed in 415 ABC DLBCL. A screening strategy restricting FISH testing to tumors of GCB subtype (by Lymph2Cx or Hans IHC) plus dual protein expression of MYC and BCL2 by IHC could limit testing to 11% to 14% of tumors, with a positive predictive value of 30% to 37%; however, this strategy would miss approximately one-quarter of tumors with HBGL-DH/TH with BCL2 rearrangement and one-third of all HGBL-DH/TH. These results provide accurate estimation of the proportion of HGBL-DH/TH among tumors with DLBCL morph...Continue Reading

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Citations

Jul 11, 2018·Expert Review of Hematology·Shaoying LiL Jeffrey Medeiros
Jul 11, 2018·Journal of Internal Medicine·T C El-GalalyC Y Cheah
Aug 17, 2018·The American Journal of Surgical Pathology·Anne M R SchraderRein Willemze
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Dec 7, 2018·Hematology·Allison Rosenthal, Lisa Rimsza
May 24, 2019·Expert Review of Hematology·Lin-Rong LiKen H Young
Jun 13, 2019·Hematological Oncology·Andrew Davies
Jul 7, 2019·American Journal of Clinical Pathology·Megan S LimMiguel Piris
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Nov 26, 2019·The American Journal of Surgical Pathology·Sarah MenguyJean-Philippe Merlio
Apr 24, 2020·Histopathology·Alberto ZamòFalko Fend
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Dec 14, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Daisuke EnnishiDavid W Scott
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