EBV-positive diffuse large B-cell lymphoma of the elderly is an aggressive post-germinal center B-cell neoplasm characterized by prominent nuclear factor-kB activation

Santiago Montes-Moreno, Lina Odqvist, Julio A. Diaz-Perez, Ana Batlle Lopez, Sonia Gonzalez De Villambrosía, Francisco Mazorra, Maria E. Castillo, Mar Lopez, Raquel Pajares, Juan F. García, Manuela Mollejo, Francisca I. Camacho, Carmen Ruiz-Marcellán, Magdalena Adrados, Nazario Ortiz, Renato Franco, Carlos Ortiz-Hidalgo, Ana Suarez-Gauthier, Ken H. Young, Miguel A. Piris

Research output: Contribution to journalArticle

Abstract

Here, we report a retrospective series of 47 EBV-positive diffuse large B-cell lymphoma associated with advanced age. Histopathology allowed to the identification of different histological patterns: cases with polymorphic diffuse large B-cell lymphoma (29 cases), Hodgkin-like (8 cases) and polymorphic lymphoproliferative disorder-like (9 cases) patterns. One case was purely monomorphic diffuse large B-cell lymphoma. We show that this lymphoma type is a neoplasm with prominent classical and alternative nuclear factor-kB pathway activation in neoplastic cells (79% of the cases showed nuclear staining for p105/p50, 74% for p100/p52 and 63% for both proteins), with higher frequency than that observed in a control series of EBV-negative diffuse large B-cell lymphoma ( χ 2 0.001). Most cases showed an activated phenotype (95% non-germinal center (Hans algorithm); 78% activated B cell (Choi algorithm)). Clonality testing demonstrated IgH and/or K/Kde/L monoclonal rearrangements in 64% of cases and clonal T-cell populations in 24% of cases. C-MYC (1 case), BCL6 (2 cases) or IgH (3 cases) translocations were detected by FISH in 18% cases. These tumors had a poor overall survival and progression-free survival (the estimated 2-year overall survival was 4010% and the estimated 2-year progression-free survival was 369%). Thus, alternative therapies, based on the tumor biology, need to be tested in patients with EBV-positive diffuse large B-cell lymphoma of the elderly.

Original languageEnglish
Pages (from-to)968-982
Number of pages15
JournalModern Pathology
Volume25
Issue number7
DOIs
Publication statusPublished - Jul 2012

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Keywords

  • DLBCL
  • EBV
  • elderly
  • NFkB
  • non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Montes-Moreno, S., Odqvist, L., Diaz-Perez, J. A., Lopez, A. B., De Villambrosía, S. G., Mazorra, F., Castillo, M. E., Lopez, M., Pajares, R., García, J. F., Mollejo, M., Camacho, F. I., Ruiz-Marcellán, C., Adrados, M., Ortiz, N., Franco, R., Ortiz-Hidalgo, C., Suarez-Gauthier, A., Young, K. H., & Piris, M. A. (2012). EBV-positive diffuse large B-cell lymphoma of the elderly is an aggressive post-germinal center B-cell neoplasm characterized by prominent nuclear factor-kB activation. Modern Pathology, 25(7), 968-982. https://doi.org/10.1038/modpathol.2012.52