t(1;14) and t(11;18) in the differential diagnosis of Waldenström's macroglobulinemia

Hongtao Ye, Shih Sung Chuang, Ahmet Dogan, Peter G. Isaacson, Ming Qing Du

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Waldenström's macroglobulinemia is caused by several B-cell proliferative disorders including lymphoplasmacytic lymphoma, marginal zone B-cell lymphoma, B-cell chronic lymphocytic leukemia and multiple myeloma. Differential diagnosis between lymphoplasmacytic lymphoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue is particularly difficult as there is a considerable overlap in histological presentation. We report a case of Waldenström's macroglobulinemia with involvement of the peripheral blood, bone marrow and stomach. Serum chemistry revealed an IgM of 5.4g/dl, but Bence-Jones protein in urine was negative. Abnormal lymphoid cells were detected in both blood and the bone marrow. Flow cytometry of the bone marrow aspirate showed that majority of cells were CD20+, CD38 +, expressing immunoglobulin lambda light chain, but CD5- and CD10-. Gastric biopsies revealed infiltration of the gastric mucosa by small lymphold cells showing plasmacytoid differentiation and occasional Dutcher bodies. Lymphoepithelial lesions and Helicobacter pylori were not seen. Thus, the differential diagnosis between lymphoplasmacytic lymphoma and mucosa-associated lymphoid tissue lymphoma was raised. To resolve this, we performed BCL10 immunohistochemistry and reverse transcriptional polymerase chain reaction (RT-PCR) for the API2-MALT1 fusion transcript of t(11;18)(q21;q21). Both bone marrow and gastric biopsies showed strong BCL10 nuclear staining, similar to that seen in t(1;14)(p22;q32) positive mucosa-associated lymphoid tissue lymphoma, but absence of the AP12-MALT1 fusion transcript. To further ascertain whether the detection of t(1;14)(p22;q32) and t(11;18)(q21;q21) can be reliably used for the differential diagnosis between lymphoplasmacytic lymphoma and mucosa-associated lymphoid tissue lymphoma, we screened for these translocations by BCL10 immunohistochemistry in 58 lymphoplasmacytic lymphomas and RT-PCR for t(11;18)(q21;ct21) in 40 lymphoplasmacytic lymphomas, respectively. None of the lymphoplasmacytic yrnphornas lymphomas studied harbored these translocations. Thus, detection of t(1;14)(p22;q32) and t(11;18)(q21;q21) is useful in the differential diagnosis between lymphoplasmacytic lymphoma and mucosa-associated lymphoid tissue lymphoma.

Original languageEnglish (US)
Pages (from-to)1150-1154
Number of pages5
JournalModern Pathology
Volume17
Issue number9
DOIs
StatePublished - Sep 2004
Externally publishedYes

Fingerprint

Waldenstrom Macroglobulinemia
Marginal Zone B-Cell Lymphoma
Differential Diagnosis
Lymphoma
Bone Marrow
Stomach
Immunoglobulin lambda-Chains
Immunohistochemistry
Bence Jones Protein
Biopsy
Polymerase Chain Reaction
B-Cell Chronic Lymphocytic Leukemia
Gastric Mucosa
Multiple Myeloma
Helicobacter pylori
Immunoglobulin M
Flow Cytometry
B-Lymphocytes
Urine
Lymphocytes

Keywords

  • MALT lymphoma
  • t(11;18)
  • t(1;14)
  • Waldenstrom's macroglobulinemia

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

t(1;14) and t(11;18) in the differential diagnosis of Waldenström's macroglobulinemia. / Ye, Hongtao; Chuang, Shih Sung; Dogan, Ahmet; Isaacson, Peter G.; Du, Ming Qing.

In: Modern Pathology, Vol. 17, No. 9, 09.2004, p. 1150-1154.

Research output: Contribution to journalArticle

Ye, Hongtao ; Chuang, Shih Sung ; Dogan, Ahmet ; Isaacson, Peter G. ; Du, Ming Qing. / t(1;14) and t(11;18) in the differential diagnosis of Waldenström's macroglobulinemia. In: Modern Pathology. 2004 ; Vol. 17, No. 9. pp. 1150-1154.
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abstract = "Waldenstr{\"o}m's macroglobulinemia is caused by several B-cell proliferative disorders including lymphoplasmacytic lymphoma, marginal zone B-cell lymphoma, B-cell chronic lymphocytic leukemia and multiple myeloma. Differential diagnosis between lymphoplasmacytic lymphoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue is particularly difficult as there is a considerable overlap in histological presentation. We report a case of Waldenstr{\"o}m's macroglobulinemia with involvement of the peripheral blood, bone marrow and stomach. Serum chemistry revealed an IgM of 5.4g/dl, but Bence-Jones protein in urine was negative. Abnormal lymphoid cells were detected in both blood and the bone marrow. Flow cytometry of the bone marrow aspirate showed that majority of cells were CD20+, CD38 +, expressing immunoglobulin lambda light chain, but CD5- and CD10-. Gastric biopsies revealed infiltration of the gastric mucosa by small lymphold cells showing plasmacytoid differentiation and occasional Dutcher bodies. Lymphoepithelial lesions and Helicobacter pylori were not seen. Thus, the differential diagnosis between lymphoplasmacytic lymphoma and mucosa-associated lymphoid tissue lymphoma was raised. To resolve this, we performed BCL10 immunohistochemistry and reverse transcriptional polymerase chain reaction (RT-PCR) for the API2-MALT1 fusion transcript of t(11;18)(q21;q21). Both bone marrow and gastric biopsies showed strong BCL10 nuclear staining, similar to that seen in t(1;14)(p22;q32) positive mucosa-associated lymphoid tissue lymphoma, but absence of the AP12-MALT1 fusion transcript. To further ascertain whether the detection of t(1;14)(p22;q32) and t(11;18)(q21;q21) can be reliably used for the differential diagnosis between lymphoplasmacytic lymphoma and mucosa-associated lymphoid tissue lymphoma, we screened for these translocations by BCL10 immunohistochemistry in 58 lymphoplasmacytic lymphomas and RT-PCR for t(11;18)(q21;ct21) in 40 lymphoplasmacytic lymphomas, respectively. None of the lymphoplasmacytic yrnphornas lymphomas studied harbored these translocations. Thus, detection of t(1;14)(p22;q32) and t(11;18)(q21;q21) is useful in the differential diagnosis between lymphoplasmacytic lymphoma and mucosa-associated lymphoid tissue lymphoma.",
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