Comparative immunohistochemical analysis of pediatric Burkitt lymphoma and diffuse large B-cell lymphoma

Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL) account for nearly all pediatric nonlymphoblastic B-cell lymphomas. Because clinical behavior, prognosis, and response to therapy might differ, diagnostic accuracy is important. Morphologic examination often is sufficient, but occasionally, diagnostic ancillary studies are required. In adults, immunophenotyping is useful; however, pediatric data are limited. We characterized the immunohistochemical expression of 6 proteins (c-myc, CD10, bcl-6, bcl-2, CD138, and MIB-1) in pediatric BL (33 cases) and DLBCL (20 cases) with classic morphologic features. Significant differences in c-myc (BL, 30/33 [91%] vs DLBCL, 5/20 [25%]; P < .0001), bcl-2 (BL, 1/25 [4%] vs DLBCL, 7/19 [37%]; P < .02), and mean MIB-1 (BL, 99% vs DLBCL, 56%; P < .0001) expression were observed. There were no significant differences for CD10 (100% expression in BL and DLBCL), bcl-6 (BL, 23/33 [70%] vs DLBCL, 15/20 [75%]), or CD138 (no expression). Thus, pediatric BL and DLBCL have distinctive immunohistochemical profiles, and staining for c-myc, MIB-1, and bcl-2 might be useful in morphologically difficult cases.     

流式细胞术在弥漫性大B细胞淋巴瘤伴大量T细胞反应病理诊断中的应用

目的探讨流式细胞免疫分型技术在弥漫大B细胞淋巴瘤伴大量T细胞反应病例诊断中的应用价值。方法对3例弥漫大B细胞淋巴瘤伴大量T细胞反应病例病理形态、免疫组织化学染色及流式细胞免疫分型进行回顾性分析。结果例1：在CIM5-SSC（Side Scatter,侧向散射角）点图上可见CD45阳性细胞明显分2群,强阳性细胞由T细胞和B细胞共同组成,但以T细胞为主,其中B细胞为免疫球蛋白轻链非限制性表达。而CD45弱阳性细胞基本都是B细胞,且为免疫球蛋白轻链入限制性表达。例2：在CD45-SSC点图中可见CD45阳性细胞因SSC大小不同而分2群,SSC较小的细胞群为T、B细胞混合存在,SSC较大,相当于单核细胞位置的细胞群主要为B细胞,且为免疫球蛋白轻链K限制性表达;例3：再作CD19／κ／CD20,CD19／λ／CD20三重标记发现部分CD19阳性细胞CD20阴性,该群细胞呈κ限制性表达。结论通过多参数、多组合流式细胞免疫分型技术可以从抗原表达减弱或增强、抗原丢失、是否表达非B系抗原、FSC（前向散射光）和（或）SSC的变化以及是否有表达不成熟B细胞的抗原6个方面将肿瘤性B细胞与反应性细胞区分开。     

Primary central nervous system B cell lymphoma with features intermediate between diffuse large B cell lymphoma and Burkitt lymphoma

B cell lymphoma with features intermediate between diffuse large B cell lymphoma and Burkitt lymphoma (DLBCL/BL) is a new lymphoma entity which is recognized in the current World Health Organization (WHO) classification (2008). We report a case of a primary central nervous system lymphoma (PCNSL) with findings consistent with DLBCL/BL. It is characterized by a very aggressive clinical course, and a widespread multifocal involvement of the CNS. Our case shows that a DLBCL/BL can manifest in the CNS alone without any systemic involvement.     

CD10 and Bcl10 expression in diffuse large B-cell lymphoma: CD10 is a marker of improved prognosis

