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Radtke AJ, Roschewski M. The follicular lymphoma tumor microenvironment at single-cell and spatial resolution. Blood 2024; 143:1069-1079. [PMID: 38194685 PMCID: PMC11103101 DOI: 10.1182/blood.2023020999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/11/2024] Open
Abstract
ABSTRACT Follicular lymphoma (FL) is a generally incurable malignancy that originates from developmentally blocked germinal center B cells residing, primarily, within lymph nodes (LNs). During the long natural history of FL, malignant B cells often disseminate to multiple LNs and can affect virtually any organ. Nonmalignant LNs are highly organized structures distributed throughout the body, in which they perform functions critical for host defense. In FL, the malignant B cells "re-educate" the lymphoid environment by altering the phenotype, distribution, and abundance of other cells such as T cells, macrophages, and subsets of stromal cells. Consequently, dramatic anatomical changes occur and include alterations in the number, shape, and size of neoplastic follicles with an accompanying attenuation of the T-cell zone. Ongoing and dynamic interactions between FL B cells and the tumor microenvironment (TME) result in significant clinical heterogeneity observed both within and across patients. Over time, FL evolves into pathological variants associated with distinct outcomes, ranging from an indolent disease to more aggressive clinical courses with early death. Given the importance of both cell-intrinsic and -extrinsic factors in shaping disease progression and patient survival, comprehensive examination of FL tumors is critical. Here, we describe the cellular composition and architecture of normal and malignant human LNs and provide a broad overview of emerging technologies for deconstructing the FL TME at single-cell and spatial resolution. We additionally discuss the importance of capturing samples at landmark time points as well as longitudinally for clinical decision-making.
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Affiliation(s)
- Andrea J. Radtke
- Lymphocyte Biology Section and Center for Advanced Tissue Imaging, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Mark Roschewski
- Lymphoid Malignancies Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
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Khanlari M, Chapman JR. Follicular lymphoma: updates for pathologists. J Pathol Transl Med 2021; 56:1-15. [PMID: 34942689 PMCID: PMC8743801 DOI: 10.4132/jptm.2021.09.29] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022] Open
Abstract
Follicular lymphoma (FL) is the most common indolent B-cell lymphoma and originates from germinal center B-cells (centrocytes and centroblasts) of the lymphoid follicle. Tumorigenesis is believed to initiate early in precursor B-cells in the bone marrow (BM) that acquire the t(14;18)(q32;q21). These cells later migrate to lymph nodes to continue their maturation through the germinal center reaction, at which time they acquire additional genetic and epigeneticabnormalities that promote lymphomagenesis. FLs are heterogeneous in terms of their clinicopathologic features. Most FLs are indolent and clinically characterized by peripheral lymphadenopathy with involvement of the spleen, BM, and peripheral blood in a substantial subset of patients, sometimes accompanied by constitutional symptoms and laboratory abnormalities. Diagnosis is established by the histopathologic identification of a B-cell proliferation usually distributed in an at least partially follicular pattern, typically, but not always, in a lymph node biopsy. The B-cell proliferation is biologically of germinal center cell origin, thus shows an expression of germinal center-associated antigens as detected by immunophenotyping. Although many cases of FLs are typical and histopathologic features are straightforward, the biologic and histopathologic variability of FL is wide, and an accurate diagnosis of FL over this disease spectrum requires knowledge of morphologic variants that can mimic other lymphomas, and rarely non-hematologic malignancies, clinically unique variants, and pitfalls in the interpretation of ancillary studies. The overall survival for most patients is prolonged, but relapses are frequent. The treatment landscape in FL now includes the application of immunotherapy and targeted therapy in addition to chemotherapy.
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Affiliation(s)
- Mahsa Khanlari
- Department of Pathology and Hematopathology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Corresponding Author: Mahsa Khanlari, MD, Department of Pathology and Hematopathology, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA Tel: +1-901-595-0394, Fax: +1-901-595-3100, E-mail:
| | - Jennifer R. Chapman
- Department of Pathology, Division of Hematopathology, University of Miami, Sylvester Comprehensive Cancer Center, and Jackson Memorial Hospitals, Miami, FL, USA
- Corresponding Author: Jennifer R. Chapman, MD, Department of Pathology, University of Miami Hospital, 4th floor, room 4076, 1400 NW 12th Ave., Miami, FL 33138, USA Tel: +1-305-689-1332, E-mail:
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Tamber GS, Chévarie-Davis M, Warner M, Séguin C, Caron C, Michel RP. In situ follicular neoplasia: a clinicopathologic spectrum. Histopathology 2021; 79:1072-1086. [PMID: 34333806 DOI: 10.1111/his.14535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/18/2021] [Accepted: 07/30/2021] [Indexed: 11/28/2022]
Abstract
AIMS In situ follicular neoplasia (ISFN) occurs in ≈2-3% of reactive lymph nodes and is currently set apart from "partial involvement by follicular lymphoma" (PFL). ISFN can progress to overt lymphoma, but precise parameters to assess this risk and its association with related diseases remain incompletely understood. This study proposes to explore these parameters. METHODS AND RESULTS We reviewed 11 cases of ISFN and 1 of PFL between 2003 and 2018. Ten patients had ISFN in lymph nodes, one in the spleen. H&E and immunohistochemical stains were reviewed. Involvement of follicles by ISFN was scored using a 3-tier scheme. Of 5 cases with low ISFN scores, one had chronic myelomonocytic leukemia, one mycosis fungoides and three were free of hematopoietic diseases. Among them, 4 are alive and one was lost to follow-up. Of the 6 ISFN cases with high scores, 2 had concurrent marginal zone lymphomas, 1 concurrent diffuse large B-cell lymphoma (DLBCL), 1 Castleman-like disease, another progressive transformation of germinal centers with IgG4-related disease, and 1 no hematopoietic disease; all are alive except one who died of concurrent DLBCL. The patient with PFL developed DLBCL 7 years after diagnosis. CONCLUSIONS Based on this limited series, we conclude that only cases with high scores are associated with an overt lymphoma or an abnormal lymphoid process, and that scoring may be a useful parameter to assess risk for associated lymphoma, deserving further study. We also carried out a comprehensive review of the literature.
