Primary Cutaneous Follicular Lymphoma: An Assessment of Clinical, Histopathologic, Immunophenotypic, and Molecular Features

Mirza, Imran; Macpherson, Nicol; Paproski, Suzanne M.; Gascoyne, R. D.; Yang, Bin; Finn, William G.; Hsi, Eric D.

doi:10.1200/jco.20.3.647

Cited by 68 publications

(13 citation statements)

References 44 publications

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“…However, among PCFCLs, trunk involvement was found to be more frequently seen than previously reported. 1,2,5,6 In this series, neither the presence of multifocal lesions (T3) nor leg involvement was associated whit a worse outcome. A possible explanation and also a limitation of the study is that because PCFCLs are indolent diseases a longer follow-up may be needed in order to identify such differences.…”

Section: Discussionmentioning

confidence: 54%

“…1,2 Thus, in contrast to systemic follicular lymphomas, PCFCLs were said to be mostly negative for BCL2 and CD10, and the presence of t(14:18) to be virtually negative. However, some recent studies have reported BCL2 positivity rates among PCFCLs ranging from 0% to 86% of cases, [3][4][5][6][7] and a variable number of cases presenting the t(14:18) translocation have also been reported. [8][9][10] In addition, the significance of such results remains controversial because the number of studies focusing on this issue is scarce and usually included small numbers of patients.…”

Section: Introductionmentioning

confidence: 99%

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Primary cutaneous vs secondary cutaneous follicular lymphomas: A comparative study focused on BCL2, CD10, and t(14;18) expression

et al. 2018

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Background Primary cutaneous follicular center‐cell lymphoma (PCFCL) is one of the most common types of cutaneous B‐cell lymphoma. Differences in immunohistochemical expression of BCL2 and CD10 antigens along with the presence of t(14:18) translocation in neoplastic cells have been postulated as relevant clues in differentiating PCFCL from cutaneous lesions secondary to a systemic follicular lymphoma (SCFL). The aim of this study is to evaluate the significance and usefulness of these parameters in a large series of patients. Methods Patients with PCFCL and SCFL diagnosed at three university hospitals in Barcelona, from 2000 to 2015 were reviewed. Clinical, histopathological, immunophenotypical, genetic, and outcome parameters were analyzed. Results Eighty‐one cases (59 PCFCL and 22 SCFL) were included. There were no significant differences between PCFCL and SCFL cases regarding clinical presentation, site of involvement, or predominant type of skin lesions. Most patients in both groups showed positivity for BCL2 and CD10, but strong expression of BCL2 and CD10 was associated with SCFL cases. Although more frequent in SCFL, a small proportion of PCFCL cases also showed the t(14:18) on FISH analysis. Conclusion The intensity of BCL2 expression was found to be the single most valuable clue in differentiating PCFCL from SCFL cases on histopathological grounds.

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Primary cutaneous vs secondary cutaneous follicular lymphomas: A comparative study focused on BCL2, CD10, and t(14;18) expression

et al. 2018

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“…t(14;18)(q32;q21) involves BCL2 and IGH and represents the cytogenetic hallmark of nodal follicular lymphoma, whereas its detection in PCFCCL requires to exclude a secondary localization [21]. BCL2 translocation has been variably detected in PCFCCL both in studies using polymerase chain reaction (PCR)-based methods (0-34%) and FISH analysis (0-41%) ( Table 5) [21][22][23][24][25][26][27][28][29][30][31][32][33]. Possible explanations for this wide range include geographic distribution, the limited number and heterogeneity of at least some of the reported series, and variation in the diagnostic criteria in different studies, probably including cases of skin involvement in the course of systemic follicular lymphoma.…”

