Carreras, JoaquimKikuti, Yara YukieMiyaoka, MasashiHiraiwa, ShinichiroTomita, SakuraIkoma, HarukaKondo, YusukeIto, AtsushiNagase, ShunsukeMiura, HisanobuRoncador, GiovannaColomo Saperas, Luis AlbertoHamoudi, RifatCampo, EliasNakamura, Naoya2024-05-232024-05-232023Carreras J, Kikuti YY, Miyaoka M, Hiraiwa S, Tomita S, Ikoma H, et al. Mutational profile and pathological features of a case of interleukin-10 and RGS1-positive spindle cCell variant diffuse large B-Cell lymphoma. Hematol Rep. 2023 Mar 12;15(1):188-200. DOI: 10.3390/hematolrep150100202038-8322http://hdl.handle.net/10230/60237Diffuse large B-cell lymphoma with spindle cell morphology is a rare variant. We present the case of a 74-year-old male who initially presented with a right supraclavicular (lymph) node enlargement. Histological analysis showed a proliferation of spindle-shaped cells with narrow cytoplasms. An immunohistochemical panel was used to exclude other tumors, such as melanoma, carcinoma, and sarcoma. The lymphoma was characterized by a cell-of-origin subtype of germinal center B-cell-like (GCB) based on Hans' classifier (CD10-negative, BCL6-positive, and MUM1-negative); EBER negativity, and the absence of BCL2, BCL6, and MYC rearrangements. Mutational profiling using a custom panel of 168 genes associated with aggressive B-cell lymphomas confirmed mutations in ACTB, ARID1B, DUSP2, DTX1, HLA-B, PTEN, and TNFRSF14. Based on the LymphGen 1.0 classification tool, this case had an ST2 subtype prediction. The immune microenvironment was characterized by moderate infiltration of M2-like tumor-associated macrophages (TMAs) with positivity of CD163, CSF1R, CD85A (LILRB3), and PD-L1; moderate PD-1 positive T cells, and low FOXP3 regulatory T lymphocytes (Tregs). Immunohistochemical expression of PTX3 and TNFRSF14 was absent. Interestingly, the lymphoma cells were positive for HLA-DP-DR, IL-10, and RGS1, which are markers associated with poor prognosis in DLBCL. The patient was treated with R-CHOP therapy, and achieved a metabolically complete response.application/pdfeng© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).info:eu-repo/semantics/articlehttp://dx.doi.org/10.3390/hematolrep15010020LymphGen 1.0Diffuse large B-cell lymphomaInterleukin 10Mutational profilingNext-generation sequencingRegulator of G protein signaling 1Spindle cellinfo:eu-repo/semantics/openAccess