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Affiliation(s)
- Gurdip S Tamber
- Department of Pathology, McGill University, Montreal, QC, Canada
| | | | - Margaret Warner
- Division of Hematology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Chantal Séguin
- Division of Hematology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Carole Caron
- Department of Pathology, Hôtel Dieu D'Alma, Alma, QC, Canada
| | - René P Michel
- Department of Pathology, McGill University, Montreal, QC, Canada
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4
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Kim M, Hwang HS, Son EM, Cho H, Yoon DH, Suh C, Park CS, Go H, Huh J. Clinicopathological and prognostic significance of BCL2, BCL6, MYC, and IRF4 copy number gains and translocations in follicular lymphoma: a study by FISH analysis. Leuk Lymphoma 2020; 61:3342-3350. [PMID: 32921221 DOI: 10.1080/10428194.2020.1815017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BCL2 translocation is the genetic hallmark of follicular lymphoma (FL). Besides BCL2 translocation, copy number (CN) gains and translocations of BCL6, MYC, and IRF4 have also been detected in FL, but there is little information regarding their prognostic significance. This retrospective study used fluorescence in situ hybridization (FISH) to analyze BCL2, BCL6, MYC, and IRF4 translocations and CN gains in 105 FL cases. Genetic translocations were detected for BCL2 (n = 64; 72.7%), BCL6 (n = 14; 15.9%), and MYC (n = 2; 2.3%); no case showed IRF4 translocation. Overall, 23 (26.1%), 30 (34.1%), 12 (13.8%), and 10 (11.0%) cases showed CN gains in BCL2, BCL6, MYC, and IRF4, respectively. BCL6 CN gain was a prognostic factor for worse overall survival, demonstrating a trend toward significance in multivariate analysis (HR =8.769, p = 0.056). BCL6 CN gain in FL might be associated with aggressive biologic behavior.
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Affiliation(s)
- Meejeong Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Sang Hwang
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Mi Son
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyungwoo Cho
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Cheolwon Suh
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chan Sik Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Heounjeong Go
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jooryung Huh
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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5
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Szankasi P, Bolia A, Liew M, Schumacher JA, Gee EPS, Matynia AP, Li KD, Patel JL, Xu X, Salama ME, Kelley TW. Comprehensive detection of chromosomal translocations in lymphoproliferative disorders by massively parallel sequencing. J Hematop 2019. [DOI: 10.1007/s12308-019-00360-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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6
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Choi SM, Betz BL, Perry AM. Follicular Lymphoma Diagnostic Caveats and Updates. Arch Pathol Lab Med 2018; 142:1330-1340. [PMID: 30221980 DOI: 10.5858/arpa.2018-0217-ra] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Follicular lymphoma is a common small B-cell lymphoma, likely to be encountered by any practicing pathologist, regardless of specialty. Although the features of typical follicular lymphoma are well known and in most instances easily identifiable, there are lesser-appreciated morphologic appearances that can raise alternative diagnostic possibilities. The limited tissue available in core needle biopsies can make it additionally challenging to thoroughly evaluate those features in the context of architecture. Furthermore, ancillary testing including immunohistochemistry and molecular/genetic analysis do not always show classic findings and may pose additional challenges to interpretation. OBJECTIVES.— To review the morphologic features of follicular lymphoma with a discussion of morphologic variants and mimics; to discuss pitfalls of ancillary testing and provide the practicing pathologist with an appropriate context for interpretation of immunohistochemical and molecular/genetic studies when follicular lymphoma is part of the differential diagnosis; and to propose diagnostic strategies when there is limited tissue for evaluation. DATA SOURCES.— We used examples of follicular lymphoma from our institution as well as a review of the literature, with a focus on the diagnostic aspects that are broadly relevant to a general pathology practice. CONCLUSIONS.— Follicular lymphoma can occasionally present with atypical morphologic, immunohistochemical, or molecular/genetic features. In particular, those findings can be difficult to interpret in the setting of a limited tissue sample. Awareness of those possibilities will help guide the pathologist to a more accurate and precise diagnosis.
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Affiliation(s)
- Sarah M Choi
- From the Department of Pathology, University of Michigan, Ann Arbor
| | - Bryan L Betz
- From the Department of Pathology, University of Michigan, Ann Arbor
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7
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Sholl LM, Longtine J, Kuo FC. Molecular Analysis of Genetic Markers for Non-Hodgkin Lymphomas. CURRENT PROTOCOLS IN HUMAN GENETICS 2017; 93:10.14.1-10.14.29. [PMID: 28384399 DOI: 10.1002/cphg.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Molecular analysis complements the clinical and histopathologic tools used to diagnose and subclassify hematologic malignancies. The presence of clonal antigen-receptor gene rearrangements can help to confirm the diagnosis of a B or T cell lymphoma and can serve as a fingerprint of that neoplasm to be used in identifying concurrent disease at disparate sites or recurrence at future time points. Certain lymphoid malignancies harbor a characteristic chromosomal translocation, a finding that may have significant implications for an individual's prognosis or response to therapy. The polymerase chain reaction (PCR) is typically used to detect antigen-receptor gene rearrangements as well as specific translocations that can be supplemented by fluorescence in situ hybridization (FISH) and karyotype analysis. © 2017 by John Wiley & Sons, Inc.