Section: Discussionmentioning

confidence: 99%

Primary cutaneous B‐cell lymphoma other than marginal zone: clinicopathologic analysis of 161 cases: Comparison with current classification and definition of prognostic markers

et al. 2016

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Categorization of primary cutaneous B‐cell lymphomas (PCBCL) other than marginal zone (MZL) represents a diagnostic challenge with relevant prognostic implications. The 2008 WHO lymphoma classification recognizes only primary cutaneous follicular center cell lymphoma (PCFCCL) and primary cutaneous diffuse large B‐cell lymphoma, leg type (PCDLBCL‐LT), whereas the previous 2005 WHO/EORTC classification also included an intermediate form, namely PCDLBCL, other. We conducted a retrospective, multicentric, consensus‐based revision of the clinicopathologic characteristics of 161 cases of PCBCL other than MZL. Upon the histologic features that are listed in the WHO classification, 96 cases were classified as PCFCCL and 25 as PCDLBCL‐LT; 40 further cases did not fit in the former subgroups in terms of cytology and/or architecture, thus were classified as PCDLBCL, not otherwise specified (PCDLBCL‐NOS). We assigned all the cases a histogenetic profile, based on the immunohistochemical detection of CD10, BCL6, and MUM1, and a “double hit score” upon positivity for BCL2 and MYC. PCDLBCL‐NOS had a clinical presentation more similar to PCFCCL, whereas the histology was more consistent with the picture of a diffuse large B‐cell lymphoma, as predominantly composed of centroblasts but with intermixed a reactive infiltrate of small lymphocytes. Its behavior was intermediate between the other two forms, particularly when considering only cases with a “non‐germinal B‐cell” profile, whereas “germinal center” cases resembled PCFCCL. Our data confirmed the aggressive behavior of PCDLBC‐LT, which often coexpressed MYC and BCL2. The impact of single factors on 5‐year survival was documented, particularly histogenetic profile in PCDLBCL and BCL2 translocation in PCFCCL. Our study confirms that a further group—PCDLBCL‐NOS—exists, which can be recognized through a careful combination of histopathologic criteria coupled with adequate clinical information.

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“…However, in examples that are follicular, especially when predominantly small cleaved cells, BCL2 is expressed in approximately 40% of cases. 73,74 …”

Section: Cutaneous B-cell Lymphomas (Cbcl)mentioning

confidence: 99%

“…72,81 The IGH@-BCL2 translocation typically seen in nodal follicular lymphoma can be seen in 0–40% of cases PCFCL with a follicular growth pattern. 74,82,83 Variation may be related to technique. 82 Gene expression profiling studies have shown that the profile resembles germinal center-like diffuse large B-cell lymphomas.…”

Section: Cutaneous B-cell Lymphomas (Cbcl)mentioning

confidence: 99%

Managing Patients with Cutaneous B-Cell and T-Cell Lymphomas Other Than Mycosis Fungoides

Kheterpal

Mehta‐Shah

Virmani

et al. 2016

Curr Hematol Malig Rep

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Cutaneous lymphomas (CL) are a heterogeneous group of neoplasms characterized with clinical and histopathological variation, as well as overlap with benign dermatoses. Diagnosis and treatment of CLs is challenging and often requires a multi-disciplinary approach. However, prognostic knowledge of these conditions and awareness of treatment options can help optimize appropriate use of available regimens, thereby improving care for patients. Here we review the most recent literature and outline treatment themes for managing patients with cutaneous B-cell and T-cell lymphomas other than mycosis fungoides.

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Primary Cutaneous Follicular Lymphoma: An Assessment of Clinical, Histopathologic, Immunophenotypic, and Molecular Features

Abstract: We demonstrated Bcl-2 protein expression and t(14;18)(q32;q21) in a significant minority of cases, suggesting a relationship with NFL. It remains to be seen whether, on longer follow-up, there is any clinical difference in cases with and without t(14;18)(q32;q21).

Cited by 68 publications

References 44 publications

Primary cutaneous vs secondary cutaneous follicular lymphomas: A comparative study focused on BCL2, CD10, and t(14;18) expression

Primary cutaneous vs secondary cutaneous follicular lymphomas: A comparative study focused on BCL2, CD10, and t(14;18) expression

Primary cutaneous B‐cell lymphoma other than marginal zone: clinicopathologic analysis of 161 cases: Comparison with current classification and definition of prognostic markers

Managing Patients with Cutaneous B-Cell and T-Cell Lymphomas Other Than Mycosis Fungoides

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