Kavita Gupta

Abstract

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of primary gastrointestinal lymphomas. It is a clinically heterogenous disease as most patients respond well to therapy, however a significant proportion of these patients become refractory or eventually relapse. Different prognostic factors for response and survival have been described for DLBCL. Immunophenotypic algorithms with small panels of biomarkers have been developed to translate the robust information from molecular studies into a routine clinical. platform. One of these biomarkers is MUM-1 which is used as a marker for classification of diffuse large B cell lymphoma into ABC type and its expression is associated with poorer overall survival as stated by various studies. We aim to study the expression pattern of MUM-1 IHC in primary gastrointestinal diffuse large B cell lymphomas and its role in prognosis and survival outcome. Materials and Methods: It was a five-year retrospective study where 40 cases of primary gastrointestinal DLBCL were identified, and MUM-1 IHC was done in 29 cases. Follow up and subsequent survival analysis was done. Results: MUM-1 was positive in 7 (24%) and negative in 22 (76%) cases of primary gastrointestinal DLBCL. The overall survival of patients with DLBCL with MUM-1 [removed]42.9%) was shorter than those without MUM-1 [removed]72.7%). This suggested that MUM-1 expression in cases with DLBCL is associated with poorer prognosis. Conclusion: Multicentre large studies are warranted to study the role of MUM-1 IHC in prognosis of primary gastrointestinal DLBCL. Keywords: Activated B cell type, Gastrointestinal lymphoma, Gene expression profiling, Germinal centre B-cell, Immunohistochemistry.

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Abstract

The occurrence of decidualization outside the endometrium, is called as ectopic decidual reaction. It can involve any abdominal organs, such as ovary, fallopian tube, cervix, uterine surface, omentum, etc. and present as grey white nodules. These nodules grossly mimic metastatic disease and granulomas, causing a diagnostic dilemma. Decidual reaction is a benign condition and can regress spontaneously in the postpartum period. Thus, it is important to accurately diagnose these lesions for optimal treatment. Histologic examination followed by immunohistochemistry can be performed on the biopsies sampled during cesarean sections, tubal ligation, appendectomy, etc. to obtain a correct diagnosis. Peritoneal location of ectopic decidua is less frequent and can be an incidental finding. Few patients may present with the symptoms of abdominal pain, hemorrhage or irritable bowel syndrome. We thereby, report a case of peritoneal ectopic decidual reaction and discuss its histopathological features, immunohistochemistry and the differential diagnosis.   Keywords: Peritoneal nodules, Metastasis, Immunohistochemistry, Pregnancy

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