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Affiliation(s)
| | | | - Frank C Kuo
- Brigham and Women's Hospital, Boston, Massachusetts
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8
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Li S, Jaye DL, Bradley KT, Zhang L, Saxe D, Deeb G, Hill CE, Mann KP. Multimodality Technologies in the Assessment of Hematolymphoid Neoplasms. Arch Pathol Lab Med 2017; 141:341-354. [DOI: 10.5858/arpa.2016-0260-sa] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Accurate assessment of tissues for hematolymphoid neoplasms requires an integrated multiparameter approach. Although morphologic examination by light microscopy remains the mainstay of initial assessment for hematolymphoid neoplasms, immunophenotypic analysis by immunohistochemistry and/or flow cytometry is essential to determine the pattern of differentiation and to detect minimal disease when morphology is inconclusive. In some cases, immunophenotypic analysis provides additional information for targeted immunotherapy and prognostication. Genotypic studies, including cytogenetics, fluorescence in situ hybridization, DNA microarray, polymerase chain reaction, and/or next-generation sequencing, are also imperative for subclassification of the genetically defined disease entities in the current World Health Organization classification of hematolymphoid neoplasms. Moreover, genotypic studies can establish clonality, stratify patients to determine appropriate treatment, and monitor patients for treatment response.
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Affiliation(s)
| | | | | | | | | | | | | | - Karen P. Mann
- From the Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
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9
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Ma ESK. Recurrent Cytogenetic Abnormalities in Non-Hodgkin's Lymphoma and Chronic Lymphocytic Leukemia. Methods Mol Biol 2017; 1541:279-293. [PMID: 27910030 DOI: 10.1007/978-1-4939-6703-2_22] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
Characteristic chromosomal translocations are found to be associated with subtypes of B-cell non-Hodgkin lymphoma (NHL), for example t(8;14)(q24;q32) and Burkitt lymphoma, t(14;18)(q32;q21) and follicular lymphoma, and t(11;14)(q13;q32) in mantle cell lymphoma. Only few recurrent cytogenetic aberrations have been identified in the T-cell NHL and the best known is the ALK gene translocation t(2;5)(p23;q35) in anaplastic large cell lymphoma. Since lymph node or other tissue is seldom submitted for conventional cytogenetics study, alternative approaches for translocation detection are polymerase chain reaction (PCR) or fluorescence in situ hybridization (FISH). FISH is more sensitive than PCR in the detection of lymphoma translocations since directly labeled large FISH probes that span the translocation breakpoints are used. Although the recurrent chromosomal abnormalities in NHL are not completely sensitive and specific for disease entities, unlike the scenario in acute leukemia, cytogenetic and molecular genetic study is commonly used to aid lymphoma diagnosis and classification. Currently, the main clinical utility is in the employment of interphase FISH panels to predict disease aggressiveness to guide therapy, for example identification of double-hit lymphoma, or in prognostication, for example risk-stratification in chronic lymphocytic leukemia. The recent application of high-throughput sequencing to NHL not only advances the understanding of disease pathogenesis and classification, but allows the discovery of new drug targets, such as BRAF gene inhibition in hairy cell leukemia. Coupled with the increasing availability of novel molecular targeted therapeutic agents, the hope for the future is to translate the genetics and genomics information to achieve personalized medicine in NHL.
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Affiliation(s)
- Edmond S K Ma
- Department of Pathology, Hong Kong Sanatorium & Hospital, 2 Village Road, Happy Valley, Hong Kong.
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10
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Park IJ, Bena J, Cotta CV, Hsi ED, Jegalian AG, Rogers HJ, Tubbs RR, Wang L, Cook JR. Frequency, interobserver reproducibility and clinical significance of equivocal peaks in PCR clonality testing using Euroclonality/BIOMED-2 primers. J Clin Pathol 2014; 67:1093-8. [PMID: 25244911 DOI: 10.1136/jclinpath-2014-202454] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS PCR studies for lymphoid clonality are now widely employed, especially using Euroclonality/BIOMED-2 primers. Criteria for interpretation as a clonal result, however, have proven controversial. This study examines the frequency and clinical significance of equivocal amplification patterns and measures the interobserver reproducibility of clonality interpretations. METHODS At our institution, results of each primer set are first classified as clonal, non-clonal or abnormal (equivocal peak on polyclonal background). Final results for all primer sets are then collectively reported as positive (≥1 clonal result), negative (non-clonal results) or indeterminate (≥1 abnormal result) for a clonal population. Results of 274 consecutive clonality cases were reviewed, and the interobserver reproducibility of individual primer set reactions and final results was determined in a subset of 30 cases. RESULTS 44/161 (27%) B-cell and 50/163 (31%) T-cell cases contained at least one abnormal peak. Of these, 29 (64%) and 31 (62%), respectively, showed clonal results in another primer set. Interobserver reproducibility was excellent for most primer sets and for final interpretations, but only fair to good for IGK V-J and TCRB D-J1+2 primer sets. A definitive diagnosis of lymphoma was rendered in 93%, 20% and 6% of B-cell cases and 90%, 42%, and 14% of T-cell cases positive, indeterminate or negative for a clonal population, respectively. CONCLUSIONS Using a subjective approach, abnormal (equivocal) peaks are frequently observed in routine practice. However, most cases with abnormal peaks contain clonal rearrangements in other primer sets, facilitating overall interpretation of final results with excellent interobserver reproducibility.
