Premium
BCL2 gene abnormalities define distinct clinical subsets of follicular lymphoma
Author(s) -
Goodlad J R,
Batstone P J,
Hamilton D A,
Kernohan N M,
Levison D A,
White J M
Publication year - 2006
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2006.02501.x
Subject(s) - chromosomal translocation , follicular lymphoma , fluorescence in situ hybridization , biology , lymphoma , incidence (geometry) , pathology , follicular phase , cytogenetics , gene , medicine , genetics , chromosome , optics , physics
Aims: Follicular lymphoma (FL) arising primarily in the skin has recently been proposed as a distinct entity on the basis of a low incidence of t(14;18)(q32;q21) and bcl‐2 expression, with a very high percentage of patients surviving more than 5 years. However, cases of t(14;18)(q32;q21)‐positive primary cutaneous FL (PCFL) and examples of t(14;18)(q32;q21)‐negative FL at nodal and other extranodal sites, are well documented. The aim of this study was to test the hypothesis that there is a subtype of FL lacking t(14;18)(q32;q21), which preferentially involves certain sites but is not restricted by anatomical location. Methods and results: A cohort of 47 stage 1 FL was stratified according to the presence or absence of t(14;18)(q32;q21) using conventional cytogenetics, polymerase chain reaction and interphase fluorescence in situ hybridization. Compared with t(14;18)(q32;q21)‐positive cases, FL lacking the translocation were less likely to express CD10 or bcl‐2 ( P < 0.01), made up a significantly greater proportion of cases arising at extranodal sites ( P < 0.001) and had a significantly better overall and disease‐specific 5‐year survival ( P < 0.01). Conclusions: These results support the concept of a subtype of FL lacking t(14;18)(q32;q21), characterized by low‐intensity bcl‐2 expression, a predilection for extranodal sites, particularly the skin, and a more favourable outcome than t(14;18)(q32;q21)‐positive FL.