Significance of CD10 protein expression in the diagnostics of follicular lymphoma: A comparison of conventional immunohistochemistry with flow cytometry supported by the establishment of BCL2 and BCL6 rearrangements

Abstract

IntroductionHistopathological examination and immunohistochemistry (IHC) with a crucial role of CD10 expression remain a standard diagnostic tool in follicular lymphoma (FL). The results of IHC CD10 detection with different primary antibodies are not fully reproducible, but some reports show that flow cytometry (FCM) can be a reliable method of CD10 identification.MethodsThe aim of the study was to compare results of CD10 expression in FL by IHC and FCM including immunophenotypic features in the context of the BCL2 and BCL6 alterations.ResultsOut of 76 histopathologically diagnosed FL, a group of 25 cases had simultaneously FCM. Immunohistochemically 77.6% of cases were CD10‐positive with comparable and reproducible results to FCM. Differences between the FCM expression of CD5/CD10/CD11c/CD25/CD43 and BCL2 overexpression (BCL2(+)higher) correlated with the BCL2 and BCL6 rearrangements (R) status. Lack of CD10 expression corresponded with the absence of BCL2R and higher MUM1 expression by IHC results but had no clinical impact on the long‐time outcomes.ConclusionsImmunohistochemistry staining is a comparable method to FCM assessment in the evaluation of CD10 expression and diagnosis of FL. Fine‐needle aspiration biopsy/FCM (FNAB/FCM) could be a useful tool for verifying FL diagnosis and CD10 detection. Despite its heterogeneity, FL has a characteristic immunophenotype. BCL2R and BCL6R FL cases differ mainly in levels of BCL2 and CD10 with CD43 co‐expression; BCL2(+)higher by FCM correlates with BCL2R. Moreover, FNAB plays an important role in material provision for supportive karyotyping and BCL2R, BCL6R assessed by FISH.

Large-Scale Proteomic Analysis of Follicular Lymphoma Reveals Extensive Remodeling of Cell Adhesion Pathway and Identifies Hub Proteins Related to the Lymphomagenesis

“…Pre-therapeutic lymphoma samples as cellular suspensions were also obtained by the same hematopathologist by FNAB/ultrasound-guided FNAB from the involved lymph nodes or tumors of patients diagnosed at Maria Sklodowska-Curie National Research Institute of Oncology between 2016 and 2017. Each case, obtained by FNAB, was also followed by detailed FCM immunophenotyping, assessment of % of pathological cells, and cytogenetics analysis as previously described [86]. Subjects submitted for lymphadenopathy screening and with reactive histopathological findings served as controls.…”

Prognostic Value of the Ki67 Proliferation Index, CD10 and MUM1 in Follicular Lymphoma

“…However, MUM1 had an adverse effect in the patients with CD10 negative. OS and PFS in the group with MUM1 positive/CD10 negative decreased significantly for 5 years than in the group [25,26]. The positive rate of MUM1 was 44.4%, higher than in the studies of Kikeri N. Naresh (37%), Eric D Hsi (14.4%) [16,22].…”

“…Luc Xerri also recommended that MUM1 can be used as a routine biomarker for the clinical management of patients with FL [15]. Otherwise, Anna Szumera-Cieckiewicz, et al suggested that the lack of CD10 expression corresponded to the absence of Bcl2 and higher expression of MUM1, but had no impact on long-term outcomes [25]. Perhaps, for patients with FL with negative CD10, a further evaluation of MUM1 should be considered as an additional prognostic factor.…”