AIMS: Diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin's lymphoma, is clinically and pathologically heterogeneous. The Bcl10 gene was recently isolated from the breakpoint region of t(1;14)(p22;q32) in mucosa-associated lymphoid tissue (MALT) lymphomas, and is considered to be an apoptosis-associated gene. CD10 is considered to be a marker of follicular centre B-cell differentiation. To assess the clinical significance and roles of CD10 and Bcl10 in DLBCL, we analysed 138 cases, using immunohistochemical methods. METHODS AND RESULTS: CD10 expression was limited to the cytoplasm, whereas Bcl10 expression was detected in the cytoplasm and/or nuclei. CD10 expression was detected in 39 of 138 cases (28.2%), cytoplasmic Bcl10 in 68 cases (49.2%), and nuclear Bcl10 in 34 cases (24.6%). Nuclear Bcl10 was detected in 14 of 28 cases (50%) of extranodal DLBCL, but only 20 of 110 cases (18.2%) of nodal DLBCL. Cytoplasmic Bcl10 was detected in 19 of 28 cases (67.8%) of extranodal DLBCL and 49 of 110 cases (44.5%) of nodal DLBCL. CD10 expression closely correlated with improved survival (68% overall survival (OS) vs. 48% OS), but not with site of disease. A high International Prognostic Index (IPI) was considered to be a poor prognostic factor associated with a shorter OS. CD10 expression was detected in 27 of 84 cases (32.1%) with low-risk IPIs, and in 12 of 54 cases (22.2%) with high-risk IPIs. In the low-risk group, cases expressing CD10 carried a better prognosis than CD10- cases (93% OS vs. 71% OS), whereas this was not the case in the high-risk group (25% vs. 20%). CONCLUSIONS: Bcl10 expression was associated with extranodal DLBCL, but not with prognosis. CD10 expression was closely associated with improved survival, but not with risk as predicted by IPI. Overall, our results suggest that CD10 expression may be useful, in combination with clinical parameters, for determining the prognosis of DLBCL.     

Comparison of multiparameter flow cytometry with cluster analysis and immunohistochemistry for the detection of CD10 in diffuse large B-Cell lymphomas.

CD10 is a critical antigen for the distinction of follicle-center lymphoma from other B-cell lymphomas composed of small cells in fine-needle aspiration specimens, tissue core biopsies, and bone marrow. In addition, CD10 is expressed in a subset of diffuse large B-cell lymphomas (DLBCLs), where it may be an adverse prognostic indicator. We have previously demonstrated that CD10 expression detected by multiparameter flow cytometry (FC) with cluster analysis is highly sensitive and specific for follicle-center lymphoma in the differential diagnosis of small B-cell lymphomas. In this study, we assessed the utility of paraffin section immunohistochemistry (IHC) for CD10 compared with FC in a cohort of 50 DLBCLs. IHC for CD10 was technically successful in 47 of the 50 (94%) DLBCLs; 3 failed based on lack of internal CD10 reactivity. CD10 was expressed by FC in 20 of 47 DLBCLs (43%); CD10 was positive by IHC in 15 of these (75%). All 27 cases that were CD10(-) by FC were negative by IHC. The level of CD10 expression by FC in the 5 FC(+)/IHC(-) cases ranged from relatively dim to bright. Our results indicate 75% sensitivity and 100% specificity of CD10 expression by IHC compared with multiparameter FC with cluster analysis and a 6% technical failure rate.     

Primary cutaneous CD30+ large cell B-cell lymphoma: a series of 10 cases.

BACKGROUND: White CD30 expression is described in extracutaneous diffuse large B-cell lymphomas, a primary cutaneous B-cell lymphoma (PCBCL) equivalent is not well defined. METHODS: Between June 1999 and July 2002 the authors encountered 10 patients with CD30+ PCBCLs of the large cell type. RESULTS: The patients comprised seven women and three men; five patients were over 80 years of age, all except one presenting with solitary plaques. With the exception of one death from myocardial infarction and one recurrence, all patients are well at a mean follow-up of 23.4 months. Skin biopsies showed a background of T-cell-rich reactive lymphoid hyperplasia in 7 of 10 patients, with variable granulomatous inflammation in 5 cases. The neoplastic large cells were immunoblastic in appearance. In four patients the infiltrate was dominated by large cells. In the remaining patients the reactive infiltrate defined the dominant cell population. The neoplastic cells expressed CD20, CD30, CD43, and BCL-2. In two cases associated with methotrexate therapy, Epstein-Barr virus expression was observed amid the neoplastic cell populace. CONCLUSIONS: CD30+ PCBCL is a distinctive form of B-cell lymphoma presenting in elderly patients and can be associated with a very good prognosis. In some patients the intensity of reactive inflammation obscures the diagnosis. In the authors' experience almost a third of the cases were associated with Epstein-Barr virus infection and methotrexate therapy, suggesting a distinctive association.     

