Abstract
Diffuse large B cell lymphoma (DLBCL) with spindle cell morphology is a rare variant that can be seen in extranodal regions. Because the spindle cell dominant morphology in lymphoma is extremely unusual, the diagnosis can easily be missed in many organ systems. We present a case of an 82-year-old male patient with complaints of abdominal pain and swelling. He operated with the preliminary diagnosis of cecum tumor and ileum perforation. Tumoral proliferation was observed originating from the submucosa and infiltrating the muscularis propria, with the features of mostly spindle-shaped, having round-shaped nuclei in some of the cells, and having relatively narrow cytoplasm. A panel of immunohistochemical stains were performed to rule out the possibilities of sarcoma, carcinoma, or melanoma. Diffuse strong positive reaction was observed for CD45, CD20, CD19, CD22, Pax5, and CD30. The case was reported as spindle cell variant of DLBCL based on the present findings. As far as we know, this is the first case described in the colon. We emphasize that pathologists should be reminded of lymphoma as a differential diagnosis of spindle cell tumors.
Similar content being viewed by others
References
Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma. World J Gastroenterol. 2011;17(6):697–707. https://doi.org/10.3748/wjg.v17.i6.697.
Kluin PM, Slootweg PJ, Schuurman HJ, Go DM, Rademakers LH, van der Putte SC, van Unnik JA. Primary B-cell malignant lymphoma of the maxilla with a sarcomatous pattern and multilobated nuclei. Cancer. 1984;54(8):1598-605. https://doi.org/10.1002/1097-0142(19841015)54:8/1598::aid-cncr2820540822/3.0.co;2-x.
Cerroni L, El-Shabrawi-Caelen L, Fink-Puches R, LeBoit PE, Kerl H. Cutaneous spindle-cell B-cell lymphoma: a morphologic variant of cutaneous large B-cell lymphoma. Am J Dermatopathol. 2000;22(4):299–304. https://doi.org/10.1097/00000372-200008000-00001.
Wang J, Sun NC, Nozawa Y, Arber DA, Chu P, Chang KL, Weiss LM. Histological and immunohistochemical characterization of extranodal diffuse large-cell lymphomas with prominent spindle cell features. Histopathology. 2001;39(5):476–81. https://doi.org/10.1046/j.1365-2559.2001.01271.x.
Kahlifa M, Buckstein R, Perez-Ordoñez B. Sarcomatoid variant of B-cell lymphoma of the uterine cervix. Int J Gynecol Pathol. 2003;22(3):289–93. https://doi.org/10.1097/01.PGP.0000070845.25718.4C.
Li Y, Cui W, Woodroof JM, Zhang D. Extranodal B cell lymphoma with prominent spindle cell features arising in uterus and in maxillary sinus: report of two cases and literature review. Ann Clin Lab Sci. 2016;46(2):213–8.
Hayashi H, Ohtani H, Ueda T, Yamaguchi J, Izawa K, Hayashida T, Higami Y, Shimokawa I. Primary hepatic lymphoma with spindle cell components: a case report. Virchows Arch. 2006;449(5):591–6. https://doi.org/10.1007/s00428-006-0276-4.
Zicherman JM, Weissman D, Gribbin C, Epstein R. Best cases from the AFIP: primary diffuse large B-cell lymphoma of the epididymis and testis. Radiographics. 2005;25(1):243–8. https://doi.org/10.1148/rg.251045041.
Satgunaseelan L, Larsen SR, Carmalt H, Cooper WA. Spindle cell variant of diffuse large B cell lymphoma occurring in the breast. Pathology. 2017;49(7):784–6. https://doi.org/10.1016/j.pathol.2017.06.009.
Sugimoto KJ, Shimada A, Ichikawa K, Wakabayashi M, Sekiguchi Y, Izumi H, Ota Y, Komatsu N, Noguchi M. Primary platelet-derived growth factor-producing, spindle-shaped diffuse large B-cell lymphoma of the skull: a case report and literature review. Int J Clin Exp Pathol. 2014;7(7):4381–90.
Sukswai N, Lyapichev K, Khoury JD, Medeiros LJ. Diffuse large B-cell lymphoma variants: an update. Pathology. 2020;52(1):53–67. https://doi.org/10.1016/j.pathol.2019.08.013.
Charli-Joseph Y, Cerroni L, LeBoit PE. Cutaneous Spindle-Cell B-Cell Lymphomas: Most are Neoplasms of Follicular Center Cell Origin. Am J Surg Pathol. 2015;39(6):737–43. https://doi.org/10.1097/PAS.0000000000000388.
Yu L, Yan LL, Yang SJ. Sarcomatoid variant of ALK- anaplastic large cell lymphoma involving multiple lymph nodes and both lungs with production of proinflammatory cytokines: report of a case and review of literature. Int J Clin Exp Pathol. 2014;7(8):4806–16.
Swerdlow SH, Campo E, Harris NL. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Revised 4th edition. IARC, Lyon 2017.
Kimura Y, Arakawa F, Kiyasu J, Miyoshi H, Yoshida M, Ichikawa A, Nakashima S, Ishibashi Y, Niino D, Sugita Y, Ishiyama K, Higuchi M, Takasaki Y, Shimomura T, Koike C, Kuwahara N, Fujikawa K, Ohshima K. A spindle cell variant of diffuse large B-cell lymphoma is characterized by T-cell/myofibrohistio-rich stromal alterations: analysis of 10 cases and a review of the literature. Eur J Haematol. 2012;89(4):302–10. https://doi.org/10.1111/j.1600-0609.2012.01826.x.
Virani N, Pang J, Lew M. Cytologic and Immunohistochemical Evaluation of Low-Grade Spindle Cell Lesions of the Gastrointestinal Tract. Arch Pathol Lab Med. 2016;140(10):1038–44. https://doi.org/10.5858/arpa.2016-0235-RA.
Ikoma N, Roland CL, Cormier JN, Chiang YJ, Torres KE, Hunt KK, You YN, Feig BW. Nongastrointestinal Stromal Tumor Spindle Cell Sarcomas of the Colon or Rectum. Am Surg. 2018;84(4):570–5.
Author information
Authors and Affiliations
Contributions
Toprak S, Bozdag Z, and Karadag N conceived and designed research. Bozdag Z, Toprak S, and Akbulut S wrote the manuscript. All authors read and approved the manuscript.
Corresponding author
Ethics declarations
Ethics Approval and Consent to Participate
Ethics approval is not applicable. Informed consent of the patient was obtained.
Consent for Publication
Informed consent for publication was obtained.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Toprak, S., Bozdag, Z., Karadag, N. et al. Spindle Variant Primary Diffuse Large B Cell Lymphoma of the Colon: Case Report and Literature Review. J Gastrointest Canc 54, 286–289 (2023). https://doi.org/10.1007/s12029-021-00790-z
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12029-021-00790-z