Overexpression of MYC and BCL2 in Diffuse Large B Cell Lymphoma through Immunohistochemical Technique to Provide Prognostic Information

Jemima Evangelyn, T (2020) Overexpression of MYC and BCL2 in Diffuse Large B Cell Lymphoma through Immunohistochemical Technique to Provide Prognostic Information. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Diffuse large B cell lymphomas are one of the most common types of non-Hodgkin lymphomas. They are aggressive tumors. With the advent of RCHOP regimen, these tumors became potentially treatable. The 2016 revised WHO classification of lymphoid neoplasms has identified overexpression of MYC and BCL2 in these lymphomas is associated with worst prognosis than those that do not overexpress these proteins. This study on overexpression of myc and bcl2 thus will provide a prognostic information for the patients with diffuse large B cell lymphoma. Only one - third of the patients with this phenotype respond to R-CHOP regimen. AIMS AND OBJECTIVES: In this study, we evaluate the status of myc and bcl2 expression in diffuse large B cell lymphoma and the proportion of myc and bcl2 overexpressing tumors, thereby providing prognostic information. METHODOLOGY: The excision biopsy specimens with the clinical details of respective patient are collected. Corresponding HPE slides are prepared from formalin fixed paraffin embedded tissue of excision biopsy specimens. Blocks of histopathologically proven diffuse large B cell lymphoma are taken up for myc and bcl2 immunohistochemical staining. OBSERVATION AND RESULTS: The current study is done on 30 patients’ tissue blocks. The median age is 53 years ; the range being 35 to 79 years with male predominance. Extranodal cases comprise about 36.7% which include gastrointestinal sites, tonsil, testis, skin and back. The age group of the current study is about 10 years younger than that in the reference studies. Cell of origin is analysed in 25 cases. 76% are of germinal center B-cell subtype and 24% are of activated B-cell subtype. C-myc positivity is seen in 10%. Bcl 2 positivity is seen in 46.6%. Double expression is seen in 10% which is less than the data provided in the reference studies. CONCLUSION: Double expression is one of the best marker for assessing prognosis, but it does not identify the double hit subtype. If strategies are developed using immunohistochemical scoring system, all the patients can be benefitted of the appropriate first line treatment, that can reduce relapse and refractory cases.

Item Type: Thesis (Masters)
Additional Information: 201713004
Uncontrolled Keywords: Diffuse large B cell lymphomas, myc, bcl2, overexpression, double expressor, prognosis.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 15:19
Last Modified: 29 Jan 2021 15:19
URI: http://repository-tnmgrmu.ac.in/id/eprint/13394

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