Immunohistochemical analysis of adhesion molecules and matrix metalloproteinases in malignant CNS lymphomas: a study comparing primary CNS malignant and CNS intravascular lymphomas

Kinoshita, Manabu; Izumoto, Shuichi; Hashimoto, Naoya; Kishima, Haruhiko; Kagawa, Naoki; Hashiba, Tetsuo; Chiba, Yasuyoshi; Yoshimine, Toshiki

doi:10.1007/s10014-008-0232-x

Cited by 45 publications

(30 citation statements)

References 17 publications

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“…32,33 The expression of certain genes 34,35 and adhesion molecules on the surface of non-Hodgkin's lymphoma cells 36,37 has been associated with a tendency towards extranodal involvement, tumor aggressiveness, and worse outcomes. These observations provide a biological hypothesis accounting for the high rates of CNS involvement seen at diagnosis and relapse in our cohort of patients.…”

Section: Clinical Factor Chop (N=12) R-chop (N=8)mentioning

confidence: 99%

Diffuse large B-cell lymphoma with involvement of the kidney: outcome and risk of central nervous system relapse

Villa¹,

Connors²,

Sehn³

et al. 2011

Haematologica

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BackgroundRenal involvement is uncommon in diffuse large B-cell lymphoma. Recent data suggest that it is an independent risk factor for central nervous system relapse. We reviewed the clinical features, risk of central nervous system involvement, and survival of patients with diffuse large Bcell lymphoma with involvement of the kidney at diagnosis. Design and MethodsAll patients with diffuse large B-cell lymphoma and renal involvement diagnosed from January 1, 1982 to December 31, 2008 at the British Columbia Cancer Agency were retrospectively identified in the Lymphoid Cancer Database. Patients were included if they were 16 years old or over, had advanced stage disease [stage III /IV, or stage I/II with B symptoms or bulky mass (>10 cm)] and were treated with curative intent. Central nervous system involvement was diagnosed by cerebrospinal fluid cytology, radiology or clinically. ResultsWe identified 55/2656 (2%) patients with diffuse large B-cell lymphoma and renal involvement at diagnosis. The male to female ratio was 2:1. The patients' median age was 58 years. Bilateral renal involvement was present in 24 (44%) and stage IV disease in 50 (91%). The International Prognostic Index score was 3, 4 or 5 in 52 (95%), the glomerular filtration rate was less than 30 mL/min/m 2 in 9 (16%) and elevated lactate dehydrogenase was recorded in 46 (84%). Twentyfive (46%) patients received CHOP plus rituximab and 30 (54%) received CHOP-like regimens without rituximab. In total, 20 (36%) patients had central nervous system involvement: four at the time of diagnosis and 16 at relapse. The median time to central nervous system relapse was 5.6 months (range, 1.2 months-4.6 years), and was not affected by the addition of rituximab (P=0.547). The 5-year overall and progression-free survival rates for the whole cohort were 29% and 25%, respectively. In patients who received rituximab, there were trends towards improved 5-year overall survival (43% versus 18%, P=0.071) and progression-free survival (40% versus 13%, P=0.057). ConclusionsThere is an exceptionally high incidence of central nervous system relapse in patients with diffuse large B-cell lymphoma and kidney involvement at diagnosis. The addition of rituximab may improve overall survival in this poor-risk population, likely through improved control of systemic disease.

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Section: Clinical Factor Chop (N=12) R-chop (N=8)mentioning

confidence: 99%

Diffuse large B-cell lymphoma with involvement of the kidney: outcome and risk of central nervous system relapse

Villa¹,

Connors²,

Sehn³

et al. 2011

Haematologica

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“…Our patient received six cycles of RCHOP chemotherapy but he had short survival as later during the course of treatment he was diagnosed with CNS lymphoma on CT scan. The mechanism of lymphoma dissemination in CNS remains unclear but the role of adhesion molecules, chemokines, and matrix metalloproteinases in tumor invasion and metastasis is getting recognized . The expression of certain genes and adhesion molecules on the surface of NHL cells is linked with the tendency toward extranodal involvement, tumor aggressiveness, and worst outcomes.…”

