In situ follicular lymphoma with progressive transformation of the germinal centers confirmed by laser capture microdissection, IGH gene rearrangement analysis, and fluorescence in situ hybridization for t(14;18)

• Published in: Human pathology 2012, Vol.43 (1), p.138-143
• Main Authors: Li, Jin-nan, MD, Zhang, Wen-yan, MD, Tang, Yuan, MD, Li, Gan-di, MD, Dong, Dan-dan, MD
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Cell Transformation, Neoplastic - genetics; Cell Transformation, Neoplastic - pathology; Chromosome aberrations; Chromosomes; Chromosomes, Human, Pair 14; Chromosomes, Human, Pair 18; Clone Cells; Disease Progression; Female; Gene Rearrangement; Germinal Center - pathology; Hematologic and hematopoietic diseases; Histology; Humans; Hybridization; Immunoglobulin Heavy Chains - genetics; Immunophenotyping; In situ follicular lymphoma; In Situ Hybridization, Fluorescence - methods; Investigative techniques, diagnostic techniques (general aspects); Laser Capture Microdissection; Lasers; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphatic system; Lymphocytes; Lymphoma; Lymphoma - genetics; Lymphoma - pathology; Lymphoma, Follicular - genetics; Lymphoma, Follicular - pathology; Medical genetics; Medical sciences; Pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Progressive transformation of germinal centers; t(14; 18)(q32; q21); Translocation, Genetic
• ISSN: 0046-8177; 1532-8392
• DOI: 10.1016/j.humpath.2011.01.035

Summary The authors report an unusual case of in situ follicular lymphoma associated with progressive transformation of the germinal centers. The patient was a 74-year-old Chinese woman with sequential lymphadenopathy in the right and left cervical regions over a period of 2 months. The first biopsy revealed in situ follicular lymphoma with progressive transformation of germinal centers, and the biopsy of the second lymph node led to a diagnosis of in situ follicular lymphoma. The immunophenotype, polymerase chain reaction amplification of the immunoglobulin heavy chain gene, and fluorescence in situ hybridization for t(14;18) were analyzed in each biopsy specimen, which showed both specimens to have t(14;18)(q32;q21) and revealed progression from polyclonality to monoclonality. These findings suggest a case of multicentric in situ follicular lymphoma and provide new insights into the pathogenesis of this disease.