Gray zone lymphoma (gray zone lymphoma, GZL) is a clinically rare special lymphoma, refers to the clinical and biological behavior between the two types of lymphoma, the classic gray area lymphoma, mainly between Hodgkin's lymphoma and diffuse large B-cell lymphoma, will now be a special type of diffuse large B-cell lymphoma and Burkett lymphoma characteristics also as a type of gray area lymphoma.
diagnosis depends on pathological examination, but there is no uniform standard.
the spectrum of lymphoma in gray areas is not yet clear, and the differences with Hodgkin's lymphoma and diffuse large B-cell lymphoma are largely unclear.
In this study, Sarkozy et al. studied 50 EBV-negative GZL and 20 EBV-positive polymorphic DLBCL NOS (Poly-EBV-L) code sequence mutations and compared them with classic Hodgkin's lymphoma (CHL), primary longitudinal large B-cell lymphoma (PMBCL) and diffuse large B-cell lymphoma (DLBCL).
Eloy all cases into two queues, 1) discovery queues: 21 cases of Poly-EBV-L patients and paired normal human exon sequences; 2) extended queues: 29 cases of GZL and 13 cases of 217 genes of PolyEBV-L targeted sequencing results.
GZL patients with small thymus biopsies in the study process had mutation characteristics similar to CHL and PMBCL, with the most common mutation genes being SOCS1 (45%), B2M (45%), TNFAIP3 (35%), GNA13 (35%), LRRN3 (32%) and NFKBIA (29%).
the mutation characteristics of thymus GZL and non-thymus GZL, GZL patients (18 cases) who are not affected by small thymus habitats have significantly different mutation patterns and are rich in apoptosis-related mutations (TP53, 39%,B CL2 (28 percent), BIRC6 (22 percent), and GNA13, XPO1, or NFKB signal path mutations (TNFAIP3, NFKBIE, IKBKB, NFKBIA) are missing.
with thymus GZL, these patients also carry more BCL2/BCL6 rearflying.
Poly-EBV-L cases showed significant mutation characteristics, including STAT3 mutations, which significantly reduced the coding mutation load compared to EBV-negative GZL.
the study highlighted the specific mutation patterns of GZL, which are associated with the stress of the thymus ecological level, suggesting that GZL may share an origin cell with pre-lymphoma.