Analysis of immunoglobulin VH genes in CD10-positive diffuse large B-cell lymphoma

CD10, a proteolytic enzyme seen in germinal center cells and in the majority of follicular lymphomas, is occasionally expressed in diffuse large B-cell lymphomas (DLBCL). To clarify the origin and cellular characteristics of CD10-positive DLBCL, we analyzed 36 de novo cases of DLBCL for somatic mutations of the immunoglobulin heavy chain variable region (VH) genes and for their immunophenotypes. Expression greater than that of grade 2 Bcl-6 was observed in 11 of the 30 CD10-negative cases (37%) and in all six CD10-positive cases (100%; P < 0.05) without expression of CD5, CD23, cyclin D1, CD30 or CD138. The average mutation frequencies of the six CD10-positive and 30 CD10-negative DLBCL were 12.9 and 9.8%, respectively. The range of SM frequencies in CD10-positive DLBCL (9.52-18.06) was distinctly narrower than that observed for CD10-negative DLBCL (0.69-26.89). These findings seem to indicate that CD10-positive DLBCL, originating from germinal center B cells, is a genetically and immunophenotypically more homogeneous group than CD10-negative DLBCL. Furthermore, three extranodal lymphomas, in five of the six CD10-positive DLBCL, showed ongoing mutation, indicating that antigen-driven, high-affinity somatic mutation may play an important role in clonal expansion in CD10-positive DLBCL. All four extranodal cases of the six CD10-positive DLBCL showed ongoing mutation and/or bcl-2/JH rearrangement. This result suggests that the cell origin of extranodal CD10-positive DLBCL may be the same as that of follicular lymphomas.     

The clinical significance of CD10 antigen expression in diffuse large B-cell lymphoma

The clinical significance and prognostic value of CD10 in de novo diffuse large B-cell lymphoma (DLBCL) is largely unknown. We retrospectively studied 19 men and 9 women based on the following criteria: (1) DLBCL with no evidence of concomitant or antecedent follicular lymphoma; (2) available flow cytometric immunophenotyping data, including CD10 status; (3) older than 15 years; (4) specific exclusion of high-grade, Burkitt-like lymphoma; and (5) exclusion of primary cutaneous DLBCL. When available, clinical data at diagnosis, including components of the international prognostic index, were reviewed. Eleven cases were CD10+, and 17 were CD10-. There was no significant difference between the CD10+ and CD10- groups in age, sex, stage, performance status, extranodal involvement, or serum lactate dehydrogenase levels at diagnosis. However, in the 26 cases for which follow-up data were available, the CD10+ group displayed a shorter overall survival than the CD10- group (8 vs 30 months). Although the clinical findings at diagnosis are similar in CD10+ and CD10- DLBCL, CD10 expression is associated with shortened overall survival. Therefore, our data suggest CD10 expression may have prognostic importance in adults with de novo DLBCL.     

Clinicopathologic analysis of CD10+ and CD10- diffuse large B-cell lymphoma. Identification of a high-risk subset with coexpression of CD10 and bcl-2

We analyzed 53 cases of diffuse large B-cell lymphoma (DLBCL) to determine whether expression of CD10 is a relevant biologic parameter. Tumor morphologic features were assessed semiquantitatively. Bcl-2 protein expression was studied by immunohistochemical analysis. The presence or absence of CD10 by flow cytometry was correlated with clinical and pathologic characteristics. CD10+ (23 cases) and CD10- (30 cases) DLBCLs were indistinguishable based on age, sex, extranodal presentation, B symptoms, clinical stage, morphologic features, or bcl-2 expression. However, cases with a CD10+ phenotype showed a significantly lower rate of complete remission. Cases expressing bcl-2 showed trends toward a lower rate of complete remission and poorer overall survival. Examination of CD10 and bcl-2 interaction revealed that the prognostic effects for both of these antigens were due to a subset of CD10+ bcl-2-positive cases. Compared with cases expressing one or neither of these markers, patients with dual-positive tumors had a poorer complete response rate to initial therapy and strikingly worse overall survival. While CD10+ and CD10- DLBCLs are similar with regard to a variety of clinical and pathologic features, CD10 and bcl-2 coexpressing tumors are an extremely high-risk subset based on response to therapy and overall survival.     

