Citations 2
Concurrent or subsequent lymphomatous effusion in large B-cell lymphoma portends a dismal prognosis: A multi-institutional study
Tang, Haiming , Xu, Jie , McCracken, Jenna , Li, Peng , Braunberger, Ryan C. , Wu, Xiaojun , Wang, Endi , Zhang, Qianyun , Soma, Lorinda, Zhang, Jingjing , Matsumoto, Nana , Xu, Mina L. , Pan, Zenggang , Tang, Haiming , Wang, Endi , Katz, Samuel G , Zhang, Jing Jing , Pan, Zenggang , Gisriel, Savanah D. , Ji, Yuan , Fang, Hong , Li, Shaoying , Xu‐Monette, Zijun Y. , Young, Ken H.
American Journal of Clinical Pathology | May 9, 2025 | Volume: 164 | Issue: 3 | Pages: 390-401
Abstract Objective Rare large B-cell lymphomas (LBCLs) present with concurrent or subsequent lymphomatous effusion (solid-effusion LBCL, SE-LBCL), which may have an inferior prognosis compared with their noneffusion counterpart. In addition, the relationship between SE-LBCL and human herpesvirus 8–negative effusion-based LBCL (EB-LBCL) remains unclear. Methods We collected 141 cases of SE-LBCL and a control cohort of 101 cases of stage IV solid-only LBCL. The clinicopathologic features were analyzed and compared between SE-LBCL and solid-only LBCL. Results Patients with SE-LBCL had a median age of 67 years with a male-to-female ratio of 1.3:1. Eighty-six patients had concurrent solid lymphoma and lymphomatous effusion, whereas 55 developed lymphomatous effusion subsequently. Most cases involved the pleural cavities (79%, 112/141), followed by the peritoneal (21%, 29/141) and pericardial (11%, 16/141) cavities. BCL6, CD10, and MUM1 were expressed in 77% (90/117), 46% (60/130), and 61% (58/95) of cases, respectively, and 58% (71/123) were subclassified into the germinal center B-cell (GCB) subtype. Rearrangements of BCL2, BCL6, and MYC were detected in 42% (31/73), 35% (22/63), and 40% (35/88), respectively, and 22% (19/87) had both MYC and BCL2 rearrangements. The patients with SE-LBCL had a dismal prognosis, with a median survival of 5.7 months, which was significantly worse than solid-only LBCL (147.5 months; P < .0001). Conclusions The pathologic features of SE-LBCL were similar to those of solid-only LBCL but distinct from those of EB-LBCL; in particular, lymphomatous effusion was an independently adverse prognostic factor in LBCL. Our study underscores the need for surveillance of lymphomatous effusion during LBCL staging and development of effective therapeutic regimens for SE-LBCL.
Molecular and Cytogenetic Education in Hematopathology Fellowship
Soma, Lorinda, Kovach, Alexandra E. , Siddon, Alexa J. , Beck, Rose , Wu, David , Cook, James R. , Prakash, Sonam , Rosado, Flavia, Bradley, Kyle T., Weinberg, Olga K. , Sargent, Rachel L. , Gibson, Sarah E. , Kovach, Alexandra E , Swerdlow, Steven H. , Kim, Annette S , Jones, Dan M. , Crane, Genevieve M.
American Journal of Clinical Pathology | March 26, 2019 | Volume: 152 | Issue: 4 | Pages: 438-445
Abstract Objectives Given the increased complexity of molecular and cytogenetic testing (MOL-CG), the Society for Hematopathology Education Committee (SH-EC) was interested in determining what the current expectations are for MOL-CG education in hematopathology (HP) fellowship training. Methods The SH-EC sent a questionnaire to HP fellowship program directors (HP-PDs) covering MOL-CG training curricula, test menus, faculty background, teaching, and sign-out roles. These findings were explored via a panel-based discussion at the 2018 SH-EC meeting for HP-PDs. Results HP fellows are expected to understand basic principles, nomenclature, and indications for and limitations of testing. Interpretation of common assays is within that scope, but not necessarily proficiency in technical troubleshooting of testing or analysis of complex raw data. Conclusions The consensus was that HP fellows should understand the components of MOL-CG testing necessary to incorporate those results into an accurate, clinically relevant, and integrated HP report.