Follicular lymphoma in situ: clinical implications and comparisons with partial involvement by follicular lymphoma

Jegalian, Armin G.; Éberlé, F.; Pack, Svetlana D.; Mirvis, Mary; Raffeld, Mark; Pittaluga, Stefania; Jaffe, Elaine S.

doi:10.1182/blood-2011-05-355255

Cited by 142 publications

(159 citation statements)

References 45 publications

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“…And one must be extremely careful, especially if there is no histopathologic correlate (eg, with fine needle aspirations), as the FCIPS may be very misleading. They may appear to have identified an overt lymphoma with CD10 þ or CD5 þ light-chain-restricted B cells but actually they represent one of the lesions we now consider to be of uncertain significance (in situ follicular lymphoma 22 or mantle cell lymphoma 23 ) or even something benign (florid follicular hyperplasia in a young adult 24 ). Or, they may suggest the wrong type of lymphoma because the phenotype is atypical (eg, a CD10À follicular lymphoma, CD5 þ marginal zone lymphoma or CD5À mantle cell lymphoma).…”

Section: Flow Cytometric Immunophenotypic Studiesmentioning

confidence: 94%

Lymphoma classification and the tools of our trade: an introduction to the 2012 USCAP Long Course

Swerdlow

2013

Modern Pathology

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Section: Flow Cytometric Immunophenotypic Studiesmentioning

confidence: 94%

Lymphoma classification and the tools of our trade: an introduction to the 2012 USCAP Long Course

Swerdlow

2013

Modern Pathology

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“…Overall, the clinicopathologic features in these four cases favored classification as lymphoplasmacytic lymphoma with a vaguely nodular architecture and variably prominent follicular colonization. Although follicular colonization is frequently seen in marginal zone lymphoma, this phenomenon may also be seen in other B-cell lymphomas, including follicular lymphoma [28][29][30][31] and mantle cell lymphoma. 32 In the 2009 Society for Hematopathology/European Association of Hematopathology workshop, cases of putative lymphoplasmacytic lymphoma with follicular colonization were accepted as bona fide lymphoplasmacytic lymphoma by some, but not all, members of the expert review panel.…”

Section: F Hamadeh Et Almentioning

confidence: 99%

MYD88 L265P mutation analysis helps define nodal lymphoplasmacytic lymphoma

et al. 2015

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The diagnosis of lymphoplasmacytic lymphoma is often challenging, especially in extramedullary tissues where the differential diagnosis includes nodal marginal zone lymphoma, splenic marginal zone lymphoma, or other small B-cell neoplasms with plasmacytic differentiation. The MYD88 L265P mutation has been recently identified in 490% of bone-marrow-based lymphoplasmacytic lymphoma, but the incidence of this abnormality and corresponding morphologic correlates in nodal lymphoplasmacytic lymphoma have not been established. We analyzed 87 cases of extramedullary lymphoplasmacytic lymphoma, splenic marginal zone lymphoma, unclassifiable splenic B-cell lymphomas, nodal marginal zone lymphoma with plasmacytic differentiation, and chronic lymphocytic leukemia/small lymphocytic lymphoma with plasmacytic differentiation for MYD88 L265P. Eighteen cases (21%) were positive, including 9/9 (100%) lymphoplasmacytic lymphomas with classic histologic features, 5/12 (42%) cases that met 2008 WHO criteria for lymphoplasmacytic lymphoma but with atypical morphologic features, 3/15 (20%) cases initially considered nodal marginal zone lymphoma with plasmacytic differentiation, and 1/6 (17%) unclassifiable splenic B-cell lymphomas. The presence of MYD88 L265P was associated with IgM paraprotein (Po0.001) and a trend for bone marrow involvement (P ¼ 0.09). Each of 44 splenectomy-defined splenic marginal zone lymphomas (19 with plasmacytic differentiation) and the chronic lymphocytic leukemia/small lymphocytic lymphoma with plasmacytic differentiation were negative for the mutation. Morphologic re-review with knowledge of MYD88 mutation status and all available clinical features suggested all MYD88 mutated cases were consistent with lymphoplasmacytic lymphoma (either classic or variant histology), except for one case which remained most consistent with nodal marginal zone lymphoma with plasmacytic differentiation. These results demonstrate the importance of MYD88 mutational analysis in better defining lymphoplasmacytic lymphoma as a relatively monomorphic small B-cell lymphoma with plasmacytic differentiation that may show total nodal architectural effacement and follicular colonization. Cases previously considered lymphoplasmacytic lymphoma that are more polymorphous and are often associated with histiocytes should no longer be included in the lymphoplasmacytic lymphoma category. Clinicopathologic review suggests that although MYD88 mutated non-lymphoplasmacytic lymphoma small B-cell neoplasms exist, they are very uncommon.

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“…More recently, it has been shown that some otherwise unremarkable lymph nodes with complete architectural preservation from patients without evidence of overt lymphoma can show BCL2-positive GCs that contain clonal B-cell populations and the IGH/BCL2 (Figure 3). [33][34][35] In some cases, only a few or even a single neoplastic GC may be present in the lymph node. These cases of so-called 'FL in situ' (also termed 'in situ involvement by FL-like cells' or 'FL-like B-cells of uncertain significance') are thought to represent the tissue equivalent of the rare circulating IGH/BCL2-positive cells detectable in normal peripheral blood.…”

Section: Precursor Lesion-'fl In Situ'mentioning

confidence: 99%

“…The presence of even focal areas with back-to-back GCs, obliterated sinuses, or extra-follicular B-cells with a GC phenotype excludes this diagnosis. 34 Because some patients with FL in situ in one sampled lymph node may have overt FL at other sites, staging studies are appropriate. In the absence of overt clinical disease, observation alone has been strongly suggested, although formal management guidelines for this condition remain lacking.…”

Section: Precursor Lesion-'fl In Situ'mentioning

confidence: 99%

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Nodal and leukemic small B-cell neoplasms

Cook

2013

Modern Pathology

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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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Follicular lymphoma in situ: clinical implications and comparisons with partial involvement by follicular lymphoma

Cited by 142 publications

References 45 publications

Lymphoma classification and the tools of our trade: an introduction to the 2012 USCAP Long Course

Lymphoma classification and the tools of our trade: an introduction to the 2012 USCAP Long Course

MYD88 L265P mutation analysis helps define nodal lymphoplasmacytic lymphoma

Nodal and leukemic small B-cell neoplasms

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