Coexisting Follicular and Mantle Cell Lymphoma With Each Having an In Situ Component

Roullet, Michele R.; Martı́nez, Daniel; Ma, Lisa; Fowler, Melissa H.; McPhail, Ellen D.; Judkins, Alexander R.; Arber, Daniel A.; Bagg, Adam

doi:10.1309/ajcp5rt4mrsdgksx

Cited by 50 publications

(10 citation statements)

References 29 publications

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“…The unique case presented by Drs. Roullet and Bagg (case 4) showed, in addition to fully developed follicular lymphoma, both FLIS and MCLIS components in a splenectomy specimen [88]. Undoubtedly, the routine use of cyclin D1 immunostaining in the diagnostic work-up of B-NHL facilitates the detection of such composite cases with a minor MCL-like population.…”

Section: Sessionmentioning

confidence: 99%

Early lesions in lymphoid neoplasia

et al. 2012

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The increasing use of immunophenotypic and molecular techniques on lymphoid tissue samples without obvious involvement by malignant lymphoma has resulted in the increased detection of “early” lymphoid proliferations, which show some, but not all the criteria necessary for a diagnosis of malignant lymphoma. In most instances, these are incidental findings in asymptomatic individuals, and their biological behaviour is uncertain. In order to better characterize these premalignant conditions and to establish diagnostic criteria, a joint workshop of the European Association for Haematopathology and the Society of Hematopathology was held in Uppsala, Sweden, in September 2010. The panel reviewed and discussed more than 130 submitted cases and reached consensus diagnoses. Cases representing the nodal equivalent of monoclonal B-cell lymphocytosis (MBL) were discussed, as well as the “in situ” counterparts of follicular lymphoma (FL) and mantle cell lymphoma (MCL), topics that also stimulated discussions concerning the best terminology for these lesions. The workshop also addressed the borderland between reactive hyperplasia, and clonal proliferations such as pediatric marginal zone lymphoma and pediatric FL, which may have very limited capacity for progression. Virus-driven lymphoproliferations in the grey zone between reactive lesions and manifest malignant lymphoma were covered. Finally, early manifestations of T-cell lymphoma, both nodal and extranodal, and their mimics were addressed. This workshop report summarizes the most important conclusions concerning diagnostic features, as well as proposals for terminology and classification of early lymphoproliferations and tries to give some practical guidelines for diagnosis and reporting.

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Section: Sessionmentioning

confidence: 99%

Early lesions in lymphoid neoplasia

et al. 2012

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“…A report of T lymphoblastic leukemia/lymphoma and diffuse large B cell lymphoma was recently published. Some of these have been reported to be monoclonal [1,6,[19][20][21], while others appear to be biclonal [10][11][12][13][14][15][16][17][18]. Analysis of clonality is important for the understanding of the origins of composite lymphomas.…”

Section: Discussionmentioning

confidence: 99%

“…However, Richter syndrome with different light chains has also been shown to be clonally related [9]. Composite lymphomas with cytogenetic or molecular evidence of biclonality have also been reported, especially composite B and T-cell lymphomas [10][11][12][13][14][15][16][17][18]. Recently, several morphologically and immunophenotypically different lymphomas have been shown to be clonally related [1,[6][7][8][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Two morphologically and immunophenotypically distinct cell populations within a composite lymphoma arise from a common precursor

et al. 2011

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The term composite lymphoma defines a lymphoma consisting of two or more morphologically and immunophenotypically distinct lymphomas within the same lymph node or other organ. Recently, several molecular studies have shown that different components within a composite lymphoma may arise from a common clone. In contrast, there are also reports of biclonal cases of composite lymphoma. For this study, we identified five cases of composite lymphoma and analyzed them by various techniques to determine the clonality of the components. In four cases (1-4), a laser capture microdissection technique was used to collect separately each of the component lymphoma types. These were analyzed by polymerase chain reaction (PCR) to assess the rearrangement of the J segment of the immunoglobulin heavy chain gene (JH). In all cases, gel electrophoresis demonstrated that the JH amplicons from each component were identical in size. DNA sequencing of the amplified JH region was successful in three of these four cases (1, 3, and 4), and the sequences of the JH regions of both components of each composite lymphoma were identical. Three of the composite lymphomas (2, 4, and 5) were also tested by a related approach: PCR of the variable region of the immunoglobulin heavy chain gene using primers that bind to framework regions 1, 2, and 3, followed by capillary electrophoresis. The PCR amplicons from tissue containing a mixture of both components of the composite lymphomas gave one major peak in each of the three electropherograms for each lymphoma, indicating that only one clone of rearranged immunoglobulin was present despite the two distinct cellular morphologies. Additionally, fluorescence in situ hybridization in case one showed identical results in the two different cell types. Our results suggest that the two different components within each composite lymphoma represent a morphologically and immunophenotypically divergent differentiation of a common clone.

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“…However, there may be a coexisting FL in the same lymph node or in other nodes as has been reported in a few cases [5, 8]. In the index patient, the lymph nodes were discovered on routine mammography.…”

Section: Discussionmentioning

confidence: 82%

“…To diagnose FLIS, the following criteria are used [4, 5, 8, 12]: preserved nodal architecture with open sinuses and preserved paracortical regions. On H&E sections, the follicles appear to be reactive.…”

Section: Discussionmentioning

confidence: 99%

Follicular LymphomaIn SituPresenting as Dermatopathic Lymphadenopathy

Obumneme

Igbokwe

Banjo

et al. 2013

Case Reports in Pathology

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Introduction. Follicular lymphoma in situ (FLIS) is a recently described entity with few cases recognized worldwide. To our knowledge, this is the first FLIS reported from West Africa. Case Presentation. We present the case of a 48-year-old civil servant with axillary lymphadenopathy discovered on routine mammography. On histology, a predominant reactive change with aggregates of melanophages was seen prompting a diagnosis of reactive lymphadenopathy. Immunohistochemistry done in our laboratory showed CD10 and Bcl-6 positive germinal centres with a small population of Bcl-2 positive germinal centre centre cells that were limited to some of the germinal centres. Conclusion. This highlights the use of immunohistochemistry in lymph node pathology—a resource which is very limited in our environment.

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Coexisting Follicular and Mantle Cell Lymphoma With Each Having an In Situ Component

Cited by 50 publications

References 29 publications

Early lesions in lymphoid neoplasia

Early lesions in lymphoid neoplasia

Two morphologically and immunophenotypically distinct cell populations within a composite lymphoma arise from a common precursor

Follicular LymphomaIn SituPresenting as Dermatopathic Lymphadenopathy

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