Small noncleaved follicular center cell (FCC) lymphoma: Burkitt and non-Burkitt variants in the United States. I. Clinical features (original) (raw)

Abstract

With the understanding that Burkitt's lymphoma was of follicular center cell (FCC) derivation, Lukes and Collins classified the tumor, descriptively, as small noncleaved FCC lymphoma. Two subtypes were described: Burkitt and non-Burkitt. Attempting to define the clinicopathologic features of the subtypes, we studied 42 patients: 25 Burkitt and 17 non-Burkitt. Histologically, the Burkitt tumor demonstrated remarkable uniformity of nuclear size and contour, whereas the non-Burkitt variant had greater variability. Immunoglobulin monoclonality was demonstrated in 83% of Burkitt and 81 % of non-Burkitt cases. Burkitt patients tended to be younger. Gastrointestinal disease was seen in 15 Burkitt and only four non-Burkitt patients (P < 0.05). Disseminated disease was found in the majority of both variants. Marrow involvement was demonstrated in 4.5% of Burkitt and 37.5% of non-Burkitt patients (P < 0.05). Median survival of Burkitt patients was 10.5 months versus 7.7 months in the non-Burkitt group. The authors believe that significant biologic differences between the variants have been demonstrated, which may be of potential value to the clinician. Cuncer 52:1073-1079, 1983. H E INTRODUCTION of newer classification systems T of malignant lymphoma'-3 based on immunologic phenotype and function has led to greater insight into the nature of lymphomatous disease, and, in some instances, improved ability to treat, or even cure affected patients4 Burkitt's lymphoma is one such example of our improved understanding of disease.' This tumor, originally described clinically by Denis Burkitt in 1958," was classified pathologically within the "undifferentiated" category of Rappap01-t.~ With an appreciation that the tumor is of "B" cell, or folicular center cell

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References (28)

