Contribution of immunohistochemistry to small B-cell lymphoma classification

Appl Immunohistochem Mol Morphol. 2006 Mar;14(1):1-6. doi: 10.1097/01.pai.0000153721.13531.c2.

Abstract

Although the small B-cell lymphomas show major morphologic overlapping, they have been recently shown to be distinct entities with several biologic and clinical differences. Therefore, the utility of a panel of paraffin-reactive antibodies in differentiating these neoplasms was investigated. Using clinical data and morphologic criteria, 134 cases of small B-cell lymphomas were grouped as those with (1) one strongly suggested diagnosis, (2) differential diagnosis between two types of lymphomas, and (3) small B-cell lymphoma without hints for further subclassification. With a panel of antibodies including CD5, CD10, CD23, CD43, bcl-2, and cyclin D1, most but not all cases could be precisely categorized. This panel confirmed the diagnosis in 96.5% of the cases from group 1. In group 2 it confirmed one of the two diagnoses in 81.5% of the cases. In group 3 it established a definitive diagnosis in 55% of the cases. When all groups were considered, a correct diagnosis could be established for 88.1% of cases; for 6.7% of them the authors remained with two possible diagnosis, and the broad "small B-cell lymphoma" was the only diagnosis for 5.2% of cases. CD10 separated most follicular lymphomas from other small B-cell lymphoid neoplasms. CD23 separated small lymphocytic lymphoma/chronic lymphocytic leukemia. Cyclin D1 separated mantle cell lymphoma. The present study selected CD10, CD23, and cyclin D1 as a minimal panel for the classification of small B-cell lymphomas, yielding a final diagnosis in 88.1% of the cases.

MeSH terms

  • Antigens, CD / biosynthesis*
  • B-Lymphocytes / immunology*
  • Diagnosis, Differential
  • Humans
  • Immunohistochemistry
  • Immunophenotyping
  • Leukemia, Lymphocytic, Chronic, B-Cell / classification*
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis*
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology
  • Lymphoma, Non-Hodgkin / classification*
  • Lymphoma, Non-Hodgkin / diagnosis*
  • Lymphoma, Non-Hodgkin / pathology
  • Proto-Oncogene Proteins c-bcl-2 / biosynthesis

Substances

  • Antigens, CD
  • Proto-Oncogene Proteins c-bcl-2