Clinical and Pathological Features of Patients With B-Cell NHL and HCV Infection
| Case, Age, Sex . | Sites of Primary Involvement by NHL . | Classification of . | Bone Marrow Involvement . | Stage . | HCV Genotype . | Cryoglobulinemia* (cryocrit level in %) . | RF/ANA . | Previous EMC or Sjögren's Syndrome . |
|---|---|---|---|---|---|---|---|---|
| . | . | B-Cell NHL . | . | . | . | . | . | . |
| . | . | REAL/W.F. . | . | . | . | . | . | . |
| 1. 53, F†‡ | LFN (lc) | Lp-Ic/A | − | III A | 2c | + type II IgMk (52%) | +/NS | + EMC |
| 2. 66, F‡ | Skin | Lp-Ic/A | + | IV A | 2c | + type II IgMk (1%) | +/− | − |
| 3. 79, F | LFN (ax, hh, lc, ing) tonsil, vagina | Uncl/Misc A + G | + | IV B | 2c | + type II IgMk (3%) | +/NS | NS |
| 4. 72, F† | Skin | Uncl/Misc A + D | + | IV A | 1b | + type II IgMk (2%) | +/+ | − |
| 5. 59, F† | LFN (lc) | FC-Foll/C | − | II A | Ib | + type II IgMk (3%) | +/+ | + EMC |
| 6. 59, F | LFN (lc, ax, nuc), spleen | Mant/E | + | IV A | 2c | + (<1%) | −/− | − |
| 7. 79, M | Parotid gland, stomach | Ex-MZ/E | + | IV A | 2c | + (<1%) | −/+ | − |
| 8. 55, M | Stomach | Ex-MZ/E | + | IV A | 1b | + type III (1%) | −/− | − |
| 9. 69, F | Submandibular gland | Ex-MZ/E | + | IV A | 1b | + type III (1%) | +/− | − |
| 10. 70, F | Bronchus | Ex-MZ/E | + | IV A | 2c | + type III (2%) | +/− | − |
| 11. 62, F | Parotid | Ex-MZ/E | − | I A | NS | + (<1%) | −/− | − |
| 12. 68, F | Stomach | DLC/Gρ | +ρ | IV A | 1b | + (1%) | +/− | − |
| 13. 76, F | Parotid gland | DLC/G | − | I A | 1b + 2b | + type II IgMk (4%) | +/− | + EMC |
| 14. 27, M | Liver | DLC/G | − | IV B | 2c | + (<1%) | +/− | − |
| 15. 68, F | Liver, LFN, spleen | DLC/G | − | IV B | 1b | + (<1%) | +/− | + Sjögren |
| 16. 55, M | Spleen, lung + LR-LFN | DLC/G | − | IV A | 2c | + type III (1%) | −/− | − |
| 17. 55, M | Rhinopharynx, liquor | DLC/G | − | IV B | 1b | + (1%) | +/− | − |
| 18. 61, M | Liver, spleen | DLC/G | − | IV A | 2c | + (<1%) | −/− | − |
| 19. 48, M | Soft tissues (neck) + LR-LFN | DLC/G | − | I A | 1b | + (<1%) | −/− | − |
| 20. 66, M | Spleen, liver | DLC/G | − | IV B | 2c | + type III (1%) | −/− | − |
| 21. 74, F | Soft tissues (thigh) + LR-LFN | DLC/G | + | IV A | 2c | + type III (1%) | −/− | − |
| 22. 72, F | Stomach | DLC/G | − | I A | 1b | + (1%) | +/− | − |
| 23. 66, M | Brain | DLC/G | − | I A | 1b | + (<1%) | −/− | − |
| 24. 61, M | Tonsil | DLC/G | − | I A | 2c | + (<1%) | −/+ | − |
| 25. 73, M | Small intestine | DLC/G | − | I A | 2c | + (<1%) | −/− | − |
| 26. 70, F | Liver, LFN(ax, ing) | DLC/G | + | IV A | 2c | + type II IgMk (1%) | +/− | + EMC |