  1. I . Lukes RJ, Collins RD. Immunologic characterization of human malignant lymphomas. Cuncer 1974; 34: 1488-1 503.
  2. Lukes RJ, Parker JW, Taylor CR, Tindle BH, Cramer AD, Lin- coln TL. Immunologic approach to non-Hodgkin's lymphoma and related leukemias: An analysis of the results of multi-parameter studies of 425 cases. Semin Hematol 1978; I5:322-35 I .
  3. Lennert K, Mohri N, Stein H, Kaiserling E. The histopathology of malignant lymphoma. Br J lluemutd 1975; 31:193.
  4. Weinstein HJ, Vance ZB, Jaffe N, Buelle D, Cassady JR, Nathan DG. Improved prognosis for patients with mediastinal lymphoblastic lymphoma. Blood 1979; 43:687-694.
  5. Ziegler JL. Burkitt's lymphoma. N Engl J Med 1981; 305:735- 745.
  6. Burkitt D. A sarcoma involving the jaws in African children. Br J Surg 1958; 46:218-223.
  7. Rappaport H. Tumors of the hematopoietic system. In: Atlas of Tumor Pathology, Section 111, Fascicle 8. Washington, DC: Armed Forces Institute of Pathology, 1966.
  8. Non-Hodgkin's Lymphoma Pathology Classification Project. National Cancer Institute sponsored study of classification of non- Hodgkin's lymphomas: Summary and description of a working for- mulation for clinical usage. Cuncer 1982; 49:2 I 12-2 135.
  9. Berard C, OConor GT, Thomas LB, Torloni H. Histopatholog- ical definition of Burkitt's tumor. Bull WHO 1969; 40:601-607. 10. Taylor CR. lmmunoperoxidase technique: Theoretical and practical aspects. Arch Path01 Lab Med 1978; 102: I 13-I2 1. I I . Snedecor GW, Cochran WG. Statistical methods. Ames, Iowa: Iowa State University Press, 1967.
  10. Pet0 R, Pike MC, Armitage P el (11. Design and analysis of randomized clinical trials requiring a prolonged observation of each patient. Br J Cuncer 1976; 34-585-6 12.
  11. Pavlova Z, Levine AM, Parker JW, Taylor CR, Lukes RJ. Small non-cleaved follicular center cell (FCC) lymphoma: Burkitt ver.w.s non-Burkitt variants. 11. Pathologic features (submitted for publica- tion).
  12. Carbone PP, Kaplan HS, Musshold K, Smith DW, Tubina M. Report of the committee of Hodgkin's disease staging classification. Cuncer Res 1971; 31:1860-1861.
  13. Ziegler JL, Magrath IT. Burkitt's lymphoma. In: Ioachirn HL, ed. Pathobiology Annual. New York: Appleton-Century Crofts 1974; 129-142.
  14. Schein PS, DeVita VT, Hubbard S et ul. Bleomycin, adria- mycin, cyclophospharnide, Vincristine and prednisone (BACOP) com- bination chemotherapy in th treatment of advanced diffuse histiocytic lymphoma. Ann Intern Med 1976; 85:417-422.
  15. McKelvey EM, Gottlieb JA, Wilson HE. Hydroxyldaunomycin (adriamycin) combination chemotherapy in malignant lymphoma. Cancer 1976; 38:1484-1493.
  16. Bagley CM, DeVita JV, Berard DW. Advanced lymphosar- coma: Intensive cyclical combination chemotherapy with cyclophos- phamide, vicristine and prednisone. Ann Intern Med 1972; 76:227- 234.
  17. Anderson T, Bender RA, Fisher RI. Combination chemother- apy in non-Hodgkin's lymphoma: Results of long-term follow-up. Cancer Treat Rep 1977; 61:1057-1066.
  18. Ziegler JL. Treatment results of 54 American patients with Burkitt's lymphoma are similar to the African experience. N Engl .I Med 1977; 297:75-80.
  19. Rodriquez V, Hart JS, Freireich EJ ef ul. POMP combination chemotherapy of adult acute leukemia. Cuncer 1973; 32:69-75.
  20. Mann RB, Jaffe ES, Braylan RC et a/. Non-endemic Burkitt's lymphoma: A B Cell tumor related to germinal cancers. N Engl J Med 23. Grogan TM, Warnke RA, Kaplan HS. A comparative study of Burkitt's and non-Burkitt's "undifferentiated" malignant lymphoma: Immunologic cytochemical, ultrastructural, cytologic, histopatholic, clinical and cell culture features. Cuncer 1982; 49: 18 17-1 828. 24. Miliauskas RJ, Berard CW, Young RC, Garvin AJ, Edwards BK, DeVita VT. Undifferentiated non-Hodgkin's lymphomas (Burkitt's and non-Burkitt's types): The relevance of making this histologic distinction. Cuncer 1982; 50:2 1 15-2 12 I.
  21. Arseneau JC, Canellos GP, Banks PM, Berard CW, Gralnick HR, DeVita VT. American Burkitt's lymphoma: A clinicopathologic study of 30 cases. 1. Clinical factors relating to prolonged survival. Am J M e d 1975; 58:314-321.
  22. Blurning AZ, Ziegler JL, Carbone PP. Bone marrow involve- ment in Burkitt's lymphoma: Results of a prospective study. Br J Huematol 1972; 22:369-376.
  23. Wright DH, Pike PA. Bone marrow involvement in Burkitt's tumour. Br J Haemutol 1968; 15:409-4 16.
  24. Dick F, Bloomfield CD, Brunning RD. Incidence, cytology and histopathology of non-Hodgkin's lymphomas in the bone marrow. Cuncer 1974; 33:1382-1398.
  25. Brunning RD, McKenna RW, Bloomfield CD, Coccia P, Gajl-
  26. Peczalska KJ. Bone marrow involvement in Burkitt's lymphoma. Cun- cer 1977; 40:1771-1779.
  27. Oviatt DL, Cousar JB, Flexner JM, Kurtin PJ, Collins RD.
  28. Stein RS. Small transformed cell lymphoma of the non-Burkitt's type (Abstr). Blood 198 I ; 58: 162a. 1976; 295:685-69 I .