ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2022
Blastoid high-grade B-cell lymphoma initially presenting in bone marrow: a diagnostic challenge.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- A Diagnostic Approach in Large B-Cell Lymphomas According to the Fifth World Health Organization and International Consensus Classifications and a Practical Algorithm in Routine Practice.International journal of molecular sciences · 2024Guideline
- Triple-hit TdT-positive high-grade B-cell lymphoma mimicking B-lymphoblastic lymphoma and exhibiting immunophenotypic change at relapse.Journal of clinical and experimental hematopathology : JCEH · 2025Article
- Mutation profiling in differential diagnosis between TdT-positive high-grade/large B-cell lymphoma and B-lymphoblastic leukaemia/lymphoma.The Journal of pathology · 2025Article
- CD5-positive B-cell acute lymphoblastic leukemia/lymphoma with MEF2D::BCL9 mimicking aggressive mature B-cell lymphoma: a case report of a newly described entity and potential diagnostic pitfall.Journal of hematopathology · 2025Article
- Case Report: Immunophenotypically diverse immature patterns, including variable TdT expression, in aggressive B-cell lymphomas and leukemia withFrontiers in oncology · 2025Article
- Advances in biology, diagnosis and treatment of DLBCL.Annals of hematology · 2024Review
- Comparison of the World Health Organisation and International Consensus Classification of haematolymphoid tumours.Journal of the colleges of medicine of South Africa · 2024Review
- Progression of follicular lymphoma and related entities: Report from the 2021 SH/EAHP Workshop.American journal of clinical pathology · 2023Article
- Review
- Unique pathologic features and gene expression signatures distinguish blastoid high-grade B-cell lymphoma from B-acute lymphoblastic leukemia/lymphoma.Haematologica · 2023Article
- Article
- Article
- TdT Positive Lymphoma with MYC, BCL2 and BCL6 Rearrangements: A Review of Diagnosis and Treatment.Mediterranean journal of hematology and infectious diseases · 2022Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The 2016 WHO classification introduced the category of high-grade B-cell lymphoma (HGBL), which includes one poorly understood subset, blastoid-HGBL. Establishing the diagnosis and distinguishing blastoid-HGBL from B-acute lymphoblastic leukemia (B-ALL) in bone marrow can be challenging. We assessed 31 cases of blastoid-HGBL diagnosed initially in bone marrow and compared this group to 36 cases of B-ALL using immunophenotyping, fluorescence in situ hybridization, and targeted next generation sequencing analysis. The 31 blastoid-HGBL cases included 14 HGBL with MYC and BCL2 and/or BCL6 rearrangements (double hit lymphoma, DHL), 13 HGBL, not otherwise specified (NOS), and four cases with TdT expression that were difficult to classify. Compared with B-ALL, blastoid-HGBL cases more often showed increased intensity/bright expression of CD20, CD38, CD45, BCL-6, and MYC, and less frequent bright expression of CD10 and TdT. Cases of blastoid-HGBL also more frequently had MYC rearrangement, a complex karyotype and TP53 mutation (p < 0.01). With the exception of CD34, no other single factor, including TdT, was sensitive or adequately specific to distinguish blastoid-HGBL from B-ALL. We developed a scoring system using six distinctive features between 16 cases of unequivocal blastoid HGBL and 22 cases of CD34-positive B-ALL, with a score of ≥3 defining blastoid-HGBL. The system was further validated by using 15 cases of surface light chain negative, and/or CD45 dim to negative blastoid-HGBL and 14 cases of CD34-negative B-ALL. The sensitivity, specificity, positive, and negative predictive value of this scoring system were 100%, 94%, 94%, and 100%, respectively. Using this system, the four cases with TdT expression were all classified as blastoid-HGBL: three were DHL and one was HGBL-NOS. In conclusion, blastoid-HGBL shows distinctive immunophenotypic, cytogenetic, and molecular features as compared with B-ALL. The proposed scoring system can be helpful for the classification of diagnostically challenging blastoid lymphoid tumors presenting initially in the bone marrow.
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