| 27. 69, M | LFN (ing, il, fem) | DLC/G | − | II A | 2c | + type III (1%) | −/+ | − |
| 28. 59, M | Liver | DLC/G | − | I A | 1b | + type III (1%) | −/− | − |
| 29. 72, F | LFN (lc, aort), tonsil | DLC/G | − | III A | 2c | + type II IgMk (4%) | +/− | + EMC |
| 30. 57, M | LFN (lc, ax, clav, ing) | DLC/G | − | III B | 2c | + type III (1%) | +/− | − |
| 31. 72, F | Spleen, LFN (hh, il, cel) | DLC/G | + | IV B | 2c | + (<1%) | +/− | − |
| 32. 65, F | Skin + LR-LFN | DLC/H | + | IV A | 2c | + type II IgMk (2%) | +/− | − |
| 33. 77, M | LFN (lc, ax, hh) | DLC/H | − | III B | 2c | + (<1%) | −/− | − |
| 34. 70, F | LFN (med), pleural effusion | DLC/H | − | IV A | 1b | + (<1%) | −/− | − |
| 35. 57, F‡ | Breast | Burkitt's/J | − | I A | 1b | + (<1%) | −/− | − |
| Case, Age, Sex . | Sites of Primary Involvement by NHL . | Classification of . | Bone Marrow Involvement . | Stage . | HCV Genotype . | Cryoglobulinemia* (cryocrit level in %) . | RF/ANA . | Previous EMC or Sjögren's Syndrome . |
|---|---|---|---|---|---|---|---|---|
| . | . | B-Cell NHL . | . | . | . | . | . | . |
| . | . | REAL/W.F. . | . | . | . | . | . | . |
| 1. 53, F†‡ | LFN (lc) | Lp-Ic/A | − | III A | 2c | + type II IgMk (52%) | +/NS | + EMC |
| 2. 66, F‡ | Skin | Lp-Ic/A | + | IV A | 2c | + type II IgMk (1%) | +/− | − |
| 3. 79, F | LFN (ax, hh, lc, ing) tonsil, vagina | Uncl/Misc A + G | + | IV B | 2c | + type II IgMk (3%) | +/NS | NS |
| 4. 72, F† | Skin | Uncl/Misc A + D | + | IV A | 1b | + type II IgMk (2%) | +/+ | − |
| 5. 59, F† | LFN (lc) | FC-Foll/C | − | II A | Ib | + type II IgMk (3%) | +/+ | + EMC |
| 6. 59, F | LFN (lc, ax, nuc), spleen | Mant/E | + | IV A | 2c | + (<1%) | −/− | − |
| 7. 79, M | Parotid gland, stomach | Ex-MZ/E | + | IV A | 2c | + (<1%) | −/+ | − |
| 8. 55, M | Stomach | Ex-MZ/E | + | IV A | 1b | + type III (1%) | −/− | − |
| 9. 69, F | Submandibular gland | Ex-MZ/E | + | IV A | 1b | + type III (1%) | +/− | − |
| 10. 70, F | Bronchus | Ex-MZ/E | + | IV A | 2c | + type III (2%) | +/− | − |
| 11. 62, F | Parotid | Ex-MZ/E | − | I A | NS | + (<1%) | −/− | − |
| 12. 68, F | Stomach | DLC/Gρ | +ρ | IV A | 1b | + (1%) | +/− | − |
| 13. 76, F | Parotid gland | DLC/G | − | I A | 1b + 2b | + type II IgMk (4%) | +/− | + EMC |
| 14. 27, M | Liver | DLC/G | − | IV B | 2c | + (<1%) | +/− | − |
| 15. 68, F | Liver, LFN, spleen | DLC/G | − | IV B | 1b | + (<1%) | +/− | + Sjögren |
| 16. 55, M | Spleen, lung + LR-LFN | DLC/G | − | IV A | 2c | + type III (1%) | −/− | − |
| 17. 55, M | Rhinopharynx, liquor | DLC/G | − | IV B | 1b | + (1%) | +/− | − |
| 18. 61, M | Liver, spleen | DLC/G | − | IV A | 2c | + (<1%) | −/− | − |
