CD10 and BCL-6 Expression in Paraffin Sections of Normal Lymphoid Tissue and B-Cell Lymphomas

Abstract

In this study the authors explored the value of immunostaining for follicular center B-cell markers, BCL-6 and CD10, in paraffin sections as a tool for the differential diagnosis of B-cell lymphomas. The cases studied comprised reactive lymphoid hyperplasia (RLH; n = 19), follicular lymphoma (FL; n = 50), low-grade mucosa-associated lymphoid tissue (MALT) lymphoma (n = 24), mantle cell lymphoma (n = 19), splenic marginal zone lymphoma (n = 13), diffuse large B-cell lymphoma (DLBCL; n = 54), Burkitt's lymphoma (BL; n = 20), nodular lymphocyte predominance Hodgkin's disease (NLPHD; n = 16), and classic Hodgkin's disease (CHD; n = 13). In RLH, CD10 and BCL-6 were expressed almost exclusively by the follicular center cells. In contrast in FL, the expression of CD10 (39/50) and BCL-6 (34/36) was seen in both follicular and interfollicular neoplastic B cells. Marginal zone/MALT lymphomas and mantle cell lymphoma were always negative. In DLBCL the expression was variable for both CD10 (21/54) and BCL-6 (39/47), with some tumors, including cases of transformed follicular lymphoma (9/10), coexpressing CD10 and BCL-6, and others expressing only BCL-6, and a small group expressing neither marker, possibly reflecting the underlying primary pathogenetic events such as the rearrangement of BCL-2 or BCL-6 genes. BL was always both CD10 and BCL-6 positive. In NLPHD the L&H cells expressed BCL-6 (11/13) but not CD10, whereas in CHD BCL-6 expression was seen in half of the cases. This study demonstrates that both CD10 and BCL-6 are reliable markers of follicular center B-cell differentiation. CD10 and BCL-6 immunostaining have an important role in differential diagnosis of FL from RLH and other low-grade B-cell lymphomas. The results also suggest that a CD10/BCL-6 expression pattern may be helpful in identifying main subsets of DLBCL. However, additional studies comparing genotype with immunophenotype are required.

Plasmablastic lymphomas and plasmablastic plasma cell myelomas have nearly identical immunophenotypic profiles

“…Diffuse large B-cell lymphomas usually express the pan-B-cell antigens, CD20, CD79a and PAX-5, 22,26 and frequently express BCL-6 (ranging from 50 to 80% of the cases). [27][28][29] Our plasmablastic lymphoma cases were consistently negative for CD20, and almost all cases were negative for CD79a, BCL-6, and PAX-5. PAX-5, a B-cell-specific transcription factor, is detectable as early as the pro-B-cell stage and subsequently in all further stages of B-cell development until the plasma cell stage, where it is downregulated.…”

Follicular lymphoma in young adults: a clinicopathological and molecular study of 200 patients

“…MUM1/IRF4, a post-GC B-cells marker, usually is not present in neoplastic cells of follicular lymphoma. 7,[28][29][30][31] BCL2 protein is expressed in most follicular lymphoma, including cases lacking the t(14, 18) translocation. Variations in this immunoprofile have been reported and some of them are associated with prognostic value.…”

A spindle cell variant of diffuse large B-cell lymphoma possesses genotypic and phenotypic markers characteristic of a germinal center B-cell origin

“…[14][15][16] Phenotypic B-cell markers include BCL-6 and CD10 proteins, which are expressed after germinal center entry, and MUM1 and CD138/syndecan-1 proteins, which are expressed during the late stages of B-cell maturation. 12,[17][18][19]21 These genotypic and phenotypic markers permit classification of B-cell lymphomas as: (1) lymphomas devoid of somatic immunoglobulin and BCL-6 gene mutation, which derive from naive pre-germinal center B-cells, (2) lymphomas exhibiting somatic immunoglobulin and BCL-6 gene mutation as well as BCL-6 and CD10 protein expression, which suggests a germinal center B-cell origin, (3) lymphomas exhibiting somatic immunoglobulin and BCL-6 gene mutation as well as MUM1 and CD138/ syndecan-1 positivity, which may indicate a postgerminal center B-cell origin. [18][19][20][21] The pattern of genotypic and phenotypic markers present in all five spindle lymphoma cases studied suggests that spindle cell lymphoma derives from germinal center B cells and should be classified together with other lymphomas exhibiting somatic immunoglobulin and BCL-6 gene mutation as well as BCL-6 protein expression.…”

“…Well-defined histogenetic markers of B-cell lymphoma currently include mutations of immunoglobulin and BCL-6 genes and expression of CD10, BCL-6, MUM1, and CD138/syndecan-1 antigens. [11][12][13][14][15][16][17][18][19] These markers are useful indicators of the origin and differentiation stage of B-cell lymphoma because each are retained upon neoplastic transformation.…”