Department of Pathology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Department of Medical Oncology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Indian J Pathol Microbiol. 2023 Jul-Sep;66(3):549-555. doi: 10.4103/ijpm.ijpm_343_21.
Primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is an uncommon extranodal lymphoma that accounts for more than 95% of all the CNS lymphomas. Unlike its systemic/nodal counterpart, which is currently subtyped into cell-of origin (COO) subtypes, its feasibility and utility are largely debatable in PCNS-DLBCL.
To classify PCNS-DLBCL into COO-subtypes based on immunohistochemical algorithms by Hans and Choi and evaluate concordance between the two. A further aim is to investigate the clinicoradiological and histomorphological parameters of the subtypes thus obtained.
As many as 143 cases of primary CNS lymphoma were evaluated by immunohistochemistry for CD10, BCL6, MUM1, GCET, and FOXP1 and based on which the said 143 cases were further classified into COO subtypes using Hans and Choi algorithms.
Mean age was 53.8 years with marginal male preponderance and predominantly centroblastic morphology (75.5%). CD 10 was positive in 8.9% of the cases, BCL6 in 58.6%, MUM1 in 89.9%, GCET in 32.9%, and FOXP1 in 79.5%. As much as 84.9% cases were of non-germinal center B-cell (GCB) subtype and 15.1% cases were of GCB subtype as determined based on Hans algorithm. Furthermore, 90.7% cases were of activated B-cell (ABC) subtype and 9.3% cases were of GCB subtype according to Choi algorithm. A 91.8% concordance was observed between Hans and Choi algorithms. Among the 6 discordant cases, 5 cases were subtyped as GCB by Hans and ABC by Choi and 1 case as ABC by Hans and GCB by Choi.
Most of PCNS-DLBCLs are of non-GCB/ABC COO subtype, but inconsistences abound in the utility of IHC algorithms in PCNS-DLBCL COO subtypes.
原发性中枢神经系统弥漫性大 B 细胞淋巴瘤（PCNS-DLBCL）是一种罕见的结外淋巴瘤，占所有中枢神经系统淋巴瘤的 95%以上。与系统/结外的对应物不同，目前后者被分为细胞起源（COO）亚型，其在 PCNS-DLBCL 中的可行性和实用性在很大程度上存在争议。
根据 Hans 和 Choi 的免疫组织化学算法将 PCNS-DLBCL 分为 COO 亚型，并评估两种方法的一致性。进一步的目的是研究由此获得的亚型的临床放射影像学和组织形态学参数。
对 143 例原发性中枢神经系统淋巴瘤进行免疫组织化学检测 CD10、BCL6、MUM1、GCET 和 FOXP1，并根据 Hans 和 Choi 算法将这 143 例进一步分为 COO 亚型。
平均年龄为 53.8 岁，男性略占优势，主要为中心母细胞形态（75.5%）。8.9%的病例 CD10 阳性，58.6%的病例 BCL6 阳性，89.9%的病例 MUM1 阳性，32.9%的病例 GCET 阳性，79.5%的病例 FOXP1 阳性。高达 84.9%的病例是非生发中心 B 细胞（GCB）亚型，15.1%的病例为 GCB 亚型，这是基于 Hans 算法确定的。此外，根据 Choi 算法，90.7%的病例为激活 B 细胞（ABC）亚型，9.3%的病例为 GCB 亚型。Hans 和 Choi 算法之间观察到 91.8%的一致性。在 6 个不一致的病例中，5 个病例根据 Hans 算法被分为 GCB 亚型，根据 Choi 算法被分为 ABC 亚型，1 个病例根据 Hans 算法被分为 ABC 亚型，根据 Choi 算法被分为 GCB 亚型。
大多数 PCNS-DLBCL 为非 GCB/ABC COO 亚型，但免疫组织化学算法在 PCNS-DLBCL COO 亚型中的应用存在不一致。
