A clinical pathological analysis for diffuse large B-cell lymphoma

Objectives To observe the morphological,immunohistochemical and genetic features of Diffuse Large B-cell Lymphoma(DLBCL) in Guizhou,according to the criterion of new WHO classification,so as to evaluate the significances of synthetic scheme for the diagnosis and differential diagnosis of DLBCL.Materials and Methods Morphologic observation and immunohistochemical were performed in twenty-eight cases of DLBCL,which were diagnosed by the criterion of new WHO classification.Furthermore,Molecular biological study for IgH and TCR-β gene rearrangements were carried out in all cases.Results A total of 22 cases of DLBCL have been classified as following four variants:17 cases of centroblastic variant(CB),5 cases of immunoblastic variant(IB),2 cases of T-cell/histiocyte-rich variant and 4 cases of anaplastic variant(ALCL).Immunostaning showed that the tumor cells in all cases of DLBCL were positive for CD20(100%),in which,4 cases of ALCL expressed CD30(14.3%),1 cases of CB showed CD5(3.5%),and 1 case of TRBL displayed lysozyme(3.5%).The detection of clonal gene rearrangement in these cases revealed a total positive rate of 75.0%(21/28).Of the positive cases,there were 9 cases positive for IgH,10 cases positive for TCR-β,and 2 cases were of double clone character.Conclusions The diagnosis and differential diagnosis for Diffuse Large B-Cell lymphoma(DLBCL) have been a difficult problem for pathologist in a long time.According to the criterion of new WHO classification,the synthetic diagnostic scheme,which comprises standard morphologic observation,systematic IHC analyses,and the detection of clonal gene rearrangement,can improve the confirmed diagnosis rate of DLBCL dramatically.