Definition, Diagnosis, and Management of Intravascular Large B-Cell Lymphoma: Proposals and Perspectives From an International Consensus Meeting
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Published:2007-07-20
Issue:21
Volume:25
Page:3168-3173
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ISSN:0732-183X
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Container-title:Journal of Clinical Oncology
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language:en
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Short-container-title:JCO
Author:
Ponzoni Maurilio1, Ferreri Andrés J.M.1, Campo Elías1, Facchetti Fabio1, Mazzucchelli Luca1, Yoshino Tadashi1, Murase Takuhei1, Pileri Stefano A.1, Doglioni Claudio1, Zucca Emanuele1, Cavalli Franco1, Nakamura Shigeo1
Affiliation:
1. From the Unit of Lymphoma Malignancies, Pathology and Oncology Units, Department of Oncology, San Raffaele Scientific Institute, Milan; Department of Pathology I, University of Brescia School of Medicine, Spedali Civili of Brescia, Brescia; Hematopathology, Bologna University School of Medicine, Bologna, Italy; Laboratory of Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain; Istituto di Patologia, Locarno; Istituto Oncologico della Svizzera Italiana, Ospedale S Giovanni, Bellinzona,...
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare form of diffuse LBCL characterized by preferential intravascular growth of malignant lymphocytes, aggressive behavior, and an often fatal course. IVLBCL usually affects elderly patients with poor performance status, elevated lactic dehydrogenase serum levels, anemia, and B symptoms. It displays some differences in clinical presentation among diverse geographical areas, mostly between patients diagnosed in Western countries and Japan. In addition, data from the literature suggest that pathologic diagnostic criteria as well as clinical features of this disease may be broader than described in current classification scheme(s). Under the sponsorship of the International Extranodal Lymphoma Study Group, clinicians and pathologists with interest in IVLBCL, coming from Western and Eastern countries, joined to reach a consensus on defining features as well as to focus on the most urgent unresolved issues in IVLBCL. To this end, a representative group of IVLBCL patients coming from both the aforementioned geographical areas were collectively analyzed. Additional features of IVLBCL were proposed both under clinical and pathologic stand points. At the meeting, it emerged that IVLBCL may have additional histopathologic/cytologic definition criteria with respect to those currently recommended, some clinical features are not randomly distributed worldwide, recent therapeutic approaches, such as anti-CD20–containing regimens, may improve outcome, and kidney, spleen, and liver involvement may show peculiar histopathologic features. Finally, a provisional practical diagnostic approach to hemophagocytosis-associated patients and a proposal for the most useful criteria in the settings of differential diagnosis are included.
Publisher
American Society of Clinical Oncology (ASCO)
Subject
Cancer Research,Oncology
Reference34 articles.
1. Intravascular lymphoma: clinical presentation, natural history, management and prognostic factors in a series of 38 cases, with special emphasis on the ‘cutaneous variant’1 2. Murase T, Nakamura S, Kawauchi K, et al: An Asian variant of intravascular large B-cell lymphoma: Clinical, pathological and cytogenetic approaches to diffuse large B-cell lymphoma associated with haemophagocytic syndrome. Br J Haematol 111:826,2000-834, 3. Intravascular lymphomatosis: a clinicopathologic study of 10 cases and assessment of response to chemotherapy. 4. Intravascular Lymphomatosis: A Study of 20 Cases in Thailand and a Review of the Literature 5. Gatter KC, Warnke RA: Intravascular large B-cell lymphoma, in Jaffe ES, Harris NL, Stein H, Vardiman JW (eds): Tumours of Haematopoietic and Lymphoid Tissues . Lyon, France, IARC Press, pp 177,2001-178
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