TY - JOUR
T1 - Splenic follicular lymphoma
T2 - Clinicopathologic characteristics of a series of 32 cases
AU - Mollejo, Manuela
AU - Rodríguez-Pinilla, María S.
AU - Montes-Moreno, Santiago
AU - Algara, Patrocinio
AU - Dogan, Ahmet
AU - Cigudosa, Juan C.
AU - Juarez, Rocío
AU - Flores, Teresa
AU - Forteza, Jerónimo
AU - Arribas, Alberto
AU - Piris, Miguel A.
PY - 2009/5
Y1 - 2009/5
N2 - The spleen is frequently involved in B-cell lymphomas other than splenic marginal zone lymphoma. Here we describe a series of follicular lymphoma (FL) cases diagnosed in the spleen, consisting of 32 patients who presented clinically with splenomegaly, and slight or no peripheral lymphadenopathy. The splenic specimen had a micronodular pattern, germinal center cytologic composition, and frequent presence of marginal zone-like cells at the periphery of the nodules. Twenty cases showed absence or only partial/weak bcl2 protein expression, and 12 cases had homogeneous and strong positive bcl2 expression. The incidences of t(14;18)(q32;q21), CD10 expression, low histologic grade, and low proliferative index were significantly more frequent in FL bcl2-positive cases than in FL bcl2-negative cases. Splenic FL cases showed frequent relapses, with an overall survival of 55% at 5 years. No significant differences in survival were found between bcl2-negative and bcl2-positive cases. Splenic FL cases could be divided into 2 main variants: one was similar to classic FL with t(14;18) and CD10 expression, whereas the other was characterized by a higher proliferation index and histologic grade, and was more frequently diagnosed as a disease restricted to the spleen. Recognition of the distinct nature of these tumors should facilitate appropriate studies for determining the best therapy for such cases.
AB - The spleen is frequently involved in B-cell lymphomas other than splenic marginal zone lymphoma. Here we describe a series of follicular lymphoma (FL) cases diagnosed in the spleen, consisting of 32 patients who presented clinically with splenomegaly, and slight or no peripheral lymphadenopathy. The splenic specimen had a micronodular pattern, germinal center cytologic composition, and frequent presence of marginal zone-like cells at the periphery of the nodules. Twenty cases showed absence or only partial/weak bcl2 protein expression, and 12 cases had homogeneous and strong positive bcl2 expression. The incidences of t(14;18)(q32;q21), CD10 expression, low histologic grade, and low proliferative index were significantly more frequent in FL bcl2-positive cases than in FL bcl2-negative cases. Splenic FL cases showed frequent relapses, with an overall survival of 55% at 5 years. No significant differences in survival were found between bcl2-negative and bcl2-positive cases. Splenic FL cases could be divided into 2 main variants: one was similar to classic FL with t(14;18) and CD10 expression, whereas the other was characterized by a higher proliferation index and histologic grade, and was more frequently diagnosed as a disease restricted to the spleen. Recognition of the distinct nature of these tumors should facilitate appropriate studies for determining the best therapy for such cases.
KW - Bcl2
KW - Follicular lymphoma
KW - Spleen
UR - http://www.scopus.com/inward/record.url?scp=65449153567&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=65449153567&partnerID=8YFLogxK
U2 - 10.1097/PAS.0b013e318193fcef
DO - 10.1097/PAS.0b013e318193fcef
M3 - Article
C2 - 19194277
AN - SCOPUS:65449153567
VL - 33
SP - 730
EP - 738
JO - American Journal of Surgical Pathology
JF - American Journal of Surgical Pathology
SN - 0147-5185
IS - 5
ER -