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Among diffuse large B-cell lymphomas, T-cell-rich/histiocyte-rich BCL and CD30+ anaplastic B-cell subtypes exhibit distinct clinical features Maes B; Anastasopoulou A; Kluin-Nelemans JC; Teodorovic I; Achten R; Carbone A; De Wolf-Peeters CAnn Oncol 2001[Jun]; 12 (6): 853-8BACKGROUND: The EORTC clinical trial 20901, activated in 1990, was designed to treat non-Hodgkin's lymphomas (NHL) of intermediate/high-grade malignancy according to the Working Formulation. Established in 1994, the R.E.A.L. Classification on NHL has now replaced all former classifications. PATIENTS AND METHODS: We reanalysed all cases (n = 273) documented by material available for review according to the R.E.A.L. Classification. In addition, we subdivided cases recognised as diffuse large B-cell lymphoma (DLBCL) into three morphologically distinct categories, namely, large cleaved DLBCL (LC-DLBCL), T-cell-rich/histiocyte-rich B-cell lymphoma (T-cell-rich/histiocyte-rich BCL) and CD30+ DLBCL with anaplastic cell features (CD30+ DLBCL). Finally, T/NULL anaplastic large-cell lymphoma (ALCL) cases were subdivided into ALK+ and ALK- lymphomas. Review was performed independently by two pathologists from two different centres. RESULTS: DLBCL (61%), T/NULL ALCL (15%) and mantle-cell lymphoma (MCL, 50%) were the main NHL categories represented in the study. Fifty-seven of one hundred sixty DLBCL cases were further subclassified as LC-DLBCL (33 cases), T-cell-rich/histiocyte-rich BCL (13 cases) or CD30+ DLBCL (11 cases). The remaining cases were indicated as unspecified DLBCL. A clinico-pathological correlation confirmed the findings of previous studies suggesting that MCL, DLBCL and ALCL represent distinct entities with MCL being characterised by a short survival, in contrast with the longer survival and less frequent progression typical of ALK+ compared to ALK- ALCL. Within DLBCL, T-cell-rich/histiocyte-rich BCL showed distinctive features at presentation whereas CD30+ DLBCL showed a trend towards a more favourable prognosis, that might be comparable to that of ALK+ ALCL. CONCLUSIONS: Our data further support the usefulness of the R.E.A.L. Classification and illustrate the feasibility of DLBCL subtyping. Moreover, our results demonstrate the distinct clinical characteristics of T-cell-rich/histiocyte-rich BCL and CD30+ DLBCL with anaplastic cell features suggesting that they may represent clinico-pathologic entities.|Adolescent[MESH]|Adult[MESH]|Anaplastic Lymphoma Kinase[MESH]|B-Lymphocyte Subsets/pathology[MESH]|Disease-Free Survival[MESH]|Female[MESH]|Humans[MESH]|Immunophenotyping[MESH]|Ki-1 Antigen/analysis[MESH]|Lymphocytes, Null/pathology[MESH]|Lymphoma, B-Cell/*classification/*diagnosis/pathology[MESH]|Lymphoma, Large B-Cell, Diffuse/*classification/diagnosis/pathology[MESH]|Male[MESH]|Middle Aged[MESH]|Prognosis[MESH]|Protein-Tyrosine Kinases/analysis[MESH]|Receptor Protein-Tyrosine Kinases[MESH]|Survival Rate[MESH]|T-Lymphocytes/pathology[MESH] |
