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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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2
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Alnoor FNU, Gandhi JS, Stein MK, Solares J, Gradowski JF. Prevalence of Lymphoid Neoplasia in a Retrospective Analysis of Warthin Tumor: A Single Institution Experience. Head Neck Pathol 2020; 14:944-950. [PMID: 32328910 PMCID: PMC7669968 DOI: 10.1007/s12105-020-01161-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/09/2020] [Indexed: 02/06/2023]
Abstract
Warthin tumor is one of the most common benign salivary gland tumors. Overt lymphoma is known to occur in the lymphoid stroma of Warthin tumor. In situ follicular neoplasia is difficult to identify in routine histologic examination of lymphoid tissue and has not been reported in association with Warthin tumor. Our objective is to determine the prevalence of overt malignant lymphoma and in situ follicular neoplasia in Warthin tumor. We conducted a retrospective histological evaluation of 89 sequential Warthin tumor cases with available slides and blocks from the years 2010-2019. Of these, 84 cases were subjected to immunohistochemical testing, while 5 cases had been previously worked up for the suspicion of lymphoma. We identified two additional cases of lymphoid neoplasia associated with Warthin tumor including small lymphocytic lymphoma/chronic lymphocytic leukemia (n = 1) and in situ follicular neoplasia (n = 1) in addition to previously reported case of follicular lymphoma included in this study. The prevalence rate of first-time detected lymphoid neoplasia in Warthin tumor is 3.4%. The prevalence rate of overt lymphoma is 2.2%, while the prevalence of in situ follicular neoplasia is 1.1%. We propose histologic criteria to identify small lymphocytic lymphoma and follicular lymphoma in Warthin tumor. These include a monotonous interfollicular expansion of small lymphocytes and germinal centers composed of a monotonous population of lymphocytes without polarity or tingible body macrophages respectively. It is very important for pathologists to perform a diligent morphological examination and perform immunohistochemistry in suspected cases to identify subtle involvement of Warthin tumor by lymphoma. In patients with involvement of Warthin tumor by in situ follicular neoplasia, concurrent lymphoma in the same tissue and other sites should be considered. Patients without overt lymphoma elsewhere likely have a low risk of progression to follicular lymphoma. The low prevalence of in situ follicular neoplasia in Warthin tumor, combined with the low rate of clinical progression to lymphoma, make routine screening of Warthin tumor for in situ follicular neoplasia unnecessary.
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Affiliation(s)
- F. N. U. Alnoor
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN USA
| | - Jatin S. Gandhi
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN USA
| | - Matthew K. Stein
- Division of Hematology and Oncology, University of Tennessee Health Science Center, Memphis, TN USA
| | - Jorge Solares
- Department of Pathology and Laboratory Medicine, Methodist University Hospital, Memphis, TN USA
| | - Joel F. Gradowski
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN USA ,Department of Pathology and Laboratory Medicine, Methodist University Hospital, Memphis, TN USA ,Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Methodist University Hospital, 1265 Union Ave, 6th Floor Sherard, Suite 621, Memphis, TN 38104 USA
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3
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Ogata S, Miyoshi H, Arakawa F, Shimono J, Yamada K, Yanagida E, Nambu M, Iwashita A, Haraoka S, Ohshima K. Clinicopathological features of in situ follicular neoplasm and relations with follicular lymphoma in Japan. Ann Hematol 2020; 99:241-253. [PMID: 31897674 DOI: 10.1007/s00277-019-03841-5] [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] [Received: 07/15/2019] [Accepted: 11/05/2019] [Indexed: 11/29/2022]
Abstract
This study aims to investigate the clinicopathological features of in situ follicular neoplasm (ISFN) in Japan. ISFN is a rare condition formerly considered as an early precursor of follicular lymphoma (FL). This is a first original report of ISFN from Asian country. We reviewed 19 biopsy samples of ISFN. ISFNs were categorized into two groups: (1) ISFN, consisting of ISFN with strong positivity for BCL-2 immunohistochemical staining (IHC), and obvious translocation of BCL-2; and (2) ISFN-like FL, featuring cases without obvious translocation but having morphological features and characteristic IHC findings of ISFN. As control, we adopted obvious FL. For some cases showing coexisting ISFN and FL lesions in the same lymph node, we could conduct further clonality analysis for each lesion. Nine of the 19 cases of ISFN coexisted with FL or had a history of overt B- or T-cell lymphoma including FL. Statistical comparison among ISFN-like FL and FL showed no significant differences in pathological features. Molecular analysis suggested that ISFN lesion and FL lesion in the same lymph node each have a different clonality. ISFN coexists or associates with other overt lymphomas frequently.
