Lawnicki Lyle C, Weisenburger Dennis D, Aoun Patricia, Chan Wing C, Wickert Robert S, Greiner Timothy C
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68198-3135, USA.
Am J Clin Pathol. 2002 Nov;118(5):765-72. doi: 10.1309/2TJU-DNLQ-5JBA-AB4T.
According to the European Organization for Research and Treatment of Cancer classification, primary cutaneous follicle center cell lymphoma is not associated with the t(14;18)(q32;q21) and only rarely expresses bcl-2 protein. To further investigate this issue, we evaluated a series of 20 patients (14 men, 6 women) with primary cutaneous follicular lymphoma (PCFL). The presenting skin lesion was located in the head and neck region in 16 of 20 patients. Most cases were grade 2 (6/20) or grade 3 (13/20), and all had a follicular architecture. Immunohistochemical analysis demonstrated bcl-2 expression in 8 cases (40%), and expression was inversely related to the grade. Of 7 grade 1 or 2 cases, 5 (71%) were positive, whereas only 3 (23%) of 13 grade 3 cases were positive for bcl-2. Clonal immunoglobulin heavy chain gene rearrangements were detected in 9 (45%) of 20 cases. In 4 (20%) of 20 cases, we identified the major breakpoint of the t(14;18) by polymerase chain reaction, 3 of which were grade 1 or 2. We conclude that bcl-2 protein expression and the t(14;18) are present in a subset of PCFL, particularly in lower grade cases.
根据欧洲癌症研究与治疗组织的分类，原发性皮肤滤泡中心细胞淋巴瘤与t(14;18)(q32;q21)无关，且仅极少表达bcl-2蛋白。为进一步研究此问题，我们评估了一系列20例原发性皮肤滤泡性淋巴瘤（PCFL）患者（14例男性，6例女性）。20例患者中16例的首发皮肤损害位于头颈部区域。多数病例为2级（6/20）或3级（13/20），且均具有滤泡结构。免疫组化分析显示8例（40%）有bcl-2表达，且表达与分级呈负相关。7例1级或2级病例中，5例（71%）为阳性，而13例3级病例中仅3例（23%）bcl-2呈阳性。20例中有9例（45%）检测到克隆性免疫球蛋白重链基因重排。20例中有4例（20%）通过聚合酶链反应鉴定出t(14;18)的主要断裂点，其中3例为1级或2级。我们得出结论，bcl-2蛋白表达和t(14;18)存在于一部分PCFL中，尤其是低级别病例。
