NON‐MEDIASTINAL CASES OF GREY ZONE LYMPHOMA: A PATHOLOGICAL AND CLINICAL SERIES OF 17 CASES FROM THE LYSA
Notice bibliographique
Résumé
Introduction: Mediastinal grey zone lymphomas (MGZL) present an intermediate morphology between classical Hodgkin lymphoma (CHL) and primary mediastinal large B cell lymphoma (PMBCL). Cases without mediastinal involvement or non-MGZL (NMGZL) have been described, but their classification remains controversial. The aim of this study was to describe their clinico-pathological characteristics. Methods: Within the LYSA-P and LYMPHOPATH network, we collected a series of GZL centrally reviewed by expert hematopathologists. A total of 135 cases classified as CHL-like (N = 90, morphology closer to CHL and an immunophenotype (IP) to PMBCL), PMBCL-like (N = 45, morphology closer to PMBCL and an IP to CHL) were collected. Clinical and follow-up data were available for 108 patients (pts): 17 NMGZL (16%) and 91 MGZL. Additional immunohistochemistry, for MAL protein and B cell markers, and fluorescence in situ hybridization using break-apart probes to assess structural alterations of the CIITA and PDL1-2 (Programmed death-ligand) gene loci were performed. Results: Among the 17 NMGZL, 12 had a CHL-like morphology with various inflammatory backgrounds and a variable degree of fibrosis. EBV positivity of the malignant cells was found in 3/11 cases (EBER) and 4/9 expressed MAL. The remaining 5 cases presented with a PMBCL-like-morphology with scant fibrosis and an inflammatory background. EBV was found in 1/5 cases, 1/3 expressed MAL, 2/5 did not expressed CD20. Compared to MGZL, there were no significant differences in subtype distribution (CHL/PMBCL-like) or with regards to EBV positivity (p = 0.48 and 0.78 chi2 test, respectively). CIITA break could be observed in 4/10 cases (2/2 PMBCL-like and 2/8 CHL-like). PDL1/2 abnormalities could be observed in 8/12 NMGZL cases (6/9 CHL-like and 2/3 PMBCL-like, figure 1): 3/12 with a break and 7/12 with a CNV (gain in 3 cases and amplification in 4). PDL1 expression was observed in 6 cases (1/3 PMBCL-like and 5/7 CHL-like). None of the cases expressed PDL2. Regarding the clinical data, the median age was 55 y, significantly older than MGZL cases (34 y, p = .01). All the 17 pts with NMGZL had nodal involvement, 9 (53%) a stage III/IV, 7 presented an extra-nodal site (3 with more than extra-nodal 1 site involved): spleen (n = 5), bone marrow (n = 3), bone (n = 2), liver (n = 3), lung (n = 3). A bulky disease (> 10 cm) was present in 5 pts (31%). The age adjusted IPI score was >1 in 7 pts (41%). Age was the only parameters that significantly differed between NMGZL and MGZL pts. Among the 17 pts, 8 received R-CHOP, 5 an intensified R-CHOP (R-ACVBP), 4 ABVD. CR was reached in 14 pts, 1 of them relapsed at 167 m with a MGZL. Three pts (18%) were primary refractory (progression <1y). The median EFS was 72 m. Although a trend towards a better outcome could be observed, there were no significant differences in EFS or OS between MGZL and NMGZL (p = 0.3 and 0.1, respectively). Keywords: Hodgkin lymphoma (HL); primary mediastinal large B-cell lymphoma (PMLBCL).
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,002 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».