PMID- 21560252
OWN - NLM
STAT- MEDLINE
DCOM- 20111013
LR  - 20110815
IS  - 1934-6638 (Electronic)
IS  - 1934-662X (Linking)
VI  - 119
IP  - 4
DP  - 2011 Aug 25
TI  - Cytopathology of "double-hit" non-Hodgkin lymphoma.
PG  - 263-71
LID - 10.1002/cncy.20160 [doi]
AB  - BACKGROUND: B-cell lymphomas with concurrent IGH-BCL2 and c-MYC rearrangements 
      (so-called "double-hit lymphomas" [DHL]) are a relatively rare, recently 
      described category in the 2008 World Health Organization classification of 
      hematopoietic neoplasms. Response to chemotherapy and survival are poor. METHODS: 
      The authors reviewed files of cytogenetically documented DHL to identify 
      cytologic features that would allow its possible recognition. RESULTS: Twelve 
      fine-needle aspirates (FNAs), 2 pleural fluids, and 1 touch imprint of 
      cytogenetically proven DHL were uncovered. Primary DHL was correctly recognized 
      in 3 of 12 FNA cases using Ki-67 staining coupled with a positive bcl-2 result as 
      the basis for performing fluorescence in situ hybridization (FISH) analysis of 
      c-MYC and IGH-BCL2 rearrangements. Remaining FNAs and non-FNA cases were 
      diagnosed as non-Hodgkin lymphoma, B-cell lymphoma, or atypical lymphocytosis. 
      Ten cases had cell block material available. All cases had high cellularity with 
      a dissociated smear pattern and background lymphoglandular bodies. Cell size 
      ranged from intermediate to large. Nuclei were predominantly rounded or slightly 
      irregular in contour; 4 FNAs had markedly cleaved nuclei. Some nuclei harbored 
      discrete but small nucleoli, whereas in others coarse chromatin and indistinct or 
      multiple small nucleoli existed. A variable number of mitotic figures, tingible 
      body macrophages, and background apoptotic cells were also present. CONCLUSIONS: 
      No specific cytomorphologic feature(s) were found to reliably identify DHL using 
      FNA or exfoliative cytology. A high Ki-67 proliferation index and positive bcl-2 
      staining (on cytospin slides or cell block material) of cases not conforming to 
      typical Burkitt lymphoma morphology should prompt FISH analysis for c-MYC and/or 
      IGH-BCL2 rearrangements to identify DHL, particularly if tissue biopsy is not 
      expected.
CI  - Copyright (c) 2011 American Cancer Society.
FAU - Elkins, Camille T
AU  - Elkins CT
AD  - Department of Pathology, The Ohio State University College of Medicine, Columbus, 
      USA.
FAU - Wakely, Paul E Jr
AU  - Wakely PE Jr
LA  - eng
PT  - Journal Article
DEP - 20110510
PL  - United States
TA  - Cancer Cytopathol
JT  - Cancer cytopathology
JID - 101499453
RN  - 0 (Immunoglobulin Heavy Chains)
RN  - 0 (Ki-67 Antigen)
RN  - 0 (MYC protein, human)
RN  - 0 (Oncogene Proteins, Fusion)
RN  - 0 (Proto-Oncogene Proteins c-bcl-2)
RN  - 0 (Proto-Oncogene Proteins c-myc)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biopsy, Fine-Needle
MH  - Female
MH  - Follow-Up Studies
MH  - *Gene Rearrangement
MH  - Humans
MH  - Immunoglobulin Heavy Chains/genetics
MH  - In Situ Hybridization, Fluorescence
MH  - Karyotyping
MH  - Ki-67 Antigen
MH  - Lymphoma, Non-Hodgkin/*genetics/*pathology
MH  - Male
MH  - Middle Aged
MH  - Oncogene Proteins, Fusion/*genetics
MH  - Prognosis
MH  - Proto-Oncogene Proteins c-bcl-2/genetics
MH  - Proto-Oncogene Proteins c-myc/genetics
MH  - *Translocation, Genetic
EDAT- 2011/05/12 06:00
MHDA- 2011/10/14 06:00
CRDT- 2011/05/12 06:00
PHST- 2011/02/23 00:00 [received]
PHST- 2011/03/26 00:00 [revised]
PHST- 2011/03/28 00:00 [accepted]
PHST- 2011/05/12 06:00 [entrez]
PHST- 2011/05/12 06:00 [pubmed]
PHST- 2011/10/14 06:00 [medline]
AID - 10.1002/cncy.20160 [doi]
PST - ppublish
SO  - Cancer Cytopathol. 2011 Aug 25;119(4):263-71. doi: 10.1002/cncy.20160. Epub 2011 
      May 10.