Clinical role of flow cytometry in redefining bone marrow involvement in diffuse large B-cell lymphoma (DLBCL) - a new perspective

Aims:  The clinical role of flow cytometry in staging bone marrow in diffuse large B-cell lymphoma (DLBCL), especially its impact on outcome, remains uncertain. The aim was to determine the contribution of flow cytometry to conventional staging, and to study the impact of this revised staging on survival.
Methods and results:  One hundred and thirteen cases of DLBCL diagnosed at The Canberra Hospital from 1996 to 2005 were identified. Blinded analysis of bone marrow (BM) morphology and flow cytometric data showed involvement on morphology (M) in 25 (22.1%) cases, on flow cytometry (F) in 21 (18.6%) cases and overall (M + F) in 32 cases (28.3%); discordance was noted in 16 cases (16.1%). Cases with and without marrow involvement on conventional staging alone (M) had no significant difference in survival ( P  = NS). However, when BM involvement was defined as positivity on morphology and/or flow cytometry (M + F), the median survival of patients with involvement was significantly worse than patients without involvement ( P  = 0.026).
Conclusions:  Flow cytometry-positive cases should be included with those positive on morphology in a summative model to define BM involvement in DLBCL, as it may have a potential impact on predicting outcome.     

CD56阳性弥漫性大B细胞淋巴瘤一例

患者男,35岁.2007年3月因颈部肿胀,CT提示胸腺占位考虑恶性淋巴瘤压迫上腔静脉在外院治疗.术前化疗2个周期后行胸腺部位肿瘤切除,术后病理诊断:纵隔肿瘤化疗后大片坏死,残留极少量变性肿瘤组织.手术后又进行瘤床放疗,治疗结束B超及CT检查均未见明显异常.同年9月患者出现腰背部疼痛,CT检查发现后腹膜多发淋巴结肿大,于2007年10月来本院治疗.根据病史考虑纵隔肿瘤术后、放化疗后,后腹膜淋巴结受累,行姑息性放化疗.4个疗程治疗结束后肿瘤明显缩小.2008年3月患者于后腹膜胰头上方出现结节灶(3.4 cm×3.0 cm×3.0 cm),经治疗后无明显改变;同期左下颈部发现直径3.0 cm大小肿块,至2008年9月左颈肿块达6 cm×5 cm×5 cm,行左颈部肿块切取活检.     

弥漫大B细胞淋巴瘤中CD27的表达及临床意义

目的探讨弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma, DLBCL)中CD27的表达及其临床意义。方法采用免疫组化EnVision法检测143例DLBCL组织中CD27蛋白的表达;应用FISH技术检测DLBCL组织中MYC、BCL-2、BCL-6基因重排情况。结果 143例DLBCL中,CD27蛋白阳性者46例,阳性率为32.2%。CD27阳性组中BCL-2重排阳性率(17.4%)明显高于CD27阴性组(4.1%),差异有统计学意义(P<0.01)。CD27阳性组病死率(30.4%)明显高于CD27阴性组(15.5%),差异有统计学意义(χ²=4.326,P=0.038)。CD27阳性者与阴性者的Kaplan-Meier生存曲线差异有显著性(χ²=4.485,P=0.034),阳性组生存期较短。结论 CD27高表达与DLBCL预后密切相关,可作为临床预后评价的指标之一。     

Sub-classification of diffuse large B-cell lymphoma by semi-quantification of the CD5 expression with flow cytometric analysis

CD5+ diffuse large B-cell lymphoma(CD5+DLBCL) is known to have different characteristics than CD5-DLBCL and mantle cell lymphoma(MCL). 9 patients with CD5+DLBCL were reviewed, and the results were compared with those of 8 CD5-DLBCL and 3 cyclin D1+MCL patients. CD5+DLBCL was more closely related to many aggressive clinical features or parameters than CD5-DLBCL: 67% of the patients were older than 60 years, 67% with performance status > or = 2, 89% with serum lactate dehydrogenase level higher than normal, 78% with stage III/IV disease at diagnosis, and 78% with more than one extranodal lesion. The overall International Prognostic Index score for the patients with CD5+DLBCL was thus significantly higher than that for those with CD5-DLBCL. Immunophenotypically, CD5+DLBCL was characterized by CD5+CD10-CD19+CD20+CD21-CD23-cyclin D1-phenotype and the predominant expression of surface IgM. Of particular interest is that the survival rate of CD5+DLBCL patients was significantly inferior to that of patients with CD5-DLBCL. To further characterize CD5+DLBCL, we semi-quantified the CD5 expression in DLBCL cells. Our findings suggest that CD5+DLBCL may constitute a unique subgroup of DLBCL and, moreover, CD5+DLBCL may consist of several subgroups.     

A spindle cell variant of diffuse large B-cell lymphoma possesses genotypic and phenotypic markers characteristic of a germinal center B-cell origin.

