Chen Lei, Al-Kzayer Lika'a Fasih Y, Liu Yi, Liu Tingting
Department of Pathology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Oncotarget. 2017 Feb 14;8(7):11544-11554. doi: 10.18632/oncotarget.14581.
B-cell lymphomas involving Waldeyer's ring (WR) comprise heterogeneous histolopathological subtypes with a wide age range and distinctive clinical features. However, the comparison between pediatric and adult patients is scarce and limited in the literature. Thirty-three cases of B-cell lymphomas involving WR, were collected and evaluated by histolopathological, immunohistochemical and FISH analyses. The 33 cases were categorized into children and adolescents referred as pediatric group (n = 12), aged (3-19) years and the adult group (n = 21), aged (20-84) years. The pediatric group included Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL) and MUM1-positive-lymphoma in 7, 3 and 2 cases, respectively. While the adult cases comprised of DLBCL, follicular lymphoma, and mucosa associated lymphoid tissue (MALT) lymphoma in 18, 2 and 1 case, respectively. Male gender was predominant in both groups with 3 folds frequency in the pediatric cases compared to 2 folds in the adults counterpart. Pediatric cases showed a significantly higher frequency of stage I disease (P = 0.019), germinal center B-cell (GCB) phenotype (P = 0.011), CD10-positive expression (P = 0.003), and MYC breaks (P = 0.029) compared to adults. However, MUM1 positive expression was less frequently detected in pediatric patients than adults (P = 0.082). BCL2 rearrangement was undetectable in both pediatric and adult groups. On the other hand, adult group had the significantly higher proportion of DLBCL (P < 0.001), BCL2 expression (P = 0.027) and stage II disease (P = 0.047) compared to pediatric group.In conclusion, B-cell lymphomas involving WR presented with a wide age range, and evident variation in clinical features, histopathological subtypes and immunophenotypes between pediatric and adult age groups.
累及韦氏环（WR）的B细胞淋巴瘤包括组织病理学亚型各异的肿瘤，发病年龄范围广，临床特征独特。然而，儿科与成人患者之间的比较在文献中较少且有限。收集了33例累及WR的B细胞淋巴瘤病例，并通过组织病理学、免疫组织化学和荧光原位杂交（FISH）分析进行评估。这33例病例分为儿童和青少年组（儿科组，n = 12），年龄在（3 - 19）岁，以及成人组（n = 21），年龄在（20 - 84）岁。儿科组分别有7例伯基特淋巴瘤（BL）、3例弥漫性大B细胞淋巴瘤（DLBCL）和2例MUM1阳性淋巴瘤。而成人病例分别有18例DLBCL、2例滤泡性淋巴瘤和1例黏膜相关淋巴组织（MALT）淋巴瘤。两组均以男性为主，儿科病例中男性的发生率是成人的3倍。与成人相比，儿科病例中I期疾病（P = 0.019）、生发中心B细胞（GCB）表型（P = 0.011）、CD10阳性表达（P = 0.003）和MYC断裂（P = 0.029）的发生率显著更高。然而，儿科患者中MUM1阳性表达的检测频率低于成人（P = 0.082）。儿科组和成人组均未检测到BCL2重排。另一方面，与儿科组相比，成人组中DLBCL的比例（P < 0.001）、BCL2表达（P = 0.027）和II期疾病（P = 0.047）显著更高。总之，累及WR的B细胞淋巴瘤发病年龄范围广，儿科和成人年龄组在临床特征、组织病理学亚型和免疫表型方面存在明显差异。
