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Isolated Follicles Enriched for Centroblasts and Lacking t(14;18)/BCL2 in Lymphoid Tissue: Diagnostic and Clinical Implications

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...

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Autores principales: Nybakken, Grant E., Bala, Rajeev, Gratzinger, Dita, Jones, Carol D., Zehnder, James L., Bangs, Charles D., Cherry, Athena, Warnke, Roger A., Natkunam, Yasodha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4798531/
https://www.ncbi.nlm.nih.gov/pubmed/26991267
http://dx.doi.org/10.1371/journal.pone.0151735
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author Nybakken, Grant E.
Bala, Rajeev
Gratzinger, Dita
Jones, Carol D.
Zehnder, James L.
Bangs, Charles D.
Cherry, Athena
Warnke, Roger A.
Natkunam, Yasodha
author_facet Nybakken, Grant E.
Bala, Rajeev
Gratzinger, Dita
Jones, Carol D.
Zehnder, James L.
Bangs, Charles D.
Cherry, Athena
Warnke, Roger A.
Natkunam, Yasodha
author_sort Nybakken, Grant E.
collection PubMed
description 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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spelling pubmed-47985312016-03-23 Isolated Follicles Enriched for Centroblasts and Lacking t(14;18)/BCL2 in Lymphoid Tissue: Diagnostic and Clinical Implications Nybakken, Grant E. Bala, Rajeev Gratzinger, Dita Jones, Carol D. Zehnder, James L. Bangs, Charles D. Cherry, Athena Warnke, Roger A. Natkunam, Yasodha PLoS One Research Article 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. Public Library of Science 2016-03-18 /pmc/articles/PMC4798531/ /pubmed/26991267 http://dx.doi.org/10.1371/journal.pone.0151735 Text en © 2016 Nybakken et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Nybakken, Grant E.
Bala, Rajeev
Gratzinger, Dita
Jones, Carol D.
Zehnder, James L.
Bangs, Charles D.
Cherry, Athena
Warnke, Roger A.
Natkunam, Yasodha
Isolated Follicles Enriched for Centroblasts and Lacking t(14;18)/BCL2 in Lymphoid Tissue: Diagnostic and Clinical Implications
title Isolated Follicles Enriched for Centroblasts and Lacking t(14;18)/BCL2 in Lymphoid Tissue: Diagnostic and Clinical Implications
title_full Isolated Follicles Enriched for Centroblasts and Lacking t(14;18)/BCL2 in Lymphoid Tissue: Diagnostic and Clinical Implications
title_fullStr Isolated Follicles Enriched for Centroblasts and Lacking t(14;18)/BCL2 in Lymphoid Tissue: Diagnostic and Clinical Implications
title_full_unstemmed Isolated Follicles Enriched for Centroblasts and Lacking t(14;18)/BCL2 in Lymphoid Tissue: Diagnostic and Clinical Implications
title_short Isolated Follicles Enriched for Centroblasts and Lacking t(14;18)/BCL2 in Lymphoid Tissue: Diagnostic and Clinical Implications
title_sort isolated follicles enriched for centroblasts and lacking t(14;18)/bcl2 in lymphoid tissue: diagnostic and clinical implications
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4798531/
https://www.ncbi.nlm.nih.gov/pubmed/26991267
http://dx.doi.org/10.1371/journal.pone.0151735
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