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Affiliation(s)
- Il Joong Park
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - James Bena
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Claudiu V Cotta
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Eric D Hsi
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Armin G Jegalian
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Heesun J Rogers
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Raymond R Tubbs
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Lu Wang
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - James R Cook
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA
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11
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Puiggros A, Venturas M, Salido M, Blanco G, Fernandez-Rodriguez C, Collado R, Valiente A, Ruiz-Xivillé N, Carrió A, Ortuño FJ, Luño E, Calasanz MJ, Ardanaz MT, Piñán MÁ, Talavera E, González MT, Ortega M, Marugán I, Ferrer A, Gimeno E, Bellosillo B, Delgado J, Hernández JÁ, Hernández-Rivas JM, Espinet B. Interstitial 13q14 deletions detected in the karyotype and translocations with concomitant deletion at 13q14 in chronic lymphocytic leukemia: different genetic mechanisms but equivalent poorer clinical outcome. Genes Chromosomes Cancer 2014; 53:788-97. [PMID: 24915757 DOI: 10.1002/gcc.22188] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 05/22/2014] [Accepted: 05/23/2014] [Indexed: 01/21/2023] Open
Abstract
Deletion of 13q14 as the sole abnormality is a good prognostic marker in chronic lymphocytic leukemia (CLL). Nonetheless, the prognostic value of reciprocal 13q14 translocations [t(13q)] with related 13q losses has not been fully elucidated. We described clinical and biological characteristics of 25 CLL patients with t(13q), and compared with 62 patients carrying interstitial del(13q) by conventional G-banding cytogenetics (CGC) [i-del(13q)] and 295 patients with del(13q) only detected by fluorescence in situ hybridization (FISH) [F-del(13q)]. Besides from the CLL FISH panel (D13S319, CEP12, ATM, TP53), we studied RB1 deletions in all t(13q) cases and a representative group of i-del(13q) and F-del(13q). We analyzed NOTCH1, SF3B1, and MYD88 mutations in t(13q) cases by Sanger sequencing. In all, 25 distinct t(13q) were described. All these cases showed D13S319 deletion while 32% also lost RB1. The median percentage of 13q-deleted nuclei did not differ from i-del(13q) patients (73% vs. 64%), but both were significantly higher than F-del(13q) (52%, P < 0.001). Moreover, t(13q) patients showed an increased incidence of biallelic del(13q) (52% vs. 11.3% and 14.9%, P < 0.001) and higher rates of concomitant 17p deletion (37.5% vs. 8.6% and 7.2%, P < 0.001). RB1 involvement was significantly higher in the i-del(13q) group (79%, P < 0.001). Two t(13q) patients (11.8%) carried NOTCH1 mutations. Time to first treatment in t(13q) and i-del(13q) was shorter than F-del(13q) (67, 44, and 137 months, P = 0.029), and preserved significance in the multivariate analysis. In conclusion, t(13q) and del(13q) patients detected by CGC constitute a subgroup within the 13q-deleted CLL patients associated with a worse clinical outcome.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Chromosome Aberrations
- Chromosome Deletion
- Chromosomes, Human, Pair 13/genetics
- Cohort Studies
- Female
- Humans
- Karyotype
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Myeloid Differentiation Factor 88/genetics
- Phosphoproteins/genetics
- Prognosis
- RNA Splicing Factors
- Receptor, Notch1/genetics
- Retinoblastoma Protein/genetics
- Ribonucleoprotein, U2 Small Nuclear/genetics
- Translocation, Genetic
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Affiliation(s)
- Anna Puiggros
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, Spain; Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Res Program, IMIM-Hospital del Mar, Barcelona, Spain
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12
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Chromosomal anomalies in primary cutaneous follicle center cell lymphoma do not portend a poor prognosis. J Am Acad Dermatol 2014; 70:1010-20. [DOI: 10.1016/j.jaad.2014.01.862] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 12/16/2013] [Accepted: 01/09/2014] [Indexed: 12/22/2022]
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13
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Argyris PP, Dolan M, Piperi E, Tosios KI, Pambuccian SE, Koutlas IG. Oral follicular lymphomas. A short report of 8 cases with assessment of the IGH/BCL2 gene fusion with fluorescence in situ hybridization. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:343-7. [PMID: 23953419 DOI: 10.1016/j.oooo.2013.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 06/11/2013] [Accepted: 06/14/2013] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To present the clinicopathologic features and confirm the presence of the IGH/BCL2 gene fusion in an oral follicular lymphoma (OFL) series. STUDY DESIGN Cases of OFLs were retrieved from a data base of non-Hodgkin lymphomas (NHL). Fluorescence in situ hybridization (FISH) was performed to confirm the IGH/BCL2 fusion. RESULTS Eight (8.7%) of 92 NHL were OFLs. Six (75%) patients were male and two female (mean age: 73.4 ± 14.8). The most frequent site was the palate. Five of the 8 patients are alive and without disease. Five (three grade 1 and two grade 2) of six successfully hybridized cases revealed the IGH/BCL2 gene fusion. The sixth case, a grade 3 follicular lymphoma (FL), demonstrated multiple BCL2 signals without IGH/BCL2 fusion. CONCLUSIONS OFLs exhibit an indolent clinical behavior. In the present study, 5/6 cases in which FISH was successful had an IGH/BCL2 fusion as would result from the t(14; 18)(q32; q21) translocation commonly seen in FL of extraoral sites.
