Splenic follicular lymphoma: Clinicopathologic characteristics of a series of 32 cases

Manuela Mollejo, María S. Rodríguez-Pinilla, Santiago Montes-Moreno, Patrocinio Algara, Ahmet Dogan, Juan C. Cigudosa, Rocío Juarez, Teresa Flores, Jerónimo Forteza, Alberto Arribas, Miguel A. Piris

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)730-738
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume33
Issue number5
DOIs
StatePublished - May 2009

Fingerprint

Follicular Lymphoma
Spleen
Germinal Center
Survival
Splenomegaly
B-Cell Lymphoma
Lymphoma
Recurrence
Incidence
Neoplasms
Proteins

Keywords

  • Bcl2
  • Follicular lymphoma
  • Spleen

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery
  • Medicine(all)

Cite this

Mollejo, M., Rodríguez-Pinilla, M. S., Montes-Moreno, S., Algara, P., Dogan, A., Cigudosa, J. C., ... Piris, M. A. (2009). Splenic follicular lymphoma: Clinicopathologic characteristics of a series of 32 cases. American Journal of Surgical Pathology, 33(5), 730-738. https://doi.org/10.1097/PAS.0b013e318193fcef

Splenic follicular lymphoma : Clinicopathologic characteristics of a series of 32 cases. / Mollejo, Manuela; Rodríguez-Pinilla, María S.; Montes-Moreno, Santiago; Algara, Patrocinio; Dogan, Ahmet; Cigudosa, Juan C.; Juarez, Rocío; Flores, Teresa; Forteza, Jerónimo; Arribas, Alberto; Piris, Miguel A.

In: American Journal of Surgical Pathology, Vol. 33, No. 5, 05.2009, p. 730-738.

Research output: Contribution to journalArticle

Mollejo, M, Rodríguez-Pinilla, MS, Montes-Moreno, S, Algara, P, Dogan, A, Cigudosa, JC, Juarez, R, Flores, T, Forteza, J, Arribas, A & Piris, MA 2009, 'Splenic follicular lymphoma: Clinicopathologic characteristics of a series of 32 cases', American Journal of Surgical Pathology, vol. 33, no. 5, pp. 730-738. https://doi.org/10.1097/PAS.0b013e318193fcef
Mollejo M, Rodríguez-Pinilla MS, Montes-Moreno S, Algara P, Dogan A, Cigudosa JC et al. Splenic follicular lymphoma: Clinicopathologic characteristics of a series of 32 cases. American Journal of Surgical Pathology. 2009 May;33(5):730-738. https://doi.org/10.1097/PAS.0b013e318193fcef
Mollejo, Manuela ; Rodríguez-Pinilla, María S. ; Montes-Moreno, Santiago ; Algara, Patrocinio ; Dogan, Ahmet ; Cigudosa, Juan C. ; Juarez, Rocío ; Flores, Teresa ; Forteza, Jerónimo ; Arribas, Alberto ; Piris, Miguel A. / Splenic follicular lymphoma : Clinicopathologic characteristics of a series of 32 cases. In: American Journal of Surgical Pathology. 2009 ; Vol. 33, No. 5. pp. 730-738.
@article{521193481a4545abbae4a1b299896c31,
title = "Splenic follicular lymphoma: Clinicopathologic characteristics of a series of 32 cases",
abstract = "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.",
keywords = "Bcl2, Follicular lymphoma, Spleen",
author = "Manuela Mollejo and Rodr{\'i}guez-Pinilla, {Mar{\'i}a S.} and Santiago Montes-Moreno and Patrocinio Algara and Ahmet Dogan and Cigudosa, {Juan C.} and Roc{\'i}o Juarez and Teresa Flores and Jer{\'o}nimo Forteza and Alberto Arribas and Piris, {Miguel A.}",
year = "2009",
month = "5",
doi = "10.1097/PAS.0b013e318193fcef",
language = "English (US)",
volume = "33",
pages = "730--738",
journal = "American Journal of Surgical Pathology",
issn = "0147-5185",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

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 -