Nodal reactive and neoplastic proliferation of monocytoid and marginal zone B cells: An immunoarchitectural and molecular study highlighting the relevance of IRTA1 and T-bet as positive markers

Roshanak Bob, Brunangelo Falini, Teresa Marafioti, Jennifer C. Paterson, Stefano Pileri, Harald Stein

Research output: Contribution to journalArticle

Abstract

Aims: Marginal zone B cells (MZCs) and monocytoid B cells (MBCs) appear to be related lymphoid cells that take part in reactive and neoplastic marginal zone proliferations. These lesions are not yet well characterized, and the aim of this study was to find better diagnostic criteria for them. Methods and results: We analysed 60 nodal lesions with MBC and/or MZC proliferation for their morphological, immunophenotypic, molecular genetic and IG gene rearrangement features. On the basis of the results of the rearrangement assay and immunoglobulin light chain restriction, the lesions were divided into reactive and neoplastic groups. Among the neoplastic lesions, polymorphic and monomorphic subgroups emerged. All reactive lesions had morphological features of the polymorphic subgroup. By immunohistochemistry, IRTA1 and/or T-bet expression was found in all reactive lesions and in 90% of neoplastic lesions. Conclusions: IRTA1 and T-bet are positive markers for the identification of MZC/MBC proliferations, and thus for the diagnosis of nodal marginal zone lymphoma (NMZL). Polymorphic and monomorphic subgroups of NMZL could be distinguished. Most morphological and immunophenotypic patterns in reactive and neoplastic nodal expansions of MZCs and MBCs overlapped. Therefore, PCR clonality assay of the immunoglobulin heavy and light chain gene loci is the most reliable method for their differentiation.

Original languageEnglish
Pages (from-to)482-498
Number of pages17
JournalHistopathology
Volume63
Issue number4
DOIs
Publication statusPublished - Oct 2013

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B-Lymphocytes
Lymphoma
Immunoglobulin Light Chain Genes
Cell Proliferation
Immunoglobulin Heavy Chain Genes
Immunoglobulin Light Chains
Gene Rearrangement
Molecular Biology
Immunohistochemistry
Lymphocytes
Polymerase Chain Reaction

Keywords

  • IRTA1/MUM2
  • Marginal zone expansion
  • Monocytoid B cells
  • Nodal marginal zone lymphoma
  • T-bet

ASJC Scopus subject areas

  • Histology
  • Pathology and Forensic Medicine

Cite this

Nodal reactive and neoplastic proliferation of monocytoid and marginal zone B cells : An immunoarchitectural and molecular study highlighting the relevance of IRTA1 and T-bet as positive markers. / Bob, Roshanak; Falini, Brunangelo; Marafioti, Teresa; Paterson, Jennifer C.; Pileri, Stefano; Stein, Harald.

In: Histopathology, Vol. 63, No. 4, 10.2013, p. 482-498.

Research output: Contribution to journalArticle

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abstract = "Aims: Marginal zone B cells (MZCs) and monocytoid B cells (MBCs) appear to be related lymphoid cells that take part in reactive and neoplastic marginal zone proliferations. These lesions are not yet well characterized, and the aim of this study was to find better diagnostic criteria for them. Methods and results: We analysed 60 nodal lesions with MBC and/or MZC proliferation for their morphological, immunophenotypic, molecular genetic and IG gene rearrangement features. On the basis of the results of the rearrangement assay and immunoglobulin light chain restriction, the lesions were divided into reactive and neoplastic groups. Among the neoplastic lesions, polymorphic and monomorphic subgroups emerged. All reactive lesions had morphological features of the polymorphic subgroup. By immunohistochemistry, IRTA1 and/or T-bet expression was found in all reactive lesions and in 90{\%} of neoplastic lesions. Conclusions: IRTA1 and T-bet are positive markers for the identification of MZC/MBC proliferations, and thus for the diagnosis of nodal marginal zone lymphoma (NMZL). Polymorphic and monomorphic subgroups of NMZL could be distinguished. Most morphological and immunophenotypic patterns in reactive and neoplastic nodal expansions of MZCs and MBCs overlapped. Therefore, PCR clonality assay of the immunoglobulin heavy and light chain gene loci is the most reliable method for their differentiation.",
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AU - Pileri, Stefano

AU - Stein, Harald

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