Follicular Colonization of Nodal Marginal-Zone B-Cell Lymphoma Resembling Follicular Lymphoma: Report of 6 Cases

Author:

Kojima Masaru1,Nakamura Shigeo2,Murase Takuhei3,Motoori Tadashi4,Murayama Kayoko,Iijima Misa5,Itoh Hideaki6,Sakata Noriyuki7,Masawa Nobuhide8

Affiliation:

1. Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, 617-1, Takabayashinishi-cho Ohta, 373-8550, Japan; Department of Pathology, Dokkyo University School of Medicine, Mibu

2. Department of Pathology and Genetics, Aichi Cancer Center Hospital, Nagoya

3. Department of Internal Medicine, Nishio Municipal Hospital, Aichi

4. Department of Pathology Kitazato Medical Center Hospital, Kitamoto

5. Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta

6. Pathology and Clinical Laboratories, Maebashi Red Cross Hospital, Maebashi

7. Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan.

8. Department of Pathology, Dokkyo University School of Medicine, Mibu

Abstract

The formation of neoplastic B-cell follicles is accepted as a diagnostic criterion of follicular lymphoma. However, extranodal marginal-zone B-cell lymphomas (MZBLs) of mucosa-associated lymphoid tissue (MALT) type also sometimes contain numerous lymphoid follicles and may even have a predominantly follicular growth pattern. However, morphologic, immunohistochemical, and genotypic findings suggest that lymphoid follicles in extranodal MZBLs are neoplastic follicles formed as the result of colonization of previously reactive follicles by tumor cells (centrocyte-like cells). We present here 6 cases of nodal MZBL demonstrating a follicular growth pattern. Immunohistochemical study demonstrated that the tumor cells were CD10-, CD20+, CD79a+,CD 138-, Bcl-2+, Bcl-6and IRF4+. Residual nonneoplastic follicular center cells were CD1O+, CD20+, CD79a+, Bcl-2-, and Bcl-6+. CD21/CD23 immunostain demonstrated a disrupted follicular dendritic cell pattern characteristic of follicular colonization in extranodal MZBL of MALT type. Taken in conjunction with the morphologic findings, nodal MZBL may also show a follicular growth pattern similar to extranodal MZBL of MALT type. The marginal-zone nature is most recognizable on immunohistochemistry, although the histologic appearance alone may cause some diagnostic problems. It is important for pathologists to consider this type of lesion in diagnostic practice.

Publisher

SAGE Publications

Subject

Pathology and Forensic Medicine,Surgery,Anatomy

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