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CD4 expression is rare in diffuse large B-cell lymphoma(DLBCL), with 4 previously reported cases. Its significance is uncertain. We report five patients with CD4+ DLBCL and one CD4+ primary mediastinal large B-cell lymphoma. Cases were identified by searching the electronic database of the department; each was reviewed. Average age was 56 years. Neoplastic cells expressed CD20(5/6 tested cases). BCL2/BCL6 expression were seen in 3/3 tested cases, suggesting a germinal center origin. Additionally, expression of T-cell antigens CD2 and CD5 was noted in 2/2 and CD7 in 1/1 tested case. CD3 was negative in all. Lymph nodes were commonly involved(67%). Patients received chemotherapy +/- radiation(6/6) and bone marrow transplant(2/6). Average survival was 44.2 mo. CD4 expression in DLBCL raises questions of lineage commitment. CD4+ DLBCL is rare; care should be exercised not to diagnose these as T-cell lymphomas. A subset behaves aggressively.
CD4 significance is not diffuse large B-cell lymphoma (DLBCL), with 4 previously reported cases. Its significance is uncertain. We report five patients with CD4 + DLBCL and one CD4 + primary mediastinal large B-cell lymphoma. Cases were identified by searching the Average age was 56 years. Neoplastic cells expressed CD20 (5/6 tested cases). BCL2 / BCL6 expression were seen in 3/3 tested cases, suggesting a germinal center origin. of T-cell antigens CD2 and CD5 was noted in 2/2 and CD7 in 1/1 tested case. CD3 was negative in all. Lymph nodes were commonly involved (67%). Patients received chemotherapy +/- radiation (6/6 ) and survival of bone marrow transplant (2/6). Average survival was 44.2 mo. CD4 expression in DLBCL raises questions of lineage commitment. CD4 + DLBCL is rare; care should be exercised not to diagnose these as T-cell lymphomas. A subset behaves aggressively .