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Affiliation(s)
- Prokopios P Argyris
- Department of Oral Pathology and Medicine, School of Dentistry, National and Kapodistrian University of Athens, Greece
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14
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Chang ST, Lu YH, Lu CL, Kuo SY, Liu H, Lin SH, Win KT, Hsieh YC, Chuang SS. Follicular lymphoma in Taiwan: a low frequency of t(14;18), with grade 3A tumours more closely related to grade 3B than to low-grade tumours. Histopathology 2013; 63:1-12. [DOI: 10.1111/his.12119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 02/23/2013] [Indexed: 12/31/2022]
Affiliation(s)
| | - Yi-Hsuan Lu
- Department of Radiology; Liouying Chi Mei Hospital; Tainan; Taiwan
| | - Chin-Li Lu
- Department of Medical Research; Chi-Mei Medical Centre; Tainan; Taiwan
| | - Szu-Yin Kuo
- Department of Pathology; Chi-Mei Medical Centre; Tainan; Taiwan
| | - Hongxiang Liu
- Molecular Malignancy Laboratory; Department of Histopathology; Addenbrooke's Hospital; Cambridge University Hospitals NHS Foundation Trust; Cambridge; UK
| | - Shu-Hui Lin
- Department of Pathology; Chi-Mei Medical Centre; Tainan; Taiwan
| | - Khin Than Win
- Department of Pathology; Chi-Mei Medical Centre; Tainan; Taiwan
| | - Yen-Chuan Hsieh
- Department of Pathology; Chi-Mei Medical Centre; Tainan; Taiwan
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15
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Swerdlow SH. Lymphoma classification and the tools of our trade: an introduction to the 2012 USCAP Long Course. Mod Pathol 2013; 26 Suppl 1:S1-S14. [PMID: 23281432 DOI: 10.1038/modpathol.2012.177] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The 2012 USCAP Long Course 'Malignant Lymphomas-Building on the Past, Moving to the Future' began with an introduction to lymphoma classification over the last half century and a discussion of our current diagnostic armamentarium, together with a look toward the future. The Rappaport classification, originally published in 1956, was a morphologic classification with few categories. The early 1970s saw a great and tumultuous revolution in the field with the publication of two functional lymphoma classifications that related the malignant lymphomas to the cells of the normal immune system-the Lukes/Collins classification from the United States and the Kiel classification from Professor Lennert and the European Lymphoma Club. With discord abounding, the NCI working formulation, published in 1982, satisfied some but was a step back to a morphologic-based classification. In 1994, the International Lymphoma Study Group published the REAL classification, which reflected state-of-the-art practice for that time, and was shortly followed by preparations for the modern World Health Organization (WHO) classification published in 2001 and revised in 2008. The WHO classification, created by hematopathologists working with the advice and consent of clinical hematologist/oncologists, recognizes numerous distinct entities, defined based on their histopathological, immunophenotypical, molecular/cytogenetic and clinical features. The classification requires use of a multiparameter approach to lymphoma diagnosis although we still rely heavily on histopathology. Immunophenotypical studies, whether using paraffin section immunohistochemistry and/or flow cytometry, are also critical in almost all circumstances. Molecular/cytogenetic techniques that are constantly changing have an increasingly important role, even if not always required. The full impact of next-generation sequencing is yet to be felt but we are beginning to catch a glimpse of what is in our future. Finally, one must not forget the great importance of clinical data in arriving at a diagnosis that best serves the patient, our ultimate goal.
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Affiliation(s)
- Steven H Swerdlow
- Division of Hematopathology, Department of Pathology, UPMC Health System-UPMC Presbyterian, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
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16
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Abstract
The small B-cell neoplasms represent some of the most frequently encountered lymphoproliferative disorders in routine surgical pathology practice. This report reviews the current diagnostic criteria for classifying small B-cell neoplasms and distinguishing them from newly recognized precursor conditions that do not appear to represent overt lymphomas. Newly available immunohistochemical stains and molecular studies that may assist in the diagnosis and classification of these neoplasms are also discussed.
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Affiliation(s)
- James R Cook
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA.
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17
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Yoshida M, Ichikawa A, Miyoshi H, Takeuchi M, Kimura Y, Nino D, Ohshima K. High frequency of t(14;18) in Hodgkin's lymphoma associated with follicular lymphoma. Pathol Int 2012; 62:518-24. [PMID: 22827759 DOI: 10.1111/j.1440-1827.2012.02835.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
t(14;18) is a common cytogenetic abnormality in B-cell lymphoma, especially in follicular lymphoma (FL), but is rarely seen in Hodgkin's lymphoma (HL). However, due to the small number of cases, the incidence of t(14;18) in HL associated with FL remains unclear. In this study, we applied chromogenic in situ hybridization and fluorescence in situ hybridization for t(14;18) on paraffin-embedded tissue from four HL associated with FL cases and 11 HL cases without a history of FL for comparison. t(14;18) was present in all of the three successfully-tested HL associated with FL cases and one case without a history of FL. The frequency of t(14;18) was significantly high in HL associated with FL (p = 0.013). All Hodgkin's and Reed-Sternberg (HRS) cells having t(14;18) showed immunoreactivity for BCL2 and were negatively stained for nuclear factor-κB (NF-κB), even in Epstein-Barr virus (EBV)-infected cases. However, HRS cells without t(14;18) showed BCL2 and NF-κB immunoreactivity in 33% and 57% of cases, respectively. There was an inverse correlation between t(14;18) and NF-κB. In conclusion, we assume the incidence of t(14;18) in HL associated with FL is higher than previously believed and BCL2 expression derived from t(14;18) may play a role in the pathogenesis of HL associated with FL.
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Affiliation(s)
- Maki Yoshida
- Department of Pathology, School of Medicine, Kurume University, Kurume city, Fukuoka, Japan.
