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Primary central nervous system lymphomas associated with chronic inflammation: diagnostic pitfalls of central nervous system lymphomas

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Abstract

In recent years, the features of lymphomas associated with chronic inflammation, referred to as diffuse large B-cell lymphoma (DLBCL) associated with chronic inflammation (DLBCL-CI), have been elucidated. DLBCL-CI is an aggressive lymphoma occurring in the context of long-standing chronic inflammation and showing an association with Epstein–Barr virus. Fibrin-associated diffuse large B-cell lymphoma (F-DLBCL) was suggested as a new and unusual form of DLBCL-CI in the most recent version of the World Health Organization classification. From the perspective of genetics, DLBCL-CI was associated with frequent TP53 mutation, MYC amplification and complex karyotypes, but cases of F-DLBCL behaved indolently and showed a relatively lower genetic complexity. In the central nervous system (CNS), several examples of DLBCL-CI and F-DLBCL have been reported. As with DLBCL-CI outside the CNS, DLBCL-CI in the CNS is an aggressive lymphoma. However, the clinical outcome of F-DLBCL in the CNS is good. Immunohistochemistry for p53 and c-Myc in DLBCL-CI and F-DLBCL in the CNS showed similar findings of those outside the CNS. However, one aggressive case showed transitional genetics and morphology between F-DLBCL and DLBCL-CI. These findings suggest that some cases of F-DLBCL in the CNS might have the potential to progress to DLBCL-CI.

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Acknowledgements

The authors wish to thank Drs. Shinji Kohno (Harasanshin Hospital) and Daisuke Mori (Saga Prefectural Hospital Koseikan) who gave us valuable materials. The authors also wish to thank Ms. Fumiko Arakawa (Kurume University School of Medicine) for her valuable technical assistance.

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Authors and Affiliations

  1. Department of Neuropathology, Neurology Center, St. Mary’s Hospital, 422 Tsubukuhonmachi, Kurume, Fukuoka, 830-8543, Japan

    Yasuo Sugita

  2. Department of Neurosurgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 840-8502, Japan

    Jun Masuoka

  3. Department of Neurosurgery, Shin-Koga Hospital, 120 Tenjincho, Kurume, Fukuoka, 830-8577, Japan

    Katsuharu Kameda

  4. Department of Neurosurgery, Neurology Center, St. Mary’s Hospital, 422 Tsubukuhonmachi, Kurume, Fukuoka, 830-8543, Japan

    Kenji Takahashi

  5. Department of Pathology, St. Mary’s Hospital, 422 Tsubukuhonmachi, Kurume, Fukuoka, 830-8543, Japan

    Yoshizo Kimura & Koichi Higaki

  6. Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan

    Takuya Furuta & Koichi Ohshima

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  1. Yasuo Sugita
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  2. Jun Masuoka
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  3. Katsuharu Kameda
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  4. Kenji Takahashi
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  6. Koichi Higaki
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  7. Takuya Furuta
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  8. Koichi Ohshima
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Correspondence to Yasuo Sugita.

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Sugita, Y., Masuoka, J., Kameda, K. et al. Primary central nervous system lymphomas associated with chronic inflammation: diagnostic pitfalls of central nervous system lymphomas. Brain Tumor Pathol 37, 127–135 (2020). https://doi.org/10.1007/s10014-020-00373-z

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  • DOI: https://doi.org/10.1007/s10014-020-00373-z

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