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Light‐chain‐restricted germinal centres in reactive lymphadenitis: report of eight cases
Author(s) -
NamCha S H,
SanMillán B,
Mollejo M,
GarcíaCosio M,
Garijo G,
Gomez M,
Warnke R A,
Jaffe E S,
Piris M A
Publication year - 2008
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.1365-2559.2008.02965.x
Subject(s) - germinal center , follicular hyperplasia , pathology , immunoglobulin light chain , follicular lymphoma , biology , lymph node , bcl6 , lymphoma , gene rearrangement , immunohistochemistry , microbiology and biotechnology , antibody , immunology , medicine , b cell , genetics , gene
Aims: Light‐chain‐restricted germinal centres are generally associated with the existence of a neoplastic lymphoproliferative disorder. The aim was to present a series of cases with persistent lymph node enlargement that featured some germinal centres showing light chain immunoglobulin restriction. Methods and results: A series of six reactive lymphadenitis and two Castleman’s disease cases was analysed by immunohistochemistry, IgH‐polymerase chain reaction (PCR) and microdissected PCR. In all cases some germinal centres contained a population of plasma cells and plasmacytoid germinal centre cells showing light chain immunoglobulin restriction. In three cases the monotypic cells also showed distinct Bcl‐2 expression. Two of the cases showed a predominant IgH rearrangement on a florid polyclonal background and one had an IgH monoclonal rearrangement, as revealed by PCR. Microdissected germinal centre PCR revealed a dominant repeated band in one of three cases and in another case a non‐repeated clonal peak was observed. One of the patients developed a follicular lymphoma, which became evident from a subsequent biopsy. Conclusions: These findings may be a manifestation of an underlying disorder in the regulation of the immune response, or an exaggeration of the germinal centre oligoclonal nature. This should be taken into account in the differential diagnosis of follicular hyperplasia.