Frequency and diagnostic patterns of lymphomas in liver biopsies with respect to the WHO classification

Abstract

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.

Hepatic pseudolymphoma: a clinicopathological study of five cases and review of the literature

“…28,29 Interestingly, marginal-zone B-cell lymphoma, the most important differential diagnosis of hepatic pseudolymphoma, showed this pattern in only one case (6% of 16 cases). 28,29 It is still ambiguous whether or not a characteristic pattern of infiltration at the edge of hepatic pseudolymphoma can be observed in low-grade B-cell lymphoma. But, unique features observed in needle biopsies (Figure 4) was not described in those two studies.…”

“…Two previous studies examined patterns of hepatic infiltration in malignant lymphoma. 28,29 The studies examined 294 cases in total, including 76 cases of low-grade B-cell lymphomas (marginal-zone B-cell lymphoma, B-CLL, mantle cell lymphoma, and follicular lymphoma). 28,29 The patterns of hepatic infiltration were classified into nodular, portal, and sinusoidal.…”

“…28,29 The studies examined 294 cases in total, including 76 cases of low-grade B-cell lymphomas (marginal-zone B-cell lymphoma, B-CLL, mantle cell lymphoma, and follicular lymphoma). 28,29 The patterns of hepatic infiltration were classified into nodular, portal, and sinusoidal. Interestingly, combined results of both studies, most of low-grade B-cell lymphomas showed a predominantly portal infiltration pattern with or without sinusoidal infiltration.…”

Pathology of the liver sinusoids

“…Two recent studies have identified three main patterns of hepatic involvement in lymphoproliferative disease – portal, nodular and sinusoidal (Figure ). In many cases, more than one of these three basic patterns is present.…”

Focal Liver Lesions: One More Example of Discordance Between Contrast-Enhanced Sonography and CT Pattern of Enhancement

“…Morphologic and immunophenotypic examinations of the sample yielded the diagnosis of extranodal marginal zone lymphoma, a subtype of B-cell peripheral neoplasms [4]. On the basis of the results of the staging workup, we concluded that the nodule was a low-grade B-cell primary hepatic lymphoma.…”