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Follicular lymphoma ( FL ) of the gastrointestinal tract, particularly duodenal follicular lymphoma ( DFL ), is a rare variant of  FL  with indolent clinical behavior, and this disease is included in the 2008 World Health Organization classification system. In contrast to nodal follicular lymphoma ( NFL ),  DFL  occurs most frequently in the second part of the duodenum, lacks follicular dendritic cell meshworks and has memory B‐cell characteristics. However, its molecular pathogenesis is still unclear. In the present study, we examined 10  DFL , 18  NFL  and 10 gastric  MALT  lymphoma samples using gene expression analysis. Quantitative  RT ‐ PCR  experiments and immunohistochemical analysis for 72 formalin‐fixed, paraffin‐embedded tissues from an independent series, including 32  DFL , 19 gastric  MALT  lymphoma and 27  NFL  samples, were performed for validation of microarray data. Gene expression profiles of the three lymphoma types were compared using 2918 differentially expressed genes ( DEG ) and results suggested that  DFL  shares characteristics of  MALT  lymphoma. Among these  DEG ,  CCL 20 and  MA d CAM ‐1 were upregulated in  DFL  and  MALT  but downregulated in  NFL . In contrast, protocadherin gamma subfamily genes were upregulated in  DFL  and  NFL . Quantitative  RT ‐ PCR  and immunohistochemical studies demonstrated concordant results. Double immunofluorescence studies revealed that  CCL 20 and  CCR 6 were co‐expressed in both  DFL  and  MALT . We hypothesize that increased expression of  CCL 20 and  MA d CAM ‐1 and co‐expression of  CCL 20 and  CCR 6 may play an important role in tumorigenesis.

Duodenal follicular lymphoma: Comprehensive gene expression analysis with insights into pathogenesis