High-grade B cell lymphoma, unclassifiable, with blastoid features: an unusual morphological subgroup associated frequently with BCL2 and/or MYC gene rearrangements and a poor prognosis.

Journal Article (Journal Article)

AIMS: A subset of B cell lymphomas with blastoid features do not fit either as B lymphoblastic lymphoma/leukaemia or blastoid mantle cell lymphoma. Their classification is challenging, even with complete clinicopathological and genetic information. At a haematopathology workshop, experts had suggested the term 'high-grade B cell lymphoma, unclassifiable, with blastoid features', and recommended further studies. METHODS AND RESULTS: We describe the clinicopathological, immunophenotypic and cytogenetic findings of 24 high-grade B cell lymphomas, unclassifiable, with blastoid features. Fifteen patients presented de novo and seven patients had a history of lymphoma. Twenty patients (83%) presented with nodal disease. All tumours expressed pan-B cell antigens and 17 (89%) of 19 tumours assessed had a germinal centre B cell immunophenotype. Ten (63%) of 16 tumours assessed by fluorescence in-situ hybridization (FISH) had MYC rearrangement, 13 of 18 (72%) carried IGH-BCL2 and nine of 15 (60%) had both (double-hit lymphoma). The median overall survival was 1.1 years. Using 2008 World Health Organization criteria, 15 cases were classified as B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma (DLBCL) and Burkitt lymphoma, and nine as DLBCL, small centroblastic variant. CONCLUSION: High-grade B cell lymphomas, unclassifiable, with blastoid features are clinically aggressive with poor survival. Most neoplasms have a germinal centre B cell phenotype. MYC rearrangements and IGH-BCL2 are common, and ~60% are double-hit lymphomas.

Full Text

Duke Authors

Cited Authors

  • Kanagal-Shamanna, R; Medeiros, LJ; Lu, G; Wang, SA; Manning, JT; Lin, P; Penn, GM; Young, KH; You, MJ; Vega, F; Bassett, R; Miranda, RN

Published Date

  • November 2012

Published In

Volume / Issue

  • 61 / 5

Start / End Page

  • 945 - 954

PubMed ID

  • 22804688

Electronic International Standard Serial Number (EISSN)

  • 1365-2559

Digital Object Identifier (DOI)

  • 10.1111/j.1365-2559.2012.04301.x


  • eng

Conference Location

  • England