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Affiliation(s)
- Satoko Ogata
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan.,Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan.
| | - Fumiko Arakawa
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Joji Shimono
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Eriko Yanagida
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Masami Nambu
- Department of Medical Technology, Kumamoto Health Science University, Kumamoto, Japan
| | - Akinori Iwashita
- Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Seiji Haraoka
- Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
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4
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Marchetti L, Perrucci L, D'Ercole F, Zatelli MC, Ambrosio MR, Giganti M, Carnevale A. Neck paraganglioma and follicular lymphoma: a case report. J Med Case Rep 2019; 13:376. [PMID: 31856921 PMCID: PMC6924013 DOI: 10.1186/s13256-019-2323-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 11/21/2019] [Indexed: 12/17/2022] Open
Abstract
Background Paragangliomas and pheochromocytomas are sympathetic or parasympathetic tumors derived from the paraganglia and the adrenal medulla, respectively. Paragangliomas and pheochromocytomas can be sporadic or familial, the latter frequently being multifocal and possibly due to succinate dehydrogenase complex genes mutations. In addition, 12% of sporadic paragangliomas are related to covered succinate dehydrogenase complex mutations. The importance of identifying succinate dehydrogenase complex mutations is related to the risk for these patients of developing multiple tumors, including non-endocrine ones, showing an aggressive clinical presentation. Case presentation We report the case of a 45-year-old Caucasian man with an indolent mass in his neck. Ultrasound of his neck, magnetic resonance imaging, and 1,4,7,10-tetraazacyclododecane-N(I),N(II),N(III),N(IIII)-tetraacetic acid(D)-Phe(1)-thy(3)-octreotide (68Ga-DOTATOC) positron emission tomography-computed tomography and endocrine work-up were consistent with a carotid body paraganglioma with concomitant nodal enlargement in several body regions, which turned out to be a follicular lymphoma at histology. He was found to carry a germline Succinate dehydrogenase subunit B gene (SDHB) mutation. Conclusion It is crucial to look for a second malignancy in the case of a paraganglioma demonstrating succinate dehydrogenase complex germline mutations.
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Affiliation(s)
- Lara Marchetti
- Department of Interventional and Diagnostic Radiology, Arcispedale Sant'Anna, Ferrara, Italy
| | - Luca Perrucci
- Section of Diagnostic Imaging, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy. .,University Radiology Unit, Radiology Department, Sant'Anna University Hospital, Ferrara, Italy.
| | - Francesca D'Ercole
- Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria Chiara Zatelli
- Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria Rosaria Ambrosio
- Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Melchiore Giganti
- Section of Diagnostic Imaging, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Aldo Carnevale
- University Radiology Unit, Radiology Department, Sant'Anna University Hospital, Ferrara, Italy
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5
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Carbone A, Roulland S, Gloghini A, Younes A, von Keudell G, López-Guillermo A, Fitzgibbon J. Follicular lymphoma. Nat Rev Dis Primers 2019; 5:83. [PMID: 31831752 DOI: 10.1038/s41572-019-0132-x] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2019] [Indexed: 12/12/2022]
Abstract
Follicular lymphoma (FL) is a systemic neoplasm of the lymphoid tissue displaying germinal centre (GC) B cell differentiation. FL represents ~5% of all haematological neoplasms and ~20-25% of all new non-Hodgkin lymphoma diagnoses in western countries. Tumorigenesis starts in precursor B cells and becomes full-blown tumour when the cells reach the GC maturation step. FL is preceded by an asymptomatic preclinical phase in which premalignant B cells carrying a t(14;18) chromosomal translocation accumulate additional genetic alterations, although not all of these cells progress to the tumour phase. FL is an indolent lymphoma with largely favourable outcomes, although a fraction of patients is at risk of disease progression and adverse outcomes. Outcomes for FL in the rituximab era are encouraging, with ~80% of patients having an overall survival of >10 years. Patients with relapsed FL have a wide range of treatment options, including several chemoimmunotherapy regimens, phosphoinositide 3-kinase inhibitors, and lenalidomide plus rituximab. Promising new treatment approaches include epigenetic therapeutics and immune approaches such as chimeric antigen receptor T cell therapy. The identification of patients at high risk who require alternative therapies to the current standard of care is a growing need that will help direct clinical trial research. This Primer discusses the epidemiology of FL, its molecular and cellular pathogenesis and its diagnosis, classification and treatment.
