Linfomas difusos de grandes células B: estudo histopatológico e imuno-histoquímico
Autor(a) principal: | |
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Data de Publicação: | 2006 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da Universidade Federal Fluminense (RIUFF) |
Texto Completo: | https://app.uff.br/riuff/handle/1/17061 |
Resumo: | Diffuse large B cell lymphomas are the most common subtype of non-Hodgkin s lymphomas, whose clinical, morphological and biological diversity has been recently well characterized. These lesions harbor cromossomial and molecular characteristics that lead to different profiles of genic expression. It indicates that the group represents more than one clinical and pathological entity, with distinct prognosis. Besides the International Prognostic Index, different approaches to assess some possible prognostic differentiation in these patients has been used. The study s aim was to evaluate whether or not immunoblastic morphology and the B-cell differentiaton immunophenotypic profile related to germinal center are anyway conected. The immunophenotypic profile is said to identify prognostically distinct groups as described in studies on cDNA microarray, and its identification is easily performed in routine diagnostic laboratories. The present study included 117 patients who presented with a de novo diffuse large B-cell lymphoma between 2002 and 2004, selected on a basis of availability of histological material. Lymphomas related to HIV infection, or originated from the gastrointestinal tract or from the central nervous system as well as those corresponding to specific subtypes (primary mediastinal lymphoma, intravascular lymphoma and primary effusion lymphoma) were not included in this study. The diagnosis of DLBCL was based on WHO classification s criteria. Patients have been also classified according to the tumor s immunoblastic content. Cases of IBL and cases of the centroblastic polymorphic subtype with immunoblasts amounting to more than 50% were defined as having immunoblastic morphology. Immunohistochemistry was performed on tissue microarray slides to establish the immunophenotypic profile. Immunohistochemical panel included antibodies to B-cell differentiation into germinal center type (CG) and non-germinal center type (pCG), CD10, Bcl-6 and MUM1, besides antibodies to CD20, CD3, CD5, CD30 and cyclin D1. Immunophenotypic profile was discriminated into CG and pCG, based on published criteria. Patients with immunoblastic morphology more frequently than not had a non-GCB phenotype (94% versus 6%). On the other hand, tumors with an immunoblastic morphology were less often bcl-6 positive than any other studied lymphomas (5,9% versus 40%, p=0.005). These findings show that the DLBCL s morphological sub-classification does have a biological meaning, and should not be overlooked in lymphoma classifications. These findings agree with recent evidence indicating different ontogeny for such lymphomas |
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Linfomas difusos de grandes células B: estudo histopatológico e imuno-histoquímicoLinfoma não-HodgkinLinfoma difuso de grandes célulasLinfoma imunoblásticoImunofenótipoLinfomaImunofenotipagemNon-Hodgkin s lymphomaDiffuse large cell LymhomaImmunoblastic lymphomaImmunophenotypeCNPQ::CIENCIAS DA SAUDE::MEDICINA::ANATOMIA PATOLOGICA E PATOLOGIA CLINICADiffuse large B cell lymphomas are the most common subtype of non-Hodgkin s lymphomas, whose clinical, morphological and biological diversity has been recently well characterized. These lesions harbor cromossomial and molecular characteristics that lead to different profiles of genic expression. It indicates that the group represents more than one clinical and pathological entity, with distinct prognosis. Besides the International Prognostic Index, different approaches to assess some possible prognostic differentiation in these patients has been used. The study s aim was to evaluate whether or not immunoblastic morphology and the B-cell differentiaton immunophenotypic profile related to germinal center are anyway conected. The immunophenotypic profile is said to identify prognostically distinct groups as described in studies on cDNA microarray, and its identification is easily performed in routine diagnostic laboratories. The present study included 117 patients who presented with a de novo diffuse large B-cell lymphoma between 2002 and 2004, selected on a basis of availability of histological material. Lymphomas related to HIV infection, or originated from the gastrointestinal tract or from the central nervous system as well as those corresponding to specific subtypes (primary mediastinal lymphoma, intravascular lymphoma and primary effusion lymphoma) were not included in this study. The diagnosis of DLBCL was based on WHO classification s criteria. Patients have been also classified according to the tumor s immunoblastic content. Cases of IBL and cases of the centroblastic polymorphic subtype with immunoblasts amounting to more than 50% were defined as having immunoblastic morphology. Immunohistochemistry was performed on tissue microarray slides to establish the immunophenotypic profile. Immunohistochemical panel included antibodies to B-cell differentiation into germinal center type (CG) and non-germinal center type (pCG), CD10, Bcl-6 and