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, 10 (2), 508-514
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Primary Type3 (Non-ABC, Non-GCB) Subtype of Extranodal Diffuse Large B-Cell Lymphoma of the Thyroid Bearing No MYD88 Mutation by Padlock Probe Hybridization

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Case Reports

Primary Type3 (Non-ABC, Non-GCB) Subtype of Extranodal Diffuse Large B-Cell Lymphoma of the Thyroid Bearing No MYD88 Mutation by Padlock Probe Hybridization

Yukiko Nishi et al. Case Rep Oncol.

Abstract

Primary extranodal malignant lymphoma of the thyroid is a rare entity composed of mostly neoplastic transformation of germinal center-like B cells (GCB) or memory B cells. Other B-cell-type malignancies arising primarily in the thyroid have rarely been described. Immunohistochemical examination of autopsied primary malignant lymphoma of the thyroid in an 83-year-old Japanese female revealed the presence of a non-GCB subtype of diffuse large B-cell lymphoma (DLBCL) without the typical codon 206 or 265 missense mutation of MYD88. The lack of the highly oncogenic MYD88 gene mutation, frequently observed in DLBCL of the activated B-cell (ABC) subtype, and the detection of an extremely aggressive yet local clinical phenotype demonstrated that the present case was an exceptional entity of the type3 (non-GCB and non-ABC) subtype.

Keywords: Diffuse large B-cell lymphoma; MYD88 gene mutation; Primary extranodal malignant lymphoma.

Figures

Fig. 1
Fig. 1
a Enlarged thyroidal mass of 13 × 13 × 8 cm prominent at autopsy. The section of the cervix reveals a whitish, solid lesion with necrotic foci (b). Although systemic involvement was not observed, the tumor infiltrated the surrounding esophagus and the trachea (b, asterisk). c Infiltration of the 3-cm malignant lymphoma is also seen in the middle of the right lobe of the lung (arrowheads). d Coincidental finding of stomach cancer on the side of the lesser curvature of the body. e Histopathological analysis of the resected thyroidal tissue specimen, showing diffuse infiltration of the round cells with scant cytoplasm and a few atrophic and destroyed thyroid glands (HE. ×200). On the other hand, the stomach cancer is a typical signet-ring cell carcinoma (f, HE. ×400).
Fig. 2
Fig. 2
a Immunohistochemical examination showing infiltrating cells positive for CD20 (×200) and MUM1 (b, ×200) and negative for CAM5.2 (c, ×200), CD3 (d, ×200), Bcl-6 (e, ×200), and CD10 (f, ×200), confirming the diagnosis of nongerminal center-like B-cell type of diffuse large B-cell lymphoma.
Fig. 3
Fig. 3
PCR conducted with the use of formalin-fixed paraffin-embedded samples to explore a genetic alteration of the MYD88 gene. The PCR products were ligated and cloned into T vector and sequenced. No typical c.794T>C mutation causing p.L256P mutation (a, arrow) or c.618T>A mutation causing p.S206S mutation (b, arrow) is seen in 12 independent clones. Hyperbranched rolling-circle amplification was conducted to confirm PCR sequencing. In the positive control specimen from a diffuse large B-cell lymphoma case with a known typical c.974T>C mutation, signals are seen in both the wild-type padlock probe (a) and mutant-type padlock probe (b). In the present case, however, signals are seen in the wild-type padlock probe (c), but no signals are seen in the mutant-type padlock probe (d).

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References

    1. Verma D, Puri V, Agarwal S, Bhaskar A. Primary thyroid lymphoma: a rare disease. J Cytol. 2014;31:218–220. - PMC - PubMed
    1. Stein SA, Wartofsky L. Primary thyroid lymphoma: a clinical review. J Clin Endocrinol Metab. 2013;98:3131–3138. - PubMed
    1. Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G, et al. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood. 2004;103:275–282. - PubMed
    1. Ngo VN, Young RM, Schmitz R, Jhavar S, Xiao W, Lim KH, et al. Oncogenically active MYD88 mutations in human lymphoma. Nature. 2011;470:115–119. - PMC - PubMed
    1. Nakagawa M, Kitazawa R, Kuwahara N, Yoshida K, Haraguchi R, Kitazawa S. Efficient Genetic analysis of microdissected samples by agarose-bead method: alterations of beta-catenin gene in fundic gland polyp and heterotopic gastric mucosa of duodenum. Acta histochemica et cytochemica. 2013;46:19–24. - PMC - PubMed

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