Phenotypic changes in large cell transformation of small cell lymphoid malignancies

Chan, Wing C.; Dekmezian, Roupen

doi:10.1002/1097-0142(19860515)57:10<1971::aid-cncr2820571015>3.0.co;2-h

Cited by 19 publications

(3 citation statements)

References 23 publications

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“…Approximately 10% of patients with MNHL have multiple histologic types of lymphoma (discordant lymphoma) identified in the biopsy tissues taken during the staging evaluation (39). In this study, we identified a discordant lymphoma in 1 case, and transformation from low-grade to high-grade lymphomas in 3 cases, which suggests that lymphomas in SS patients tend to evolve toward a less differentiated cell type in some cases.…”

Section: Discussionmentioning

confidence: 59%

Malignant lymphoma in primary Sj�gren's syndrome: A multicenter, retrospective, clinical study by the European concerted action on Sj�gren's syndrome

Voulgarelis

Dafni

Isenberg³

et al. 1999

Arthritis & Rheumatism

457

237

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Objective. Several reports have noted an increased incidence of malignant lymphoma in patients with Sjögren's syndrome (SS). Each case series has consisted of a limited number of patients with malignant non-Hodgkin's lymphoma (MNHL). In this report, we describe the disease characteristics, the clinical course, and the evolution in 33 patients followed up in 9 European medical centers. Methods. The pool of MNHL patients from participating centers in a European Concerted Action on SS were analyzed. We report on the disease characteristics , its evolution, prognosis, current treatment practices , and survival. Results. The MNHLs in this study were primarily situated in the marginal zone (48.5%), with the manifestations mostly extranodal (78.8%) and most often identified in the salivary glands (54.6%). Lymphadeno-pathy (65.6%), skin vasculitis (33.3%), peripheral nerve involvement (24.2%), low-grade fever (25.0%), anemia (48.1%), and lymphopenia (78.6%) were observed significantly more frequently than in the general SS population. Patients with high-to-intermediate grade lym-phoma had significantly worse survival (P 0.041). The presence of B symptoms (fever, night sweats, and weight loss) and a large tumor diameter (>7 cm) were additional independent risk factors for death. Conclusion. The novel observations of this study

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Section: Discussionmentioning

confidence: 59%

Malignant lymphoma in primary Sj�gren's syndrome: A multicenter, retrospective, clinical study by the European concerted action on Sj�gren's syndrome

Voulgarelis

Dafni

Isenberg³

et al. 1999

Arthritis & Rheumatism

457

237

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“…The idea that LCT signified worsening disease was initially, in part, inferred from similar findings in systemic B-cell lymphoma 16 and was sustained by the idea that the large lymphocytes were the histological expression of a transition to an independent malignant lymphoma. 17 The definition of LCT has evolved over time: at one point, LCT implied a change in classification of a CTCL to a subtype of large cell lymphoma; 4 subsequently, the term was defined as requiring >50% large cells 18 or a ‘predominance’ of large cells; 19 the current minimum criteria for LCT include the presence of >25% large cells or the presence of microscopic aggregates of large cells.…”

Section: Discussionmentioning

confidence: 95%

Mycosis fungoides with large cell transformation: clinicopathological features and prognostic factors

et al. 2014

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Summary Large cell transformation of mycosis fungoides (MF-LCT) occurs in 20–50% of advanced MF, and is generally associated with poor prognosis, although some patients have indolent disease. We sought to identify clinicopathological prognostic factors in a large number of patients with MF-LCT. We identified patients with MF-LCT treated between 1991 and 2012 at a referral centre for cutaneous lymphoma. Clinical and pathological records, and histopathological slides were reviewed. Associations of clinicopathological variables with disease-specific survival were analysed. In 51 patients with MF-LCT, factors significantly associated with shorter survival were: age >60 years (25 versus 61 months, p = 0.01), stage III/IV (25 versus 44 months, p = 0.049), high serum lactate dehydrogenase (LDH; 24 versus 53 months, p = 0.007), absent papillary dermal involvement (8 versus 30 months, p = 0.008); follicular mucin at transformation (24 versus 42 months, p = 0.007); and the absence of fibrosis at transformation (21 versus 42 months, p = 0.03). Patients presenting with transformation at diagnosis had better survival than those who started with a small cell phenotype (p = 0.02). Age >60 years was independently associated with poorer survival (HR 5.61, 95%CI 1.17–26.8, p = 0.03), and the presence of fibrosis at transformation was independently associated with improved survival (HR 0.30, 95%CI 0.09–0.97, p = 0.045). In patients with MF-LCT, clinical features (age, stage, serum LDH) are important in assessing prognosis. Additional clinical and pathological features identified in this study may also assist in prognostic stratification. Studies of larger cohorts should be performed to validate the prognostic significance of these features.

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“…1,4 Cases with predominance of atypical lymphocytes should be diagnosed as atypical CLL or other B-cell lymphoproliferative disorders, such as B-cell prolymphocytic leukemia (in cases with Q55% prolymphocytes in the peripheral blood). 32,33 Rarely, both CLL and SLL can transform to Hodgkin lymphoma and the myeloid neoplasm interdigitating dendritic cell sarcoma. 1,4 The darker areas are composed of sheets of small lymphocytes with more condensed chromatin that display low mitotic activity.…”

Section: What Is the Clinical And Laboratory Evidence Supporting The mentioning

confidence: 99%

Small Lymphocytic Lymphoma and Chronic Lymphocytic Leukemia

Santos¹,

O’Brien²

2012

The Cancer Journal

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Chronic lymphocytic leukemia (CLL) is the most common leukemia in the Western world, characterized by peripheral blood B-cell lymphocytosis as well as lymphadenopathy, organomegaly, cytopenias, and systemic symptoms. Chronic lymphocytic leukemia cells have a distinctive immunophenotype, and the disease has a characteristic pattern of histological infiltration in the lymph node and bone marrow. The clinical course of CLL is heterogeneous, with some patients presenting with very indolent disease and other patients having a more aggressive malignancy. It is known that genetic abnormalities underlie this difference in clinical presentation. Some patients may present solely with lymphadenopathy, organomegaly, and presence of infiltrating monoclonal B cells with the same immunophenotype as CLL cells, but lacking peripheral blood lymphocytosis. This disease is called small lymphocytic lymphoma (SLL) and has been considered for almost 2 decades to be the tissue equivalent of CLL. Both CLL and SLL are currently considered different manifestations of the same entity by the fourth edition of the World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. It is suspected that differential expression of chemokine receptors (e.g., reduced expression of R1 and CCR3 in SLL cells), integrins (e.g., CLL cells have lower expression of integrin αLβ2), and genetic abnormalities (a higher incidence of trisomy 12 and lower incidence of del(13q) is found in SLL) may explain some of the clinical differences between these 2 disorders. However, there is still a lack of knowledge on the precise biological basis underlying the different clinical presentations of CLL and SLL. It is expected that future studies will shed light on the pathophysiology of both disorders.

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Phenotypic changes in large cell transformation of small cell lymphoid malignancies

Cited by 19 publications

References 23 publications

Malignant lymphoma in primary Sj�gren's syndrome: A multicenter, retrospective, clinical study by the European concerted action on Sj�gren's syndrome

Malignant lymphoma in primary Sj�gren's syndrome: A multicenter, retrospective, clinical study by the European concerted action on Sj�gren's syndrome

Mycosis fungoides with large cell transformation: clinicopathological features and prognostic factors

Small Lymphocytic Lymphoma and Chronic Lymphocytic Leukemia

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