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[Grey zone lymphoma with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma: clinicopathologic characterization of 16 cases showing different patterns].
[hodgkin lymphoma, classical]
To
profile
the
clinicopathologic
features
of
a
series
of
grey
zone
lymphoma
(
GZL
)
cases
with
hybrid
features
of
diffuse
large
B-
cell
lymphoma
(
DLBCL
)
and
classical
Hodgkin
lymphoma
(
CHL
)
,
with
a
purpose
to
gain
an
in
-depth
understanding
of
the
borderline
B-
cell
neoplasm
.
The
clinical
,
morphologic
and
immunophenotyical
characteristics
of
16
cases
were
retrospectively
analyzed
.
The
patients
were
mostly
male
adults
,
with
a
male
to
female
ratio
of
1
.
7
:
1
.
0
and
a
mean
age
of
40
.
2
years
.
Eight
patients
presented
with
peripheral
nodal
lesions
and
five
cases
with
mediastinal
involvement
.
Histologically
and
immunophenotypically
,
the
16
cases
were
classified
into
three
sub-categories
.
In
4
cases
,
the
morphologic
features
resembled
CHL
more
closely
,
but
the
neoplastic
cells
showed
uniform
and
intense
positive
staining
of
CD
2
0
(
pattern
1
)
.
Although
the
initial
impression
of
the
other
8
cases
was
that
of
DLBCL
,
the
expression
levels
of
CD
2
0
and
PAX
5
were
variable
,
and
CD
30
or
CD
15
was
positive
(
pattern
2
)
.
A
characteristic
feature
of
pattern
3
,
observed
in
the
remaining
4
cases
,
demonstrated
a
broad
spectrum
of
morphology
with
hybrid
features
of
both
CHL
and
DLBCL
.
The
neoplastic
cells
in
pattern
3
were
positive
for
CD
2
0
,
CD
30
and
CD
15
.
EBV-LMP
1
was
detected
in
6
of
the
11
tested
cases
.
Clinically
,
most
patients
with
GZL
seemed
insensitive
to
immuno-chemotherapy
of
the
R-CHOP
regimen
.
T
he
diagnostic
criteria
for
GZL
with
features
intermediate
between
DLBCL
and
CHL
is
proposed
by
the
three
histologic
patterns
commonly
seen
in
these
lesions
.
Cases
presented
with
peripheral
lesions
might
differ
from
those
with
mediastinal
presentation
pathologically
.
At
current
time
,
there
is
no
effective
treatment
for
these
borderline
B-
cell
lymphomas
and
the
prognosis
is
poor
.
Diseases
Validation
Diseases presenting
"neoplasm"
symptom
adrenal incidentaloma
alexander disease
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentin dysplasia
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial hypocalciuric hypercalcemia
focal myositis
hodgkin lymphoma, classical
hydrocephalus with stenosis of the aqueduct of sylvius
junctional epidermolysis bullosa
kabuki syndrome
liposarcoma
lymphangioleiomyomatosis
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wolf-hirschhorn syndrome
This symptom has already been validated