Immunohistochemical Expression of BCL6 in Nodal and Extranodal Cases of Diffuse Large B Cell Lymphoma-A Study in a Tertiary Care Hospital in Islamabad

  • Armaghana Qamar Khan Department of Pathology, Pakistan Institute of Medical Sciences (P.I.M.S)
  • Mariam Khan Qamar District Health Officer
  • Qudsia Ishaq Department of Biochemistry, Federal Medical Teaching (FMT)
  • Shafaq Khadija Department of Pathology, Fazaia Medical College
  • Sidrah Omair Department of Pathology, Pakistan Institute of Medical Sciences (P.I.M.S)
  • Alina Ali Department of Pathology, Pakistan Institute of Medical Sciences (P.I.M.S)
Keywords: BCL6, DLBCL, prognosis

Abstract

Background: Diffuse Large B Cell Lymphoma (DLBCL) is a common non Hodgkin lymphoma with a high mortality rate. BCL6 is the common oncogene that is mutated in DLBCL. Special therapeutic agents have been designed to target the mutated BCL6 gene. Therefore, DLBCL is a curable malignancy, and patients who are positive for BCL6 gene expression have better prognosis and survival, as they benefit from targeted therapy against BCL6 mutations.

Objectives: To determine BCL6 expression in DLBCL in nodal and extranodal cases.

Material & Methods: This descriptive cross-sectional study was carried out in the Pathology department of Pakistan Institute of Medical Sciences Islamabad. Duration of study was 3 years and 2 months, from 1st October 2014 to December 2017. Lymph node biopsies and surgical specimens with clinical suspicion of a mass were processed through various steps; slides were prepared and stained with H&E. A comprehensive panel of antibodies including LCA, Pan B (CD-20), Pan T (CD-3), Ki-1 (CD- 30), (CD 15), (CD 10), (BCL 2), and MIB-1 (Ki-67) was applied on cases with morphology of lymphoproliferative disease. LCA, CD20 positive cases, and those cases with Ki 67 of more than 40% were selected for BCL6 protein expression Immuno-staining with BCL6 was done after numerous successive steps. Immuno-expression of BCL6 in all slides was assessed and noted in Annexure. Data were analyzed using SPSS version 21.

Results: Patients included were 57. The mean age was 50.1 years. Males were 54%. The frequency of the BCL6 gene expression was 33%. The majority of the nodal cases were negative for BCL6 31%. Positive nodal cases were 16%. The majority of the extranodal cases were also negative for BCL6 36%. The positive extra nodal cases were 17%.

Conclusion: BCL6 immunoexpression has a fair presence in DLBCL. It can be used as an adjunct tool in evaluating patients of DLBCL. Patients with positive BCL6 gene mutation can benefit from BCL6 specific target chemotherapy

Published
2023-01-16