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18
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Yamamoto K, Okamura A, Inui Y, Yakushijin K, Murayama T, Matsuoka H, Minami H. Cryptic insertion of BCL2 gene into immunoglobulin heavy locus in follicular lymphoma with t(6;9)(p23;p13). Leuk Res 2012; 36:e202-5. [PMID: 22658849 DOI: 10.1016/j.leukres.2012.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 05/03/2012] [Accepted: 05/08/2012] [Indexed: 11/26/2022]
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19
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Selvi N, Kosova B, Hekimgil M, Gündüz C, Kaymaz BT, Karaca E, Saydam G, Tombuloğlu M, Büyükkeçeci F, Cağırgan S, Ertan Y, Topçuoğlu N. Molecular Evaluation of t(14;18)(bcl-2/IgH) Translocation in Follicular Lymphoma at Diagnosis Using Paraffin-Embedded Tissue Sections. Turk J Haematol 2012; 29:126-34. [PMID: 24744643 PMCID: PMC3986950 DOI: 10.5505/tjh.2012.93898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 03/05/2011] [Indexed: 12/05/2022] Open
Abstract
Objective: Follicular lymphoma (FL) is one of the most common lymphomas, and is characterized by t(14;18)(q32;q21) in more than 80% of patients. The aim of this study was to determine the rate of t(14;18) positivity based onthe detection of mbr or mcr in paraffin-embedded tissue samples. Material and Methods: The study included 32 paraffin-embedded tissue samples collected from 32 consecutive FL patients that were diagnosed and followed-up at our hospital between 1999 and 2006. The MBR breakpoint wasidentified based on real-time PCR using a LightCycler v.2.0 t(14;18) Quantification Kit (MBR), multiplex PCR, and seminestedPCR. To identify the mcr breakpoint, real-time PCR was performed using specific primers and the FastStart DNAMaster SYBR Green I Kit. To detect t(14;18) via fluorescence in situ hybridization (FISH) nuclei from paraffin-embeddedtissue sections were extracted and used together with LSI IgH (immunoglobulin heavy chain) (spectrum green)/bcl-2(B-cell leukemia-lymphoma 2) (spectrum orange) probes. Results: The DNA and nuclei isolation success rate for B5 formalin-fixed, paraffin-embedded tissue sections (n = 12)was 42% and 33%, respectively, versus 95% and 60%, respectively, for 20 tissue sections fixed in formalin only. In all,24 paraffin-embedded tissue sections were analyzed and mbr positivity was observed in the DNA of 82.14% via seminested PCR, in 53.57% via multiplex PCR, and in 28.57% via real-time PCR. We did not detect mcr rearrangementin any of the samples. In all, 15 of 16 patients (93.75%) whose nuclei were successfully isolated were observed to bet(14;18) positive via the FISH method. Conclusion: Semi-nested PCR and FISH facilitated the genetic characterization of FL tumors. As such, FISH and PCR complement each other and are both essential for detecting t(14;18) translocation.
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Affiliation(s)
- Nur Selvi
- Ege University, School of Medicine, Medical Biology Department, İzmir, Turkey
| | - Buket Kosova
- Ege University, School of Medicine, Medical Biology Department, İzmir, Turkey
| | - Mine Hekimgil
- Ege University, School of Medicine, Pathology Department, İzmir, Turkey
| | - Cumhur Gündüz
- Ege University, School of Medicine, Medical Biology Department, İzmir, Turkey
| | | | - Emin Karaca
- Ege University, School of Medicine, Medical Genetics Department, İzmir, Turkey
| | - Güray Saydam
- Ege University, School of Medicine, Hematology Department, İzmir, Turkey
| | - Murat Tombuloğlu
- Ege University, School of Medicine, Hematology Department, İzmir, Turkey
| | - Filiz Büyükkeçeci
- Ege University, School of Medicine, Hematology Department, İzmir, Turkey
| | - Seçkin Cağırgan
- Ege University, School of Medicine, Hematology Department, İzmir, Turkey
| | - Yeşim Ertan
- Ege University, School of Medicine, Pathology Department, İzmir, Turkey
| | - Nejat Topçuoğlu
- Ege University, School of Medicine, Medical Biology Department, İzmir, Turkey
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20
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Abstract
Abstract
A plethora of genetic abnormalities has been described in B-cell lymphomas, some of which arise when physiologic mechanisms involved in the generation of immunologic diversity go awry. Several different lymphoma types, such as follicular lymphoma (FL), mantle cell lymphoma (MCL), and Burkitt lymphoma (BL), are associated with hallmark translocations that occur as a consequence of these errors (t(14;18)(q32;q21), t(11;14)(q13;q32), and t(8;14)(q24;q32), respectively); however, none of these associations is absolute and none is completely diagnostically specific or sensitive. The advantages and limitations of a variety of different testing strategies in the 2 most common lymphomas, FL and diffuse large B-cell lymphoma (DLBCL), are reviewed herein, including an evaluation of the role of PCR-based approaches, FISH, and more nascent genomic technologies. The use of immunophenotypic strategies that may potentially provide, albeit imperfectly, more user-friendly surrogates for underlying genetic aberrations and cell-of-origin designations derived from gene-expression profiling analyses are also discussed. Finally, a newly designated category of lymphoma with features intermediate between DLBCL and BL is appraised, highlighting the central role of genetic analysis in this diagnostic gray zone.