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Affiliation(s)
- Antonino Carbone
- Centro di Riferimento Oncologico di Aviano IRCCS, Aviano, Italy.
| | - Sandrine Roulland
- Aix Marseille University, CNRS, INSERM, Centre d'Immunologie de Marseille-Luminy, Marseille, France
| | - Annunziata Gloghini
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Anas Younes
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Jude Fitzgibbon
- Barts Cancer Institute, Queen Mary University of London, London, UK
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6
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Pirozzi A, Cartenì G, Scagliarini S, Fusco M, Riccardi F. Incidental finding of non-Hodgkin's lymphoma in a patient affected by castration-sensitive prostate cancer: A case report. Medicine (Baltimore) 2019; 98:e14805. [PMID: 30882658 PMCID: PMC6426560 DOI: 10.1097/md.0000000000014805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
RATIONALE This article describes the case of a patient with 2 simultaneous malignant diseases: Follicular lymphoma and 'castration sensitive prostate cancer. Patients with multiple cancers are not easy to manage and it is difficult to find the appropriate approach and resources to use with them. We focused our attention on how to choose the correct strategy to face 2 different neoplasms and control the adverse reactions related to the corresponding treatments. PATIENT CONCERNS We present a case of a 71-year-old man who came to us complaining about an abnormal difficulty in urinating associated with an interrupted flow and excessive urination at night. Clinical examination detected multiple enlarged superior and inferior diaphragmatic lymph nodes. DIAGNOSIS Prostate biopsy revealed an acinar adenocarcinoma (Gleason 4+3, Grade group 3). Clinical staging by bone scan was negative but computed tomography scan (CT) detected multiple enlarged superior and inferior diaphragmatic, and inguinal lymph nodes. This type of lymph node involvement pattern is unusual for an acinar adenocarcinoma prostate cancer therefore we suspected the simultaneous presence of a lymphatic neoplasm. Fluorodeoxyglucose positron emission tomography scan. The exam showed one of the left inguinal lymph nodes had the highest standardized uptake value (13.0) so a biopsy was taken. The sample analysis confirmed the diagnosis of a follicular non-Hodgkin lymphoma of Grade 3a. INTERVENTIONS We used a multidisciplinary clinical approach based on Rituximab+CHOP administered every 21 days. Simultaneously, the patient underwent androgen deprivation therapy with triptorelin monthly and bicalutamide administered just during the first month of treatment. When we obtained a complete response for the lymphoma, the patient continued the therapy with Rituximab once every 2 months for the next 2 years. Then we added volumetric modulated arc therapy (VMAT) radiotherapy with simultaneous integrated boost (SIB) to androgen deprivation therapy for the duration of 1 month. OUTCOMES After 1 year and 6 months since the conclusion of therapy for prostate cancer and Follicular lymphoma, patient's conditions are good and he is in complete remission for both diseases. Gut toxicity is reduced with a mean number of 2 to 3 discharges daily and an increased body weight. LESSONS The presence of diffuse lymphadenopathy and urinary symptoms in the same patients must induce the suspect of 2 contemporary cancer diseases. Parallel treatments of follicular lymphoma and prostate cancer should consider the increased risk of severe adverse effects related to the treatment and their management. We describe our therapeutic strategy to highlight the importance to balance benefits and disadvantages to get the best possible response and maintain a good quality of life in this complex setting.
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Affiliation(s)
- Angelo Pirozzi
- Department of Clinical Medicine and Surgery, University Federico II of Naples
| | - Giacomo Cartenì
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria “A. Cardarelli”, Naples
| | - Sarah Scagliarini
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria “A. Cardarelli”, Naples
| | - Mario Fusco
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | - Ferdinando Riccardi
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria “A. Cardarelli”, Naples
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8
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Suarez JP, Dominguez ML, Gomez MA, Fernandez N, Muñoz J. A unique case of in situ follicular lymphoma associated with two nonlymphoid malignancies. Leuk Lymphoma 2016; 57:2917-2918. [PMID: 27054481 DOI: 10.3109/10428194.2016.1169409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Juan Pablo Suarez
- a Department of Nuclear Medicine , "San Pedro De Alcantara" Hospital , Caceres , Spain
| | - Maria Luz Dominguez
