Follicular lymphoma of the spleen: multiparameter analysis of 16 cases.

Follicular lymphoma (FL) involving the spleen must be distinguished from reactive hyperplasia and from other lymphomas. A prior study reported that splenic FLs frequently lack BCL2 expression, further complicating diagnosis. We examined 16 cases of splenic FL, including 12 cases initially diagnosed at splenectomy. Two morphologic patterns were identified: one with architectural abnormalities (AA) and one with an extensive architectural preservation (AP) pattern. Newly diagnosed AP cases were associated with older age (P = .051) and grade 1 histologic features (P = .023). All cases displayed a CD10+/BCL2+ phenotype. Cytogenetics and FISH identified IGH/BCL2 or BCL6 translocations in all tested cases. Splenic FLs display phenotypic and cytogenetic findings similar to nodal FLs. However, splenic FLs frequently display an exclusively intrafollicular growth pattern resembling so-called in situ FL. Recognition of subtle FL with preserved architecture is important because patients may have overt FL at other sites or the FL may progress to overt nodal disease.

[1]  A. Salar,et al.  Splenic marginal zone lymphoma proposals for a revision of diagnostic, staging and therapeutic criteria , 2008, Leukemia.

[2]  S. Janz,et al.  Distribution of t(14;18)‐positive, putative lymphoma precursor cells among B‐cell subsets in healthy individuals 1 , 2007, British journal of haematology.

[3]  B. Nadel,et al.  Follicular lymphoma-like B cells in healthy individuals: a novel intermediate step in early lymphomagenesis , 2006, The Journal of experimental medicine.

[4]  A. Ho,et al.  The bcl-2/IgH rearrangement in a population of 204 healthy individuals: occurrence, age and gender distribution, breakpoints, and detection method validity. , 2006, Leukemia research.

[5]  S. Swerdlow,et al.  t(14;18)(q32;q21) involving IGH and MALT1 is uncommon in cutaneous MALT lymphomas and primary cutaneous diffuse large B‐cell lymphomas , 2006, Journal of cutaneous pathology.

[6]  Juan F. García,et al.  Nodal and splenic marginal zone B cell lymphomas , 2005, Hematological oncology.

[7]  K. Karube,et al.  Low-grade follicular lymphoma with t(14;18) presents a homogeneous disease entity otherwise the rest comprises minor groups of heterogeneous disease entities with Bcl2 amplification, Bcl6 translocation or other gene aberrances , 2005, Leukemia.

[8]  R. Marcus,et al.  Follicular lymphoma: time for a re-think? , 2005, Blood reviews.

[9]  C. Ross,et al.  Histopathologic features of splenic small B-cell lymphomas. A study of 42 cases with a definitive diagnosis by the World Health Organization classification. , 2003, American journal of clinical pathology.

[10]  C. Ross,et al.  Histopathologic Features of Splenic Small B-Cell Lymphomas , 2003 .

[11]  M. Boccadoro,et al.  PCR-detectable nonneoplastic Bcl-2/IgH rearrangements are common in normal subjects and cancer patients at diagnosis but rare in subjects treated with chemotherapy. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  E. Jaffe,et al.  In situ localization of follicular lymphoma: description and analysis by laser capture microdissection. , 2002, Blood.

[13]  M. Fleming,et al.  The spleen as a diagnostic specimen , 2001, Cancer.

[14]  T. Lister,et al.  Frequency of the Bcl-2/IgH rearrangement in normal individuals: implications for the monitoring of disease in patients with follicular lymphoma. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[15]  E. Campo,et al.  A marginal zone pattern may be found in different varieties of non‐Hodgkin's lymphoma: the morphology and immunohistology of splenic involvement by B‐cell lymphomas simulating splenic marginal zone lymphoma , 1998, Histopathology.

[16]  S. Pittaluga,et al.  "Small" B-cell non-Hodgkin's lymphomas with splenomegaly at presentation are either mantle cell lymphoma or marginal zone cell lymphoma. A study based on histology, cytology, immunohistochemistry, and cytogenetic analysis. , 1996, The American journal of surgical pathology.

[17]  D. Jong,et al.  Lymphoma-associated translocation t(14;18) in blood B cells of normal individuals. , 1995, Blood.

[18]  R. Bende,et al.  Molecular pathways in follicular lymphoma , 2007, Leukemia.

[19]  D. Arber,et al.  Non-Hodgkin's lymphoproliferative disorders involving the spleen. , 1997, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.