Key result
Intravascular large B-cell lymphoma is characterized by frequent mutations in genes activating the BCR/NF-κB pathway, particularly PIM1, MYD88, and CD79B, along with alterations in immune escape genes.
Why the study?
Intravascular large B-cell lymphoma is an uncommon, aggressive lymphoma whose pathogenesis is uncertain, with little information available on underlying genomic alterations.
Observational (n=15)
Yes
Answers are grounded in this paper and cite their sources.
IVLBCL is characterized by frequent mutations in BCR/NF-κB signaling and immune escape pathways, including PIM1, MYD88, and CD79B, regardless of extravascular dissemination or hemophagocytic syndrome.
Intravascular large B-cell lymphoma (IVLBCL) is an uncommon lymphoma with an aggressive clinical course characterized by selective growth of tumor cells within the vessels. Its pathogenesis is still uncertain and there is little information on the underlying genomic alterations. In this study, we performed a clinicopathologic and next-generation sequencing analysis of 15 cases of IVLBCL using a custom panel for the detection of alterations in 68 recurrently mutated genes in B-cell lymphomagenesis. Six patients had evidence of hemophagocytic syndrome. Four patients presented concomitantly a solid malignancy. Tumor cells outside the vessels were observed in 7 cases, 2 with an overt diffuse large B-cell cell lymphoma. In 4 samples, tumor cells infiltrated lymphatic vessel in addition to blood capillaries. Programmed death-ligand 1 (PD-L1) was positive in tumor cells in 4 of 11 evaluable samples and in macrophages intermingled with tumor cells in 8. PD-L1 copy number gains were identified in a higher proportion of cases expressing PD-L1 than in negative tumors. The most frequently mutated gene was PIM1 (9/15, 60%), followed by MYD88L265P and CD79B (8/15, 53% each). In 6 cases, MYD88L265P and CD79B mutations were detected concomitantly. We also identified recurrent mutations in IRF4 , TMEM30A , BTG2 , and ETV6 loci (4/15, 27% each) and novel driver mutations in NOTCH2 , CCND3 , and GNA13 , and an IRF4 translocation in 1 case each. The mutational profile was similar in patients with and without evidence of hemophagocytic syndrome and in cases with or without dissemination of tumor cells outside the vessels. Our results confirm the relevance of mutations in B-cell receptor/nuclear factor-κB signaling and immune escape pathways in IVLBCL and identify novel driver alterations. The similar mutational profile in tumors with extravascular dissemination suggests that these cases may also be considered in the spectrum of IVLBCL.
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González‐Farré et al. (2022) conducted an observational in Intravascular Large B-Cell Lymphoma (n=15). Intravascular Large B-Cell Lymphoma was evaluated on Frequency of genetic alterations. Intravascular large B-cell lymphoma is characterized by frequent mutations in genes activating the BCR/NF-κB pathway, particularly PIM1, MYD88, and CD79B, along with alterations in immune escape genes.
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