| 19. 48, M | Soft tissues (neck) + LR-LFN | DLC/G | − | I A | 1b | + (<1%) | −/− | − |
| 20. 66, M | Spleen, liver | DLC/G | − | IV B | 2c | + type III (1%) | −/− | − |
| 21. 74, F | Soft tissues (thigh) + LR-LFN | DLC/G | + | IV A | 2c | + type III (1%) | −/− | − |
| 22. 72, F | Stomach | DLC/G | − | I A | 1b | + (1%) | +/− | − |
| 23. 66, M | Brain | DLC/G | − | I A | 1b | + (<1%) | −/− | − |
| 24. 61, M | Tonsil | DLC/G | − | I A | 2c | + (<1%) | −/+ | − |
| 25. 73, M | Small intestine | DLC/G | − | I A | 2c | + (<1%) | −/− | − |
| 26. 70, F | Liver, LFN(ax, ing) | DLC/G | + | IV A | 2c | + type II IgMk (1%) | +/− | + EMC |
| 27. 69, M | LFN (ing, il, fem) | DLC/G | − | II A | 2c | + type III (1%) | −/+ | − |
| 28. 59, M | Liver | DLC/G | − | I A | 1b | + type III (1%) | −/− | − |
| 29. 72, F | LFN (lc, aort), tonsil | DLC/G | − | III A | 2c | + type II IgMk (4%) | +/− | + EMC |
| 30. 57, M | LFN (lc, ax, clav, ing) | DLC/G | − | III B | 2c | + type III (1%) | +/− | − |
| 31. 72, F | Spleen, LFN (hh, il, cel) | DLC/G | + | IV B | 2c | + (<1%) | +/− | − |
| 32. 65, F | Skin + LR-LFN | DLC/H | + | IV A | 2c | + type II IgMk (2%) | +/− | − |
| 33. 77, M | LFN (lc, ax, hh) | DLC/H | − | III B | 2c | + (<1%) | −/− | − |
| 34. 70, F | LFN (med), pleural effusion | DLC/H | − | IV A | 1b | + (<1%) | −/− | − |
| 35. 57, F‡ | Breast | Burkitt's/J | − | I A | 1b | + (<1%) | −/− | − |
Where underlined, the site of primary B-cell NHL localization at onset was evaluated by pathological studies.
Abbreviations: NS, not studied; RF, serum rheumatoid factor (positive if ≥40 IU/mL); ANA, serum antinuclear antibodies (positive for titers ≥1:40); W.F., Working Formulation; LFN, lymph nodes (hh, hepatic hylum; ax, axillary; lc, latero-cervical; clav, supra-clavear; aort, para-aortic; il, iliac; fem, femoral; cel, celiac; ing, inguinal; nuc, nucal; med, mediastinal; LR, locoregional); Uncl, Unclassifiable; Lp-Ic, Lymphoplasmocytoid-Immunocytoma; FC-Foll, Follicular center, follicular; Misc, Miscellaneous Group; Ex-MZ, Extranodal marginal zone; DLC, Diffuse large cell.
Where not reported, serum cryoglobulins could not be typified due to cryocrit levels ≤1%.
A histopathologic picture of either reactive lymphadenopathy or atypical lymphoproliferative disorder had been detected in the previous years.
Lymphoma relapse was observed during the follow-up, with unchanged histotype in patients 1 and 35, and progression to DLC B-cell lymphoma (F group in the W.F.) in patient 2.
ρ With pathological features of Ex-MZ NHL in some residual areas of gastric mucosa, and bone marrow involvement detected only by flow cytometry.