Another look at follicular lymphoma: Immunophenotypic and molecular analyses identify distinct follicular lymphoma subgroups

Teresa Marafioti, Christiane Copie-Bergman, Maria Calaminici, Jennifer C. Paterson, Vishvesh H. Shende, Hongxiang Liu, Maryse Baia, Alan D. Ramsay, Claudio Agostinelli, Josette Brière, Andrew Clear, Ming Qing Du, Pier Paolo Piccaluga, Noraidah Masir, Elizabeth P. Nacheva, Pierre Sujobert, Kandavel Shanmugam, Thomas M. Grogan, Simon P. Brooks, Asim KhwajaKirit Ardeshna, William Townsend, Stefano A. Pileri, Corinne Haioun, David Linch, John G. Gribben, Philippe Gaulard, Peter G. Isaacson

Research output: Contribution to journalArticlepeer-review


Aims: The aim of this study was to analyse the immunophenotypic and molecular features of a large series of follicular lymphomas, focusing in particular on atypical cases that fail to express CD10 and/or bcl-2. Such cases present diagnostic pitfalls, especially with regard to the differential diagnosis from follicular hyperplasia and marginal zone B-cell lymphoma. Therefore, we also included an immunohistochemical evaluation of stathmin, which is strongly expressed by germinal centre B cells, as a putative new marker for follicular lymphomas, particularly those with an atypical phenotype. Methods and results: Two hundred and five follicular lymphomas were investigated with immunohistochemistry and fluorescence in-situ hybridization (FISH). The use of three distinct anti-bcl-2 antibodies together with CD10 expression data and FISH analysis for bcl-2 and bcl-6 rearrangements allowed subclassification of follicular lymphoma into four distinct subgroups: (i) CD10-positive/bcl-2-positive, (ii) CD10-positive/bcl-2-negative, (iii) CD10-negative/bcl-2-positive, and (iv) CD10-negative/bcl-2-negative. All cases were bcl-6-positive. STMN1 (stathmin) was shown to be helpful in diagnosing bcl-2-negative and/or CD10-negative follicular lymphomas, and in their distinction from marginal zone B-cell lymphoma. Conclusions: Combined immunohistological and molecular analyses reveal that follicular lymphomas showing an atypical immunophenotypic and molecular profile exist, and we demonstrate that STMN1 represents a novel useful diagnostic marker for these.

Original languageEnglish
Pages (from-to)860-875
Number of pages16
Issue number6
Publication statusPublished - May 2013


  • Bcl-2
  • FISH
  • Follicular lymphoma
  • Immunohistochemistry
  • Phenotype
  • Stathmin

ASJC Scopus subject areas

  • Histology
  • Pathology and Forensic Medicine


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