Aggressive large B-cell lymphoma with plasma cell differentiation: immunohistochemical characterization of plasmablastic lymphoma and diffuse large B-cell lymphoma with partial plasmablastic phenotype

Haematologica. 2010 Aug;95(8):1342-9. doi: 10.3324/haematol.2009.016113. Epub 2010 Apr 23.

Abstract

Background: Plasmablastic lymphoma has recently come to be considered a distinct entity among mature B cell neoplasms, although the limits with diffuse large B-cell lymphoma (DLBCL) need to be more accurately defined.

Design and methods: Here we show the results of an immunohistochemical study of 35 cases of plasmablastic lymphoma compared with a set of 111 conventional DLBCLs.

Results: Our results demonstrate that the use of a limited combination of immunohistochemical markers (PAX5&CD20, PRDM1/BLIMP1 and XBP1s) enables the identification of a plasmablastic immunophenotype highly characteristic of plasmablastic lymphoma cases and associated with an aggressive clinical behavior. Additionally, the study shows that the acquisition of a partial plasmablastic phenotype (PRDM1/BLIMP1 expression) in DLBCL is associated with shorter survival in R-CHOP-treated patients.

Conclusions: The use of a restricted combination of immunohistochemical markers (PAX5&CD20, PRDM1/BLIMP1 and XBP1s) enables a more accurate definition of terminal differentiation for large B-cell lymphoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, CD20 / metabolism
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cell Differentiation
  • Female
  • Humans
  • Immunohistochemistry
  • Immunophenotyping
  • Lymphoma, B-Cell / drug therapy
  • Lymphoma, B-Cell / metabolism*
  • Lymphoma, B-Cell / pathology
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / metabolism*
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • PAX5 Transcription Factor / metabolism
  • Plasma Cells / chemistry*
  • Plasma Cells / drug effects
  • Plasma Cells / pathology
  • Positive Regulatory Domain I-Binding Factor 1
  • Repressor Proteins / metabolism
  • Survival Analysis
  • Treatment Outcome
  • Young Adult

Substances

  • Antigens, CD20
  • PAX5 Transcription Factor
  • PAX5 protein, human
  • Repressor Proteins
  • PRDM1 protein, human
  • Positive Regulatory Domain I-Binding Factor 1