MUM1, besides antibodies to CD20, CD3, CD5, CD30 and cyclin D1. Immunophenotypic profile was discriminated into CG and pCG, based on published criteria. Patients with immunoblastic morphology more frequently than not had a non-GCB phenotype (94% versus 6%). On the other hand, tumors with an immunoblastic morphology were less often bcl-6 positive than any other studied lymphomas (5,9% versus 40%, p=0.005). These findings show that the DLBCL s morphological sub-classification does have a biological meaning, and should not be overlooked in lymphoma classifications. These findings agree with recent evidence indicating different ontogeny for such lymphomasO linfoma difuso de grandes células B (LDGCB) representa o subtipo mais comum dos linfomas não Hodgkin. Embora considerado como uma categoria específica, a diversidade na apresentação clínica e morfológica, associada a presença de alterações cromossômicas e moleculares caracterizando diferentes padrões de expressão gênica, sugere que representem um grupo heterogêneo de neoplasias, mais que uma entidade clinicopatológica única. Para a distinção desses grupos de prognóstico distinto, diversos parâmetros tem sido utilizados além dos relacionados ao Índice Prognóstico Internacional. Este estudo tem o objetivo de avaliar uma possível associação entre o aspecto morfológico e o perfil imuno-histoquímico de diferenciação linfóide B relacionada ao centro germinativo. Esse perfil permite reproduzir os dois grupos prognósticos distintos de linfoma difuso de grandes células B identificados por cDNA microarray, e é prontamente aplicável na rotina diagnóstica. Foi realizada revisão morfológica de 117 casos de linfoma difuso de grandes células B de novo com material adequado para revisão histológica e para realização da técnica de imuno-histoquímica. Foram excluídos casos de linfomas mediastinais primários, granulomatose de Liebow e linfoma primário de efusão, considerados como entidades anatomo-clínicas individuais, além de linfomas associados ao HIV e de linfomas de localização no trato gastro intestinal. Foi utilizada a classificação da Organização Mundial de Saúde, além da categorização dos pacientes de acordo com o número de imunoblastos presentes na lesão para análise comparativa com o estudo imuno-histoquímico. Nesta categorização, considera-se linfoma com morfologia imunoblástica os representados por linfoma imunoblástico, por linfoma anaplásico e por linfoma centroblástico polimórfico com mais de 50% de imunoblastos. Os cortes histológicos para imuno-histoquímica foram obtidos com a técnica de tissue microarray (TMA) e o painel de marcadores utilizado incluiu os anticorpos anti-CD10, anti-Bcl-6 e anti MUM1/IRF4, descritos na literatura para distinção dos padrões de diferenciação, além de anticorpos para CD20, CD3, CD30, Bcl-2, CD5 e ciclinaD1. Pacientes com linfomas de morfologia imunoblástica evidenciaram mais freqüentemente fenótipo tipo pós centro germinativo (94% versus 6%, p=0,003), inversamente proporcional à expressão de Bcl-6 (5.9% versus 40%, p=0.005). Esses achados indicam que a subclassificação morfológica dos linfomas difusos de grandes células B tem significado biológico, coerente com os estudos mais recentes relacionados à ontogenia dessas lesõesPrograma de Pós-graduação em PatologiaPatologiaMorais, José CarlosCPF:89995411322http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4781880E8Lopes, Vânia SilamiCPF:99985743122http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4793225Y6Paiva, Daurita Darci deCPF:98765382722http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4790581E6Lusis, Mônica Kopschitz PraxedesCPF:01165454522Milito, Cristiane BedranCPF:97752384322http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4751334T1Camara, Denize D azambuja Ramos Raposo da2021-03-10T19:09:20Z2008-01-172021-03-10T19:09:20Z2006-12-18info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfapplication/pdfhttps://app.uff.br/riuff/handle/1/17061porCC-BY-SAinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da Universidade Federal Fluminense (RIUFF)instname:Universidade Federal Fluminense (UFF)instacron:UFF2021-03-10T19:09:20Zoai:app.uff.br:1/17061Repositório InstitucionalPUBhttps://app.uff.br/oai/requestriuff@id.uff.bropendoar:21202024-08-19T11:00:54.191559Repositório Institucional da Universidade Federal Fluminense (RIUFF) - Universidade Federal Fluminense (UFF)false |
dc.title.none.fl_str_mv |
Linfomas difusos de grandes células B: estudo histopatológico e imuno-histoquímico |
title |
Linfomas difusos de grandes células B: estudo histopatológico e imuno-histoquímico |
spellingShingle |
Linfomas difusos de grandes células B: estudo histopatológico e imuno-histoquímico Camara, Denize D azambuja Ramos Raposo da Linfoma não-Hodgkin Linfoma difuso de grandes células Linfoma imunoblástico Imunofenótipo Linfoma Imunofenotipagem Non-Hodgkin s lymphoma Diffuse large cell Lymhoma Immunoblastic lymphoma Immunophenotype CNPQ::CIENCIAS DA SAUDE::MEDICINA::ANATOMIA PATOLOGICA E PATOLOGIA CLINICA |
title_short |
Linfomas difusos de grandes células B: estudo histopatológico e imuno-histoquímico |
title_full |
Linfomas difusos de grandes células B: estudo histopatológico e imuno-histoquímico |
title_fullStr |
Linfomas difusos de grandes células B: estudo histopatológico e imuno-histoquímico |
title_full_unstemmed |
