Overlapping morphologic and immunophenotypic profiles in small B-cell lymphoma. A report of two cases

We present two cases of small B-cell lymphomas of particular diagnostic interest because the histological patterns were at variance with their immunophenotype. One of these lymphomas, involving the gallbladder and duodenum, showed a marginal zone lymphoma-like (MALT type) pattern of cellular infiltr...

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Veröffentlicht in:Virchows Archiv : an international journal of pathology 2006-09, Vol.449 (3), p.320-327
Hauptverfasser: KOSTOPOULOS, Ioannis, COCCO, Mario, GINANNESCHI, Chiara, D'AMURI, Alessandro, LAZZI, Stefano, FABBRI, Alberto, FORCONI, Francesco, MARGHERITA DE SANTI, Maria, LEONCINI, Lorenzo
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container_title Virchows Archiv : an international journal of pathology
container_volume 449
creator KOSTOPOULOS, Ioannis
COCCO, Mario
GINANNESCHI, Chiara
D'AMURI, Alessandro
LAZZI, Stefano
FABBRI, Alberto
FORCONI, Francesco
MARGHERITA DE SANTI, Maria
LEONCINI, Lorenzo
description We present two cases of small B-cell lymphomas of particular diagnostic interest because the histological patterns were at variance with their immunophenotype. One of these lymphomas, involving the gallbladder and duodenum, showed a marginal zone lymphoma-like (MALT type) pattern of cellular infiltration with CD5 negativity but (unexpectedly) Cyclin D1 positivity. Fluorescence in situ hybridization analysis of this case was performed because of the aberrant expression of Cyclin D1, and was clearly positive for the Cyclin D1 gene translocation. The second case, occurring in a lymph node, showed the typical growth pattern of a follicular lymphoma but it had an atypical immunophenotype, namely, expression of Cyclin D1, CD10, and Bcl2 and focally Bcl6, accompanied by a lack of CD5 and CD23. The Cyclin D1 gene translocation was detected by fluorescence in situ hybridisation (FISH), whereas c-myc and Bcl2 genes translocation were absent. Numerical chromosomal changes, which were visualized for chromosomes 8, 11, and 18 could be correlated to the aberrant immunoprofile. In this context, we discuss the diagnostic value of Cyclin D1, CD5, CD23, CD10, Bcl6 markers revealed by immunohistochemistry, as well as the significance of detection by FISH of chromosomal translocations such as t(11;14) and t(14;18). The question still remains as to whether such cases should be designated as specific lymphoma entities or reported as unclassifiable and the chromosome aberration reported.
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Fluorescence in situ hybridization analysis of this case was performed because of the aberrant expression of Cyclin D1, and was clearly positive for the Cyclin D1 gene translocation. The second case, occurring in a lymph node, showed the typical growth pattern of a follicular lymphoma but it had an atypical immunophenotype, namely, expression of Cyclin D1, CD10, and Bcl2 and focally Bcl6, accompanied by a lack of CD5 and CD23. The Cyclin D1 gene translocation was detected by fluorescence in situ hybridisation (FISH), whereas c-myc and Bcl2 genes translocation were absent. Numerical chromosomal changes, which were visualized for chromosomes 8, 11, and 18 could be correlated to the aberrant immunoprofile. In this context, we discuss the diagnostic value of Cyclin D1, CD5, CD23, CD10, Bcl6 markers revealed by immunohistochemistry, as well as the significance of detection by FISH of chromosomal translocations such as t(11;14) and t(14;18). 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The question still remains as to whether such cases should be designated as specific lymphoma entities or reported as unclassifiable and the chromosome aberration reported.</abstract><cop>Berlin</cop><pub>Springer</pub><pmid>16847683</pmid><doi>10.1007/s00428-006-0242-1</doi><tpages>8</tpages></addata></record>
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subjects Aged
B-Lymphocytes - metabolism
B-Lymphocytes - pathology
Biological and medical sciences
Biomarkers, Tumor - metabolism
Chromosome aberrations
Chromosomes
Chromosomes, Human, Pair 11 - genetics
Chromosomes, Human, Pair 14 - genetics
Chromosomes, Human, Pair 18 - genetics
Chromosomes, Human, Pair 8 - genetics
Cyclin D1 - genetics
Cyclin D1 - metabolism
Female
Fluorescence
Hematologic and hematopoietic diseases
Humans
Immunophenotyping - methods
In Situ Hybridization, Fluorescence
Investigative techniques, diagnostic techniques (general aspects)
Leukemia, Lymphocytic, Chronic, B-Cell - genetics
Leukemia, Lymphocytic, Chronic, B-Cell - metabolism
Leukemia, Lymphocytic, Chronic, B-Cell - pathology
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Lymph Nodes - metabolism
Lymph Nodes - pathology
Lymphoma
Male
Medical sciences
Middle Aged
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Translocation
Translocation, Genetic
title Overlapping morphologic and immunophenotypic profiles in small B-cell lymphoma. A report of two cases
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