Some diffuse large B cell lymphomas (<scp>DLBCL</scp>s) present with clone‐dependent <scp>TTF</scp>‐1 positivity

Bockstal, Mieke Van; Camboni, Alessandra; Vlieghere, Elly De; Ryck, Frédéric De; Candaele, Ann-Sophie; Geenen, Sofie; Vandemaele, Lies; Wever, Olivier De; Libbrecht, Louis; Verbeke, Sofie; Dorpe, Jo A. Van

doi:10.1111/his.13477

Cited by 3 publications

(7 citation statements)

References 6 publications

(10 reference statements)

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“…As they could not find information on nonspecific TTF-1 staining in DLBCLs, they went on to examine a large series of DLBCL cases and found that 4 of 106 DLBCLs (3.8%) showed nuclear positivity with TTF-1/SPT24, while no nuclear staining was observed with TTF-1/8G7G3/1. 5 Similarly, in our study, clone SPT24 showed a higher rate and extent of expression in lymphoma cases than clone 8G7G3/1; however, the TTF-1-positive cases in our series were PTCL, not DLBCL as in their study. Interestingly, such a nonspecific expression clustered in ATLL and AITL cases, which has never been reported yet.…”

Section: Discussionsupporting

confidence: 53%

“…Recently, Van Bockstal et al reported their experience of encountering TTF-1 expression in a poorly differentiated, subcutaneous neoplasm of uncertain origin on the thorax of a man with a history of pulmonary adenocarcinoma. 5 Although TTF-1 expression might suggest a metastatic lung cancer, the correct diagnosis of DLBCL was reached through additional lymphoma markers. As they could not find information on nonspecific TTF-1 staining in DLBCLs, they went on to examine a large series of DLBCL cases and found that 4 of 106 DLBCLs (3.8%) showed nuclear positivity with TTF-1/SPT24, while no nuclear staining was observed with TTF-1/8G7G3/1.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, such a nonspecific expression clustered in ATLL and AITL cases, which has never been reported yet. The reason for this nonspecific TTF-1 expression in lymphoma is unclear, even after immunoblotting analysis by Van Bockstal et al 5…”

Section: Discussionmentioning

confidence: 99%

“…4 Recently, Van Bockstal et al reported that 3.8% (4/106) cases of diffuse large B-cell lymphoma (DLBCL) showed a nonspecific TTF-1 positivity by clone SPT24, while all cases were negative by clone 8G7G3/1. 5…”

Section: Introductionmentioning

confidence: 99%

“…At that time, we found the report by Van Bockstal et al showing a small percentage of DLBCL might be nonspecifically positive for TTF-1/SPT24. 5 This prompted us to investigate a series of ATLL, other types of peripheral T-cell lymphoma (PTCL), and DLBCL using 3 different TTF-1 clones.…”

Section: Introductionmentioning

confidence: 99%

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Aberrant TTF-1 Expression in Peripheral T-Cell Lymphomas: A Diagnostic Pitfall

Chang

Chen

et al. 2020

Int J Surg Pathol

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Background Thyroid transcription factor-1 (TTF-1) is a useful marker for identifying thyroid and lung cancers in diagnostic pathology, particularly for the investigation of unknown primary cancers. However, some other tumors such as colorectal cancer might aberrantly express TTF-1, particularly with the less specific clone SPT24. Occasional diffuse large B-cell lymphoma (DLBCL) cases have been reported to be TTF-1-positive, yet there is no information on TTF-1 expression in peripheral T-cell lymphoma (PTCL). Methods We investigated a series of PTCL and DLBCL by immunohistochemistry for TTF-1 expression using 2 commercially available clones. Results We found that 33% (5/15) adult T-cell leukemia/lymphomas (ATLLs) and 25% (2/8) angioimmunoblastic T-cell lymphomas (AITLs) were positive by clone SPT24 and only 2ATLL cases were positive by clone 8G7G3/1. Overall TTF-1 expression rates of PTCL by SPT24 and 8G7G3/1 were 16% (7/43) and 5% (2/43), respectively. All DLBCLs were negative. Conclusion Although TTF-1 is a relatively specific marker for thyroid and lung cancers, it might be expressed in some lymphomas, particularly PTCL when using clone SPT24. Pathologist should be aware of this possible diagnostic pitfall when using TTF-1 in investigating tumors of unknown origin.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Aberrant TTF-1 Expression in Peripheral T-Cell Lymphomas: A Diagnostic Pitfall

Chang

Chen

et al. 2020

Int J Surg Pathol

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Markers and Immunoprofile of Pulmonary Tumors and Tumors of the Upper Respiratory Tract and Middle and Inner Ear

Tuffaha,

Guski,

Kristiansen

2023

Immunohistochemistry in Tumor Diagnostics

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Difficulties in diagnostics of lung tumours in biopsies: an interpathologist concordance study evaluating the international diagnostic guidelines

et al. 2021

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AimsAccurate and reliable diagnosis is essential for lung cancer treatment. The study aim was to investigate interpathologist diagnostic concordance for pulmonary tumours according to WHO diagnostic criteria.MethodsFifty-two unselected lung and bronchial biopsies were diagnosed by a thoracic pathologist based on a broad spectrum of immunohistochemical (IHC) stainings, molecular data and clinical/radiological information. Slides stained with H&E, thyroid transcription factor-1 (TTF-1) clone SPT24 and p40 were scanned and provided digitally to 20 pathologists unaware of reference diagnoses. The pathologists independently diagnosed the cases and stated if further diagnostic markers were deemed necessary.ResultsIn 31 (60%) of the cases, ≥80% of the pathologists agreed with each other and with the reference diagnosis. Lower agreement was seen in non-small cell neuroendocrine tumours and in squamous cell carcinoma with diffuse TTF-1 positivity. Agreement with the reference diagnosis ranged from 26 to 45 (50%–87%) for the individual pathologists. The pathologists requested additional IHC staining in 15–44 (29%–85%) of the 52 cases. In nearly half (17 of 36) of the malignant cases, one or more pathologist advocated for a different final diagnosis than the reference without need of additional IHC markers, potentially leading to different clinical treatment.ConclusionsInterpathologist diagnostic agreement is moderate for small unselected bronchial and lung biopsies based on a minimal panel of markers. Neuroendocrine morphology is sometimes missed and TTF-1 clone SPT24 should be interpreted with caution. Our results suggest an intensified education need for thoracic pathologists and a more generous use of diagnostic IHC markers.

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Some diffuse large B cell lymphomas (DLBCLs) present with clone‐dependent TTF‐1 positivity

Cited by 3 publications

References 6 publications

Aberrant TTF-1 Expression in Peripheral T-Cell Lymphomas: A Diagnostic Pitfall

Aberrant TTF-1 Expression in Peripheral T-Cell Lymphomas: A Diagnostic Pitfall

Markers and Immunoprofile of Pulmonary Tumors and Tumors of the Upper Respiratory Tract and Middle and Inner Ear

Difficulties in diagnostics of lung tumours in biopsies: an interpathologist concordance study evaluating the international diagnostic guidelines

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