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21
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Spence JM, Rothberg PG, Wang N, Burack WR. Demonstration of array-based analysis for highly multiplexed PCR assays application to detection of IGH@-BCL2 translocations in FFPE follicular lymphoma specimens. J Mol Diagn 2011; 13:252-62. [PMID: 21497287 DOI: 10.1016/j.jmoldx.2010.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 11/10/2010] [Accepted: 11/20/2010] [Indexed: 11/30/2022] Open
Abstract
We demonstrate an approach that allowed rapid development of a robust assay for the detection of chromosomal translocations. The method includes highly multiplexed PCR with analysis of the PCR products performed by array detection. As proof of principle, we applied this approach to the detection of IGH@-BCL2 translocations in DNA prepared from FFPE specimens. This translocation and specimen type were chosen because of the known difficulties associated with PCR-based detection of this lesion and the additional loss of sensitivity associated with FFPE samples. The multiplex PCR with array detection method detected the IGH@-BCL2 translocation in 26 of 36 FFPE follicular lymphoma specimens, whereas the BIOMED-2 assay detected 13 of 36 specimens. This increased sensitivity was the result of both the increased density of BCL2 primers and identification of PCR products by low-density array. The method was specific and allowed mapping of the BCL2 break point in all cases. The method detected the IGH@-BCL2 lesion when the tumor DNA was diluted more than 1:20 in normal DNA but not when it was diluted more than 1:100. This sensitivity allows detection of diagnostically relevant levels of IGH@-BCL2 but will not detect the rare cells with IGH@-BCL2 translocations in healthy individuals.
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Affiliation(s)
- Janice M Spence
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA
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22
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Piccaluga PP, Sapienza MR, Agostinelli C, Sagramoso C, Mannu C, Sabattini E, Zinzani PL, Pileri SA. Biology and treatment of follicular lymphoma. Expert Rev Hematol 2011; 2:533-47. [PMID: 21083019 DOI: 10.1586/ehm.09.49] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Follicular lymphoma (FL) is the second most common lymphoid tumor. It is composed of elements resembling those of normal germinal centers. In particular, it is constituted by small centrocytes and large centroblasts, typically CD10+, CD19+, CD20+, CD79a+ and BCL6+, with follicular growth pattern. The molecular hallmark of FL is the t(14;18)(q32;q21) translocation, which leads to inappropriate BCL2 expression. This feature, other than representing a pathogenetic primary event, constitutes a suitable diagnostic marker, as well as a target for minimal residual disease monitoring and, hopefully, future therapies. Clinically, FL presents with indolent behavior, characterized by prompt response to initial therapy but almost invariably subsequent relapses. Novel approaches, including stem cell transplantation, monoclonal antibodies and innovative agents, should be then considered for improving long-term results.
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Affiliation(s)
- Pier Paolo Piccaluga
- Molecular Pathology Laboratory, Hematopathology Unit, Department of Hematology and Oncological Sciences L and A Seràgnoli, S Orsola Malpighi Hospital, University of Bologna, Via Massarenti 9, Bologna, Italy.
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23
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Wilkins BS. Pitfalls in lymphoma pathology: avoiding errors in diagnosis of lymphoid tissues. J Clin Pathol 2011; 64:466-76. [PMID: 21325143 DOI: 10.1136/jcp.2010.080846] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The complexity involved in the histological interpretation of lymph nodes and other lymphoid tissue specimens suspected of harbouring lymphoma is underappreciated. As with other histology specimens, the quality of sections and background information are crucial but so, increasingly, is the appropriate use of immunocytochemistry and a variety of molecular analyses. Within the UK National Health Service, progressive regional centralisation is ongoing, to ensure access to specialist expertise and a full range of testing beyond traditional stains. This is to be welcomed but there remains a need to maintain skills in smaller district hospitals, to ensure lymphoma recognition in unexpected circumstances, to permit clinically useful interim diagnoses when needed urgently and to sustain training in haematopathology among junior pathologists. In this review a range of potential pitfalls in lymphoid tissue pathology is outlined, arising at all stages from specimen preparation to reporting. Knowledge of such pitfalls, some of which are common while others are rare but of vital clinical importance, should help increase confidence in lymphoma diagnosis among histopathologists.
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Affiliation(s)
- Bridget S Wilkins
- Histopathology Department, Second Floor, North Wing, St Thomas' Hospital and King's College, London SE1 7EH, UK.
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24
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Baró C, Espinet B, Salido M, García M, Sánchez B, Florensa L, Bellosillo B, Serrano S, Solé F. Cryptic IGH/BCL2 rearrangements with variant FISH patterns in follicular lymphoma. Leuk Res 2010; 35:256-9. [PMID: 20952062 DOI: 10.1016/j.leukres.2010.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 07/16/2010] [Accepted: 09/16/2010] [Indexed: 11/18/2022]
Abstract
Follicular lymphoma (FL) is one of the most common non-Hodgkin lymphomas (NHL). Translocation t(14;18)(q32;q21) involving IGH and BCL2 genes represents its genetic hallmark. We present six cases of a series of 75 well diagnosed FL patients in which variant fluorescence in situ hybridization (FISH) patterns for this rearrangement were found. Moreover, G-banding cytogenetics and polymerase chain reaction (PCR) methods were unable to detect t(14;18)(q32;q21). According to our results, FISH is the best technique to define variant rearrangements of IGH/BCL2 genes and is important to detect it in cases with non-conclusive FL characteristics to avoid misdiagnosis with other NHL.
