Blood Res.  2018 Mar;53(1):87-89. 10.5045/br.2018.53.1.87.

Primary CNS high-grade B-cell lymphoma, with rearrangements of MYC and BCL6 : a case report

• Sasapu A
• Atwal D
• Insuasti-Beltran G
• Jethava Y

• KMID: 2414372
• DOI: http://doi.org/10.5045/br.2018.53.1.87

Abstract

No abstract available.

MeSH Terms

B-Lymphocytes*
Lymphoma, B-Cell*

Figure

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  Fig. 1 Brain biopsy showing characteristic findings. (A) ×100 magnification; (B) ×400 magnification. Small foci of necrosis and frequent mitosis noted. (C-I) ×400 magnification. IHC stains on tumor cells were positive for CD20 (C), BCL2 (G), BCL6 (F), and MYC (I). The Ki-67 index was >95% (H). Tumor cells were negative for CD3 (D) and CD10 (E).

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  Fig. 2 (A) BCL6 centromere (green arrow) and telomere (red arrow). (B) MYC centromere (green arrow) and telomere (red arrow). (C) IGH locus two signals (green arrow) and BCL2 locus only one signal present (red arrow).

Reference

1. Nayak L, Pentsova E, Batchelor TT. Primary CNS lymphoma and neurologic complications of hematologic malignancies. Continuum (Minneap Minn). 2015; 21:355–372.

2. Hoang-Xuan K, Bessell E, Bromberg J, et al. Diagnosis and treatment of primary CNS lymphoma in immunocompetent patients: guidelines from the European Association for Neuro-Oncology. Lancet Oncol. 2015; 16:e322–e332.

3. Rosenthal A, Younes A. High grade B-cell lymphoma with rearrangements of MYC and BCL2 and/or BCL6: Double hit and triple hit lymphomas and double expressing lymphoma. Blood Rev. 2017; 31:37–42.

4. Ferreri AJ, Cwynarski K, Pulczynski E, et al. Chemoimmunotherapy with methotrexate, cytarabine, thiotepa, and rituximab (MATRix regimen) in patients with primary CNS lymphoma: results of the first randomisation of the International Extranodal Lymphoma Study Group-32 (IELSG32) phase 2 trial. Lancet Haematol. 2016; 3:217–227.

5. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016; 127:2375–2390.

6. Kim S, Nam SJ, Kwon D, et al. MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system. BMC Cancer. 2016; 16:363.

7. Tapia G, Baptista MJ, Muñoz-Marmol AM, et al. MYC protein expression is associated with poor prognosis in primary diffuse large B-cell lymphoma of the central nervous system. APMIS. 2015; 123:596–603.

8. Gill KZ, Iwamoto F, Allen A, et al. MYC protein expression in primary diffuse large B-cell lymphoma of the central nervous system. PLoS One. 2014; 9:e114398.

9. Kreher S, Jöhrens K, Strehlow F, et al. Prognostic impact of B-cell lymphoma 6 in primary CNS lymphoma. Neuro Oncol. 2015; 17:1016–1021.

10. Sakurai H, Sugimoto KJ, Shimada A, et al. Primary CNS CCND1/MYC-positive double-hit B-cell lymphoma: a case report and review of the literature. J Clin Oncol. 2015; 33:e79–e83.

11. Brunn A, Nagel I, Montesinos-Rongen M, et al. Frequent triple-hit expression of MYC, BCL2, and BCL6 in primary lymphoma of the central nervous system and absence of a favorable MYC(low)BCL2 (low) subgroup may underlie the inferior prognosis as compared to systemic diffuse large B cell lymphomas. Acta Neuropathol. 2013; 126:603–605.