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Low stage follicular lymphoma: biologic and clinical characterization according to nodal or extranodal primary origin.

Authors
  • Weinberg, Olga K
  • Ma, Lisa
  • Seo, Katie
  • Beck, Andrew H
  • Pai, Reetesh K
  • Morales, Anjali
  • Kim, Youn
  • Sundram, Uma
  • Tan, Daryl
  • Horning, Sandra J
  • Hoppe, Richard T
  • Natkunam, Yasodha
  • Arber, Daniel A
Type
Published Article
Journal
The American Journal of Surgical Pathology
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Apr 01, 2009
Volume
33
Issue
4
Pages
591–598
Identifiers
DOI: 10.1097/PAS.0b013e31818e6489
PMID: 19065102
Source
Medline
License
Unknown

Abstract

Studies suggest that primary extranodal follicular lymphoma (FL) is not infrequent but it remains poorly characterized with variable histologic, molecular, and clinical outcome findings. We compared 27 extranodal FL to 44 nodal FL using morphologic, immunohistochemical, and molecular genetic techniques and evaluated the clinical outcome of these 2 similarly staged groups. Eight cases of primary cutaneous follicle center lymphoma were also studied. In comparison to nodal FL, a greater number of extranodal FL contained a diffuse growth pattern (P=0.004) and lacked CD10 expression (P=0.014). Fifty-four percent of extranodal and 42% of nodal FL cases showed evidence of t(14;18), with minor breakpoints (icr, 3'BCL2, 5'mcr) more commonly found in extranodal cases (P=0.003). Outcome data showed no significant differences in overall survival (P=0.565) and progression-free survival (P=0.627) among extranodal, nodal, and primary cutaneous follicle center lymphoma cases. Analysis of all cases by t(14;18) status indicate that the translocation-negative group is characterized by a diffuse growth pattern (P=0.043) and lower BCL2 expression (P=0.018). The t(14;18)-positive group showed significantly better overall survival (P=0.019) and disease-specific survival (P=0.006) in comparison with the t(14;18)-negative group. In low stage FL, the status of t(14;18) seems to be more predictive of outcome than origin from an extranodal versus nodal site.

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