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Affiliation(s)
- Cristina Baró
- Laboratori de Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Parc de Salut Mar, GRETNHE, IMIM-Hospital del Mar, Barcelona, Spain
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25
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Sholl LM, Longtine J. Molecular analysis of genetic markers for non-Hodgkin lymphomas. CURRENT PROTOCOLS IN HUMAN GENETICS 2010; Chapter 10:Unit 10.14.1-25. [PMID: 20373512 DOI: 10.1002/0471142905.hg1014s65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Molecular analysis complements the clinical and histopathologic tools used to diagnose and subclassify hematologic malignancies. The presence of clonal antigen-receptor gene rearrangements can help to confirm the diagnosis of a B or T cell lymphoma and can serve as a fingerprint of that neoplasm to be used in identifying concurrent disease at disparate sites or recurrence at future time points. Certain lymphoid malignancies harbor a characteristic chromosomal translocation, a finding that may have significant implications for an individual's prognosis or response to therapy. The polymerase chain reaction (PCR) is typically used to detect antigen-receptor gene rearrangements as well as specific translocations that can be supplemented by fluorescence in situ hybridization (FISH) and karyotype analysis.
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26
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Talaulikar D, Shadbolt B, Dahlstrom JE, McDonald A. Routine use of ancillary investigations in staging diffuse large B-cell lymphoma improves the International Prognostic Index (IPI). J Hematol Oncol 2009; 2:49. [PMID: 19930611 PMCID: PMC2786909 DOI: 10.1186/1756-8722-2-49] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Accepted: 11/22/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The International Prognostic Index (IPI) is used to determine prognosis in diffuse large B-cell lymphoma (DLBCL). One of the determinants of IPI is the stage of disease with bone marrow involvement being classified as stage IV. For the IPI, involvement on bone marrow is traditionally defined on the basis of histology with ancillary investigations used only in difficult cases to aid histological diagnosis. This study aimed to determine the effect of the routine use of flow cytometry, immunohistochemistry and molecular studies in bone marrow staging upon the IPI. RESULTS Bone marrow trephines of 156 histologically proven DLBCL cases at initial diagnosis were assessed on routine histology, and immunohistochemistry using two T-cell markers (CD45RO and CD3), two B-cell markers (CD20 and CD79a) and kappa and lambda light chains. Raw flow cytometry data on all samples were reanalysed and reinterpreted blindly. DNA extracted from archived paraffin-embedded trephine biopsy samples was used for immunoglobulin heavy chain and light chain gene rearrangement analysis. Using immunophenotyping (flow cytometry and immunohistochemistry), 30 (19.2%) cases were upstaged to stage IV. A further 8 (5.1%) cases were upstaged using molecular studies. A change in IPI was noted in 18 cases (11.5%) on immunophenotyping alone, and 22 (14.1%) cases on immunophenotyping and molecular testing. Comparison of two revised IPI models, 1) using immunophenotyping alone, and 2) using immunophenotyping with molecular studies, was performed with baseline IPI using a Cox regression model. It showed that the revised IPI model using immunophenotyping provides the best differentiation between the IPI categories. CONCLUSION Improved bone marrow staging using flow cytometry and immunohistochemistry improves the predictive value of the IPI in patients with DLBCL and should be performed routinely in all cases.
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Affiliation(s)
- Dipti Talaulikar
- Department of Haematology, The Canberra Hospital, Yamba Drive, Garran, Canberra, ACT, 2605, Australia
- Australian National University Medical School, Yamba Drive, Garran, Canberra, ACT, 2605, Australia
| | - Bruce Shadbolt
- Australian National University Medical School, Yamba Drive, Garran, Canberra, ACT, 2605, Australia
- Department of Epidemiology, The Canberra Hospital, Yamba Drive, Garran, Canberra, ACT, 2605, Australia
| | - Jane E Dahlstrom
- Australian National University Medical School, Yamba Drive, Garran, Canberra, ACT, 2605, Australia
- Department of Anatomical Pathology, The Canberra Hospital, Yamba Drive, Garran, Canberra, ACT, 2605, Australia
| | - Anne McDonald
- National Capital Private Hospital, Yamba Drive, Garran, Canberra, ACT, 2605, Australia
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27
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Chang CM, Schroeder JC, Huang WY, Dunphy CH, Baric RS, Olshan AF, Dorsey KC, Dent GA, Cerhan JR, Lynch CF, Rothman N, Cantor KP, Blair A. Non-Hodgkin lymphoma (NHL) subtypes defined by common translocations: utility of fluorescence in situ hybridization (FISH) in a case-control study. Leuk Res 2009; 34:190-5. [PMID: 19505720 DOI: 10.1016/j.leukres.2009.05.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 05/07/2009] [Accepted: 05/12/2009] [Indexed: 11/19/2022]
Abstract
We used fluorescence in situ hybridization (FISH) assays to identify t(14;18) translocations in archival paraffin-embedded tumor sections from non-Hodgkin lymphoma (NHL) cases enrolled in a population-based study. t(14;18) was identified in 54% of 152 cases, including 39% of diffuse large cell lymphomas (26 of 66 cases) and 84% of follicular lymphomas (36 of 43 cases). Eighty-seven percent of t(14;18)-positive cases and 57% of t(14;18)-negative cases expressed bcl-2. FISH assays detected twice as many t(14;18)-positive follicular lymphomas as PCR assays. Overall, study findings support the use of FISH assays to detect t(14;18) in archival tumor samples for epidemiologic studies of NHL subtypes.
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MESH Headings
- Case-Control Studies
- Chromosomes, Human, Pair 14
- Chromosomes, Human, Pair 18
- Humans
- In Situ Hybridization, Fluorescence/methods
- In Situ Hybridization, Fluorescence/standards
- Lymphoma, Follicular/genetics
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Non-Hodgkin/classification
- Lymphoma, Non-Hodgkin/genetics
- Proto-Oncogene Proteins c-bcl-2/analysis
- Translocation, Genetic
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Affiliation(s)
- Cindy M Chang
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Blvd., EPS 7074, Rockville, MD 20892, USA.
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