Section: Discussionmentioning

confidence: 79%

An unusual presentation of diffuse large B‐cell lymphoma with ureteric involvement: A case report

et al. 2018

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Introduction Non‐Hodgkin's lymphomas are a heterogeneous group of malignancies in the lymphoid system and ureteric involvement by non‐Hodgkin's lymphoma is very rare. Case presentation We present a 37‐year‐old male, presenting with lower urinary tract symptoms and right flank pain. Initially, he presented with lower urinary tract symptoms without having any evidence of urinary tract infection and was managed for nonspecific cystitis. His ureteral histopathology report indicated a diffused infiltration by malignant lymphoid cells and the final diagnosis revealed diffuse large B‐cell lymphoma. His positron‐emission tomography scan indicated stage 4 disease with skeletal involvement and he was then treated by rituximab, cyclophosphamide, liposomal doxorubicin, vincristine, and methylprednisolone chemotherapy. Later, he was also diagnosed with central nervous system lymphoma and died during his stay in the hospital. Conclusion Primary diffuse large B‐cell lymphoma of the ureter is extremely rare; however, it should be considered in the differential diagnosis for patients presenting with obstructive uropathy as its early detection is crucial for diagnostic and therapeutic treatment.

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“…Some challenge the notion of IVLBCL concomitantly involving the CNS extravascularly due to the fact that they are thought to have absent surface adhesion molecules CD29, CD54 (ICAM-1), and CD11a, preventing them from being able to cross small CNS vessels to form perivascular or extravascular infiltrates [28]. However, a biologic explanation for the predilection for IVLBCL to involve the CNS with an extravascular growth pattern could be due to the fact that as veno-occlusive events occur secondary to small vessel involvement by IVLBCL, the permeability of the blood-brain-barrier is altered [29] such that it allows for passive diffusion of neoplastic cells across vessels into the brain parenchyma to form extravascular infiltrates.…”

Section: Discussionmentioning

confidence: 99%

A Small Case Series of Intravascular Large B-Cell Lymphoma with Unexpected Findings: Subset of Cases with Concomitant Extravascular Central Nervous System (CNS) Involvement Mimicking Primary CNS Lymphoma

Poropatich

Dittmann

Chen

et al. 2017

J Pathol Transl Med

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BackgroundIntravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal lymphoma with growth mainly in the lumina of vessels. We studied a small series of IVLBCL and focused on its central nervous system (CNS) involvement. MethodsSearching the medical records of Northwestern Memorial Hospital, we identified five cases of IVLBCL from January 2007 to January 2015. Clinical information, hematoxylin and eosin stained histologic slides and immunohistochemistry studies were reviewed for all cases. Polymerase chain reaction (PCR) analysis for the immunoglobulin (Ig) heavy and light chain gene rearrangement was performed on all five cases.ResultsThree of the five cases of IVLBCL were autopsies. Patients’ age ranged from 56 to 84. CNS involvement was present in two cases—in both patients, the CNS involvement showed an extravascular pattern with confluent sheet-like formation. PCR analysis confirmed that in one case the systemic intravascular and CNS extravascular components were clonally identical. ConclusionsIn a small case series of IVLBCL, we observed that CNS involvement by IVLBCL often has an extravascular morphology, but is clonally identical to the intravascular counterpart by PCR analysis. As IVLBCL can have a rapidly progressing poor outcome, it should be kept in the differential diagnoses for patients presenting with lymphoma of the CNS. The presence of extravascular growth patterns in the CNS should not exclude IVLBCL as a diagnosis.

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Immunohistochemical analysis of adhesion molecules and matrix metalloproteinases in malignant CNS lymphomas: a study comparing primary CNS malignant and CNS intravascular lymphomas

Cited by 45 publications

References 17 publications

Diffuse large B-cell lymphoma with involvement of the kidney: outcome and risk of central nervous system relapse

Diffuse large B-cell lymphoma with involvement of the kidney: outcome and risk of central nervous system relapse

An unusual presentation of diffuse large B‐cell lymphoma with ureteric involvement: A case report

A Small Case Series of Intravascular Large B-Cell Lymphoma with Unexpected Findings: Subset of Cases with Concomitant Extravascular Central Nervous System (CNS) Involvement Mimicking Primary CNS Lymphoma

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