Lymphoma with prominent spindle cell features, the so-called spindle cell lymphoma, is an unusual morphological variant of diffuse large B-cell lymphoma. Five new cases of spindle cell lymphoma have been analyzed by a multiparameter approach in order to clarify its clinical and biological features. All patients presented advanced stage disease with extranodal involvement. Vagina was the most common extranodal site. All patients received chemotherapy and are alive in complete remission. Morphologically, all five cases exhibited proliferation of spindle cells with a vaguely storiform pattern highly suggestive of spindle cell neoplasms of nonlymphoid origin. In contrast, the results of immunohistochemical analysis indicated that all five cases were hematolymphoid neoplasms of the B-cell lineage. These lymphomas consisted of a B-cell clonal population which exhibited somatic immunoglobulin and BCL-6 mutations as well as BCL-6 protein expression. The neoplastic spindle cells therefore closely resemble B cells residing in the germinal center. The absence of MUM1 expression in neoplastic spindle cells suggested that neoplastic spindle cells may be related to the early phases of intragerminal center maturation of B cells. The germinal center phenotype, with restricted expression of BCL-6, was associated with the presence of a primary extranodal origin, normal lactate dehydrogenase levels, and good response to treatment.     

CD56 positive diffuse large B-cell lymphoma: a case report and literature review

CD56 positive B-cell lymphoma is very rare. We experienced a case of CD56 positive diffuse large B-cell lymphoma, occurred in a young child. A 5-year-old girl complained with snoring and open mouth breathing. No any abnormality in laboratory or physical examination was present, except enlarged both tonsils. Bilateral tonsillectomy was performed. Cut sections of right tonsil showed a 2 cm size, solid mass. On microscopically, large monomorphic lymphoid cells were diffusely proliferated and showed positivity for CD20 and CD56 and negative for Epstein-Barr virus (EBV) polymerase chain reaction (PCR). Monoclonality was observed on immunoglobulin heavy chain gene rearrangement. This is a unique case with incidentally found and occurred in a young child.     

Hsa-miR-150过表达诱导弥漫大B淋巴瘤细胞系OCI-Ly10再分化

 目的:探究hsa-miR-150过表达诱导弥漫大B淋巴瘤细胞系OCI-Ly10再分化的机制。方法:运用real-time PCR检测hsa-miR-150在永生化CD19+B细胞和OCI-Ly10细胞中的表达,利用Western blotting和免疫荧光细胞化学检测hsa-miR-150靶基因c-myb的表达;通过LipofectamineTM 2000脂质体法将含有重组慢病毒质粒的病毒上清转染OCI-Ly10细胞（Ly10-control组和Ly10-miR-150组）;对新构建的细胞亚系,通过MTT法检测细胞增殖能力,流式细胞术检测细胞周期及凋亡;运用real-time PCR、免疫荧光细胞化学和Western blotting检测Ly10-control和Ly10-miR-150的B细胞分化相关基因及c-Myb的表达;利用干扰片段干扰OCI-Ly10细胞c-myb表达后,运用real-time PCR和Western blotting检测干扰效率及干扰后转录调节因子BCL6和浆细胞分化开关蛋白PRDM1的表达。结果:（1）CD19+B淋巴细胞的 hsa-miR-150表达量明显高于OCI-Ly10细胞（P<0.05）;c-Myb在OCI-Ly10细胞中表达较强,而在CD19+B淋巴细胞表达较弱。（2）OCI-Ly10细胞经转染hsa-miR-150后,B细胞分化相关基因的表达都明显发生了变化,B细胞特异性激活蛋白（PAX5）和BCL6表达下调（P<0.05）;干扰素调节因子4（IRF4）、PRDM1和X盒结合蛋白1(XBP1)的表达上调（P<0.05）;和对照组相比,c-Myb在Ly10-miR-150细胞中表达明显下调（P<0.05）。（3）干扰OCI-Ly10细胞c-myb表达后,BCL6表达明显下调,而PRDM1表达明显上调。结论:（1）hsa-miR-150过表达对OCI-Ly10细胞抑制增殖和诱导凋亡作用非常明显。（2）过表达hsa-miR-150可诱导该瘤细胞向末端B细胞方向分化,作用机制可能与下调其靶基因c-myb的表达有关。     

The spectrum of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma: a description of 10 cases

