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Blood, 1 October 2005, Vol. 106, No. 7, pp. 2491-2497.
Prepublished online as a Blood First Edition Paper on June 9, 2005; DOI 10.1182/blood-2005-03-1175.
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Submitted March 23, 2005
Accepted May 25, 2005
Primary cutaneous large B-cell lymphomas. Clinicopathologic features, classification, and prognostic factors in a large series of patients.
Kazuo Kodama, Cesare Massone, Andreas Chott, Dieter Metze, Helmut Kerl, and Lorenzo Cerroni*
Departments of Dermatology, Medical University, Graz, Austria; Hokkaido University, Sapporo, Japan
Departments of Dermatology, Medical University, Graz, Austria
Department of Pathology, Medical University of Vienna, Vienna, Austria
University of Munster, Munster, Germany
* Corresponding author; email: lorenzo.cerroni{at}meduni-graz.at.
In the new World Health Organization/European Organization for Research and Treatment of Cancer (WHO/EORTC) classification of cutaneous lymphomas, large B-cell lymphomas (LBCLs) are divided into 3 groups: LBCL, leg-type (LBCLLT); follicle center lymphoma, diffuse type (FCLDT); LBCL, others (LBCLO). We studied a large number of primary cutaneous LBCLs in order to test the validity of the classification, and to identify prognostic factors for these patients. Ninety-three cases of primary cutaneous LBCL were analyzed for clinicopathologic features, expression of several markers including Bcl-2, Bcl-6, MUM-1, and FOX-P1, in-situ-hybridization for Epstein-Barr virus, and molecular analyses of IgH gene rearrangement and of Borrelia burgdorferi and Human herpesvirus 8 DNA. Patients were classified into the following categories: FCLDT: 44 cases; LBCLLT: 40 cases. LBCLO: 9 cases. Statistical analyses showed that the groups of LBCLLT and FCLDT were clearly distinct in terms of clinicopathologic features and survival. The group of LBCLO had features in-between those of LBCLLT and FCLDT. Our study shows that accurate morphologic and phenotypic analyses allow to stratify most patients into the prognostically different categories of LBCLLT and FCLDT. The definition of a third category of LBCLO requires further studies to clarify whether these cases show indeed distinct clinicopathologic features.

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