- a Department of Nuclear Medicine , "San Pedro De Alcantara" Hospital , Caceres , Spain
| | - Maria Asuncion Gomez
- a Department of Nuclear Medicine , "San Pedro De Alcantara" Hospital , Caceres , Spain
| | - Nuria Fernandez
- b Department of Histopathology , "San Pedro de Alcantara" Hospital , Caceres , Spain
| | - Jose Muñoz
- c Department of Nuclear Medicine , Hospital of Orense , Orense , Spain
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9
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Nybakken GE, Bala R, Gratzinger D, Jones CD, Zehnder JL, Bangs CD, Cherry A, Warnke RA, Natkunam Y. Isolated Follicles Enriched for Centroblasts and Lacking t(14;18)/BCL2 in Lymphoid Tissue: Diagnostic and Clinical Implications. PLoS One 2016; 11:e0151735. [PMID: 26991267 PMCID: PMC4798531 DOI: 10.1371/journal.pone.0151735] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 02/29/2016] [Indexed: 11/18/2022] Open
Abstract
We sought to address the significance of isolated follicles that exhibit atypical morphologic features that may be mistaken for lymphoma in a background of reactive lymphoid tissue. Seven cases that demonstrated centroblast-predominant isolated follicles and absent BCL2 staining in otherwise-normal lymph nodes were studied. Four of seven cases showed clonal B-cell proliferations amid a polyclonal B cell background; all cases lacked the IGH-BCL2 translocation and BCL2 protein expression. Although three patients had invasive breast carcinoma at other sites, none were associated with systemic lymphoma up to 44 months after diagnosis. The immunoarchitectural features of these highly unusual cases raise the question of whether a predominance of centroblasts and/or absence of BCL2 expression could represent a precursor lesion or atypical reactive phenomenon. Differentiating such cases from follicular lymphoma or another mimic is critical, lest patients with indolent proliferations be exposed to unnecessarily aggressive treatment.
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Affiliation(s)
- Grant E. Nybakken
- Department of Pathology, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Rajeev Bala
- Department of Pathology, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Dita Gratzinger
- Department of Pathology, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Carol D. Jones
- Department of Pathology, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - James L. Zehnder
- Department of Pathology, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Charles D. Bangs
- Department of Pathology, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Athena Cherry
- Department of Pathology, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Roger A. Warnke
- Department of Pathology, Stanford University School of Medicine, Stanford, California, 94305, United States of America
| | - Yasodha Natkunam
- Department of Pathology, Stanford University School of Medicine, Stanford, California, 94305, United States of America
- * E-mail:
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10
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Xerri L, Dirnhofer S, Quintanilla-Martinez L, Sander B, Chan JKC, Campo E, Swerdlow SH, Ott G. The heterogeneity of follicular lymphomas: from early development to transformation. Virchows Arch 2015; 468:127-39. [PMID: 26481245 DOI: 10.1007/s00428-015-1864-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/10/2015] [Accepted: 10/01/2015] [Indexed: 12/11/2022]
Abstract
Follicular lymphoma (FL) is a lymphoma composed of germinal center B cells, i.e., centroblasts and centrocytes, that almost always show at least a focal follicular growth pattern. Most cases have a characteristic CD5-, CD10+, BCL6+, and BCL2+ immunophenotype, and 85 % of cases exhibit the hallmark translocation t(14;18)(q32;q21) involving BCL2 and IGH. Although the typical clinicopathological findings of FL are well recognized, cases with unusual clinical, morphologic, immunophenotypic, and genetic features may pose problems in diagnosis and nomenclature. In the slide workshop organized by the European Association for Haematopathology (EAHP) and the Society for Hematopathology (SH) held in Istanbul, Turkey, unusual variants of FL were discussed based on the submitted cases, including early lesions, localized extranodal presentation, uncommon immunophenotype, rare genetic alterations, diffuse variant, and marginal zone differentiation. Interesting features such as blastoid morphology and unusual progression forms were presented, aiming to understand the genetic basis of transformation. In this report, novel findings and diagnostic challenges emerging from the submitted cases will be highlighted, and new terminologies for some of these lesions are proposed.
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Affiliation(s)
- Luc Xerri
- Department of Bio-Pathology, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France.
