Immunoarchitectural patterns of germinal center antigens including LMO2 assist in the differential diagnosis of marginal zone lymphoma vs follicular lymphoma

Am J Clin Pathol. 2013 Aug;140(2):149-54. doi: 10.1309/AJCPHPVH4M7MTWUN.

Abstract

Objectives: To examine the immunoarchitectural patterns of the germinal center (GC)-associated markers CD10, BCL6, and LMO2 and their utility in the differential diagnosis of marginal zone lymphoma (MZL) vs follicular lymphoma (FL).

Methods: Forty-two cases of MZL involving lymph nodes and 88 cases of FL were examined.

Results: Interfollicular staining for GC markers was uncommon in MZL but common in FL, including BCL2-positive and BCL2-negative cases. Two atypical patterns of intrafollicular GC staining were identified that were more common in MZL than in FL.

Conclusions: Staining for LMO2 in addition to CD10 and BCL6 facilitates the detection of a GC phenotype in FL. Lymph nodes involved by MZL frequently show characteristic alterations of GC immunoarchitecture. Recognizing these altered patterns assists in the distinction between MZL and FL.

Keywords: Follicular lymphoma; Germinal center; Immunohistochemistry; LMO2; Lymphoma; Marginal zone lymphoma.

MeSH terms

  • Adaptor Proteins, Signal Transducing / metabolism*
  • Adult
  • Biomarkers, Tumor / metabolism
  • Diagnosis, Differential
  • Germinal Center / metabolism*
  • Germinal Center / pathology
  • Humans
  • LIM Domain Proteins / metabolism*
  • Lymph Nodes / metabolism
  • Lymph Nodes / pathology
  • Lymphoma, B-Cell, Marginal Zone / diagnosis*
  • Lymphoma, B-Cell, Marginal Zone / metabolism
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • Lymphoma, Follicular / diagnosis*
  • Lymphoma, Follicular / metabolism
  • Lymphoma, Follicular / pathology
  • Neprilysin / metabolism
  • Proto-Oncogene Proteins / metabolism*
  • Repressor Proteins / metabolism

Substances

  • Adaptor Proteins, Signal Transducing
  • BCOR protein, human
  • Biomarkers, Tumor
  • LIM Domain Proteins
  • LMO2 protein, human
  • Proto-Oncogene Proteins
  • Repressor Proteins
  • Neprilysin