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Stomach

Lymphoma

Diffuse large B-cell lymphoma

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 13 September 2012, last major update September 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● High grade B cell tumor (Am J Surg Pathol 2003;27:790)
● May arise from transformed extranodal marginal zone (MALT) lymphoma
● Usually > age 50 years
● 5 year survival is 65% (related to stage)
● Coexistence of MALT lymphoma and diffuse large B-cell lymphoma: do not reported as “high grade MALT” (MALT is usually indolent); report instead as diffuse large B-cell lymphoma with coexisting MALT lymphoma

Favorable prognostic factors
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● Cases associated with extranodal marginal zone (MALT) lymphoma have 84% 5 year cause specific survival (Am J Surg Pathol 2001;25:95), better than without coexisting MALT
● Germinal center origin (CD10+, bcl6+, Am J Surg Pathol 2000;24:1641)

Case reports
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● 61 year old man with coexisting early gastric carcinoma (Arch Pathol Lab Med 1989;113:419)

Gross description
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● Large polypoid or lobulated mass with superficial or deep ulceration; often in distal stomach, but sparing pylorus

Micro description
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● Infiltrative pattern of high grade, centroblast like cells; multinucleated forms may resemble Reed-Sternberg cells

Positive stains
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● bcl6 (variable), CD10 (variable), CD35 (variable), keratin (rare, Am J Surg Pathol 1996;20:346)

Differential diagnosis
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● Undifferentiated carcinoma: continuity between tumor cells and epithelium, acinar pattern, muscularis mucosa destruction, positive for keratin and mucin

End of Stomach > Lymphoma > Diffuse large B-cell lymphoma

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