| | - Stephan Dirnhofer
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tübingen and Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | - Birgitta Sander
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet and Karolinska University Hospital Huddinge, Stockholm, Sweden
| | | | - Elias Campo
- Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Steven H Swerdlow
- Division of Hematopathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Hospital and Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
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11
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Morita K, Nakamine H, Nakai T, Takano M, Takeda M, Enomoto Y, Yoshii Y, Kanno M, Ohbayashi C. A retrospective study of patients with follicular lymphoma (FL): identification of in situ FL or FL-like B cells of uncertain significance in lymph nodes resected at the time of previous surgery for carcinomas. J Clin Pathol 2015; 68:541-6. [DOI: 10.1136/jclinpath-2015-202933] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 03/22/2015] [Indexed: 12/22/2022]
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12
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Mamessier E, Broussais-Guillaumot F, Chetaille B, Bouabdallah R, Xerri L, Jaffe ES, Nadel B. Nature and importance of follicular lymphoma precursors. Haematologica 2014; 99:802-10. [PMID: 24790058 PMCID: PMC4008113 DOI: 10.3324/haematol.2013.085548] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 02/10/2014] [Indexed: 11/09/2022] Open
Abstract
It is now widely recognized that cancer development is a protracted process requiring the stepwise acquisition of multiple oncogenic events. In humans, this process can take decades, if not a lifetime, blurring the notion of 'healthy' individuals. Follicular lymphoma exemplifies this multistep pathway of oncogenesis. In recent years, variants of follicular lymphoma have been recognized that appear to represent clonal B-cell expansions at an early stage of follicular lymphoma lymphomagenesis. These include follicular lymphoma in situ, duodenal follicular lymphoma, partial involvement by follicular lymphoma, and in the blood circulating follicular lymphoma-like B cells. Recent genetic studies have identified similarities and differences between the early lesions and overt follicular lymphoma, providing important information for understanding their biological evolution. The data indicate that there is already genomic instability at these early stages, even in instances with a low risk for clinical progression. The overexpression of BCL2 in t(14;18)-positive B cells puts them at risk for subsequent genetic aberrations when they re-enter the germinal center and are exposed to the influences of activation-induced cytidine deaminase and somatic hypermutations. The emerging data provide a rationale for clinical management and, in the future, may identify genetic risk factors that warrant early therapeutic intervention.
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13
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Karube K, Scarfò L, Campo E, Ghia P. Monoclonal B cell lymphocytosis and "in situ" lymphoma. Semin Cancer Biol 2013; 24:3-14. [PMID: 23999128 DOI: 10.1016/j.semcancer.2013.08.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 08/15/2013] [Accepted: 08/21/2013] [Indexed: 01/09/2023]
Abstract
The finding of monoclonal B-cell populations not fulfilling criteria for a lymphoid malignancy has given great impulse to study mechanisms involved in lymphomagenesis and factors responsible for the transition from B-cell precursor states to overt lymphoproliferative disorders. Monoclonal B cell expansions were initially recognized in peripheral blood of otherwise healthy subjects (thus defined monoclonal B-cell lymphocytosis, MBL) and in most cases share the immunophenotypic profile of chronic lymphocytic leukemia (CLL). The clinical relevance of this phenomenon is different according to B-cell count: high-count MBL is considered a preneoplastic condition and progresses to CLL requiring treatment at a rate of 1-2% per year, while low-count MBL, though persisting over time, has not shown a clinical correlation with frank leukemia so far. MBL other than CLL-like represent a minority of cases and are ill-defined entities for which clinical and biological information is still scanty. In situ follicular lymphoma (FL) and mantle cell lymphoma (MCL) are characterized by the localization of atypical lymphoid cells, carrying t(14;18)(q32;q21) or t(11;14)(q13;q32), only in the germinal centers and mantle zones respectively, where their normal counterparts are localized. The localization of these cells indicates that germinal centers or mantle zones provide appropriate microenvironments for cells carrying these oncogenic alterations to survive or proliferate. The progression of these lesions to overt lymphomas occurs rarely and may require the accumulation of additional genetic events. Individuals with these lymphoid proliferations should be managed with caution.
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MESH Headings
- B-Lymphocytes/pathology
- Cell Lineage
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphocytosis/blood
- Lymphocytosis/genetics
- Lymphocytosis/pathology
- Lymphoma, Follicular/blood
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/pathology
- Lymphoma, Mantle-Cell/blood
- Lymphoma, Mantle-Cell/pathology
- Translocation, Genetic
- Tumor Microenvironment/genetics
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Affiliation(s)
- Kennosuke Karube
- Department of Anatomic Pathology, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain
| | - Lydia Scarfò
- Laboratory of B-cell Neoplasia, Division of Molecular Oncology, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Via Olgettina 58, 20132 Milano, Italy; Clinical Unit of Lymphoid Malignancies, Department of Onco-Hematology, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milano, Italy
| | - Elias Campo
- Department of Anatomic Pathology, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain.
| | - Paolo Ghia
- Laboratory of B-cell Neoplasia, Division of Molecular Oncology, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Via Olgettina 58, 20132 Milano, Italy; Clinical Unit of Lymphoid Malignancies, Department of Onco-Hematology, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milano, Italy
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Carbone A, Gloghini A. Emerging issues after the recognition ofin situfollicular lymphoma. Leuk Lymphoma 2013; 55:482-90. [DOI: 10.3109/10428194.2013.807926] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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