B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, is a diagnostic provisional category in the World Health Organization (WHO) 2008 classification of lymphomas. This category was designed as a measure to accommodate borderline cases that cannot be reliably classified into a single distinct disease entity after all available morphological, immunophenotypical and molecular studies have been performed. Typically, these cases share features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, or include characteristics of both lymphomas. The rarity of such cases poses a tremendous challenge to both pathologists and oncologists because its differential diagnosis has direct implications for management strategies. In this study, we present 10 cases of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma and have organized the criteria described by the WHO into four patterns along with detailed clinical, morphological and immunophenotypic characterization and outcome data. Our findings show a male preponderance, median age of 37 years and a mediastinal presentation in 80% of cases. All cases expressed at least two markers associated with B-cell lineage and good response to combination chemotherapy currently employed for non-Hodgkin lymphomas.     

Follicular origin of a subset of CD5+ diffuse large B-cell lymphomas

Most follicular lymphomas (FLs) have a phenotype consistent with the origin from CD5-, CD10+, bcl-6+ follicular center cells and can progress to diffuse large B-cell lymphoma (DLBCL). CD5 is expressed in about 10% of DLBCLs, showing prognostic value, whereas expression is rare in FL. We present 6 cases with coexisting features of CD5+ FL and CD5+ DLBCL, supporting a follicular origin for some CD5+ DLBCLs. The follicular areas showed a meshwork of CD21+ follicular dendritic cells that were lacking in the DLBCL areas. All cases showed a clonal CD19+, CD20+, CD5+, and CD10+ population in both follicular and diffuse areas. Molecularly, 4 of 6 cases demonstrated immunoglobulin heavy chain rearrangements and 1 case, a bcl-2/immunoglobulin heavy chain gene rearrangement. Somatic hypermutations were high in all 4 cases, in keeping with their germinal center origin. Four of five patients died of disease within 42 months, consistent with the proposed prognostic value of CD5 expression in DLBCL. Our data describe an aggressive variant of CD5+ FL suggesting the follicular origin of some CD5+ DLBCLs.     

Assessment of CD10 in the diagnosis of small B-cell lymphomas: a multiparameter flow cytometric study

We evaluated the usefulness of multiparameter flow cytometry with cluster analysis in the diagnosis of a series of 100 well-characterized small B-cell lymphomas (SBCLs). The histologic diagnoses in the 100 cases were follicular lymphoma (FL) in 58, marginal zone lymphoma (MZL) in 17, small lymphocytic lymphoma in 15, and mantle cell lymphoma (MCL) in 10. Of the 58 FLs, 57 were CD10 positive (98% sensitivity). The 1 negative case was unusual in that it occurred in the small intestine. However; architectural, cytologic, and immunohistochemicalfeatures were diagnostic of FL. Of 42 other SBCLs, 2 were CD10+ (95% specificity); 1 was a CD5+/cyclin D1 + MCL, and the other was an extranodal MZL. We found that assessment of CD10 expression using multiparameter flow cytometry with cluster analysis is highly sensitive and specific for the diagnosis of FL, validating its usefulness in situations in which adequate tissue is not available for definitive histologic diagnosis.     

The usefulness of CD71 expression by flow cytometry for differentiating indolent from aggressive CD10+ B-cell lymphomas

We studied 34 low- and 30 high-grade CD10+ B-cell lymphomas. Forward light scatter (FSC) and CD71 fluorescence intensity (CD71i) of tumor cells were measured and normalized by corresponding values for resting T cells. Significant differences in CD71i values between low- and high-grade lymphomas were observed by the Mann-Whitney U test (P < .001) and receiver operating characteristic (ROC) curve analysis (P < .001). FSC was not significantly different between low- and high-grade lymphomas; the area under the ROC curve was less than that for CD71i. Neither FSC nor CD71i significantly differentiated follicular lymphoma (FL) grades. A comparison of all FLs (grades 1-3) and non-FL high-grade lymphomas (Burkitt lymphoma [BL] and large B-cell lymphoma [LBCL]) showed significant differences in CD71i (P < .001) and FSC (P = .021). Differences were significant in CD71i and FSC between FL and LBCL (P < .001) but not between FL and BL. CD71i is more potent than FSC for distinguishing CD10+ low- from high-grade lymphomas and FL from non-FL high-grade lymphomas. Sensitivity and specificity are limited owing to inability to identify FL3. In ROC analysis, a high value for CD71i can identify BL and LBCL with a high degree of certainty.