Linfomas difusos de grandes células B: estudo histopatológico e imuno-histoquímico |
title_sort |
Linfomas difusos de grandes células B: estudo histopatológico e imuno-histoquímico |
author |
Camara, Denize D azambuja Ramos Raposo da |
author_facet |
Camara, Denize D azambuja Ramos Raposo da |
author_role |
author |
dc.contributor.none.fl_str_mv |
Morais, José Carlos CPF:89995411322 http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4781880E8 Lopes, Vânia Silami CPF:99985743122 http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4793225Y6 Paiva, Daurita Darci de CPF:98765382722 http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4790581E6 Lusis, Mônica Kopschitz Praxedes CPF:01165454522 Milito, Cristiane Bedran CPF:97752384322 http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4751334T1 |
dc.contributor.author.fl_str_mv |
Camara, Denize D azambuja Ramos Raposo da |
dc.subject.por.fl_str_mv |
Linfoma não-Hodgkin Linfoma difuso de grandes células Linfoma imunoblástico Imunofenótipo Linfoma Imunofenotipagem Non-Hodgkin s lymphoma Diffuse large cell Lymhoma Immunoblastic lymphoma Immunophenotype CNPQ::CIENCIAS DA SAUDE::MEDICINA::ANATOMIA PATOLOGICA E PATOLOGIA CLINICA |
topic |
Linfoma não-Hodgkin Linfoma difuso de grandes células Linfoma imunoblástico Imunofenótipo Linfoma Imunofenotipagem Non-Hodgkin s lymphoma Diffuse large cell Lymhoma Immunoblastic lymphoma Immunophenotype CNPQ::CIENCIAS DA SAUDE::MEDICINA::ANATOMIA PATOLOGICA E PATOLOGIA CLINICA |
description |
Diffuse large B cell lymphomas are the most common subtype of non-Hodgkin s lymphomas, whose clinical, morphological and biological diversity has been recently well characterized. These lesions harbor cromossomial and molecular characteristics that lead to different profiles of genic expression. It indicates that the group represents more than one clinical and pathological entity, with distinct prognosis. Besides the International Prognostic Index, different approaches to assess some possible prognostic differentiation in these patients has been used. The study s aim was to evaluate whether or not immunoblastic morphology and the B-cell differentiaton immunophenotypic profile related to germinal center are anyway conected. The immunophenotypic profile is said to identify prognostically distinct groups as described in studies on cDNA microarray, and its identification is easily performed in routine diagnostic laboratories. The present study included 117 patients who presented with a de novo diffuse large B-cell lymphoma between 2002 and 2004, selected on a basis of availability of histological material. Lymphomas related to HIV infection, or originated from the gastrointestinal tract or from the central nervous system as well as those corresponding to specific subtypes (primary mediastinal lymphoma, intravascular lymphoma and primary effusion lymphoma) were not included in this study. The diagnosis of DLBCL was based on WHO classification s criteria. Patients have been also classified according to the tumor s immunoblastic content. Cases of IBL and cases of the centroblastic polymorphic subtype with immunoblasts amounting to more than 50% were defined as having immunoblastic morphology. Immunohistochemistry was performed on tissue microarray slides to establish the immunophenotypic profile. Immunohistochemical panel included antibodies to B-cell differentiation into germinal center type (CG) and non-germinal center type (pCG), CD10, Bcl-6 and MUM1, besides antibodies to CD20, CD3, CD5, CD30 and cyclin D1. Immunophenotypic profile was discriminated into CG and pCG, based on published criteria. Patients with immunoblastic morphology more frequently than not had a non-GCB phenotype (94% versus 6%). On the other hand, tumors with an immunoblastic morphology were less often bcl-6 positive than any other studied lymphomas (5,9% versus 40%, p=0.005). These findings show that the DLBCL s morphological sub-classification does have a biological meaning, and should not be overlooked in lymphoma classifications. These findings agree with recent evidence indicating different ontogeny for such lymphomas |
publishDate |
2006 |
dc.date.none.fl_str_mv |
2006-12-18 2008-01-17 2021-03-10T19:09:20Z 2021-03-10T19:09:20Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://app.uff.br/riuff/handle/1/17061 |
url |
https://app.uff.br/riuff/handle/1/17061 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
CC-BY-SA info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
CC-BY-SA |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Programa de Pós-graduação em Patologia Patologia |
publisher.none.fl_str_mv |
Programa de Pós-graduação em Patologia Patologia |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da Universidade Federal Fluminense (RIUFF) instname:Universidade Federal Fluminense (UFF) instacron:UFF |
instname_str |
Universidade Federal Fluminense (UFF) |
instacron_str |
UFF |
institution |
UFF |
reponame_str |
Repositório Institucional da Universidade Federal Fluminense (RIUFF) |
collection |
Repositório Institucional da Universidade Federal Fluminense (RIUFF) |
repository.name.fl_str_mv |
Repositório Institucional da Universidade Federal Fluminense (RIUFF) - Universidade Federal Fluminense (UFF) |
repository.mail.fl_str_mv |
riuff@id.uff.br |
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1811823635618332672 |