Diffuse large B-cell lymphoma (DLBCL) with significant intravascular invasion. Close resemblance of its clinicopathological features to intravascular large B-cell lymphoma, but not to DLBCL-not otherwise specified

  • Itami Hiroe
    Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan,
  • Nakamine Hirokazu
    Division of Pathology and Laboratory Medicine, The Japan Baptist Hospital, Kyoto, Japan,
  • Kubo Masayuki
    Department of Hematology, Nara Medical University, Kashihara, Japan,
  • Ogawa Kohei
    Department of Dermatology, Nara Medical University, Kashihara, Japan,
  • Tani Rina
    Department of Molecular Pathology, Nara Medical University, Kashihara, Japan,
  • Nakamura Shinji
    Department of Surgery, Takanohara Central Hospital, Nara, Japan,
  • Takeda Maiko
    Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan,
  • Nitta Yuji
    Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan,
  • Uchiyama Tomoko
    Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan,
  • Fujii Tomomi
    Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan,
  • Hatakeyama Kinta
    Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan, Department of Diagnostic Pathology, Minami-Nara General Medical Centre, Oyodo, Japan
  • Ohbayashi Chiho
    Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan,

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<p>Intravascular large B-cell lymphoma (IVLBCL) is defined by the World Health Organization (WHO) Classification as one type of extranodal large B-cell lymphoma and it is characterized by the selective growth of lymphoma cells within blood vessels with minimal extravascular invasion. According to the criteria, however, several reported cases of IVLBCL with significant extravascular invasion cannot be classified as IVLBCL. The purpose of the present study was to assess the clinicopathological significance of the WHO criteria for IVLBCL. We characterized clinical, histopathological, and immunohistochemical features of 11 patients with extranodal diffuse large B-cell lymphoma (DLBCL) with significant intravascular invasion (DLBCL-IV), and statistically compared their features with those of 11 patients with IVLBCL and 15 patients with extranodal DLBCL with virtually no intravascular invasion (DLBCL-noIV). When compared with the DLBCL-noIV group, the DLBCL-IV group was characterized by significantly higher rates of splenomegaly, hemophagocytosis, advanced stage disease, and CD5 expression; higher average platelet count, serum lactate dehydrogenase level, and serum ferritin level. Progression-free survival was significantly shorter in the DLBCL-IV group than the DLBCL-noIV group. In contrast, there were no significant differences in clinicopathological features between the DLBCL-IV and the IVLBCL groups. Our study suggests that DLBCL-IV should be regarded as IVLBCL-related.</p>

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