Sotomayor Edgar A, Shah Inangati M, Sanger Warren G, Mark Hon Fong L
Department of Pathology, Creighton University School of Medicine and Creighton University Medical Center, 601 N 30th Street Omaha, NE 68131, USA.
Exp Mol Pathol. 2007 Oct;83(2):254-8. doi: 10.1016/j.yexmp.2007.03.001. Epub 2007 Mar 24.
The main differential diagnosis for follicular lymphoma (FL, or in situ localization of follicular lymphoma) is follicular hyperplasia. However, this differentiation is quite challenging when the initial presentation of FL is in one lymph node and such a lymph node is only partially involved. In other words, only a few lymphomatous follicles are present in an otherwise nodal reactive follicular hyperplasia. The use of FISH on formalin-fixed, paraffin-embedded tissue as an adjunct to routine histomorphological and immunohistochemical evaluation is valuable for reaching an initial diagnosis of in situ follicular lymphoma in a lymph node which shows predominantly reactive follicular hyperplasia. In this report, we describe our experience in rendering such an initial diagnosis of in situ FL in an apparently healthy individual who has a single persistently enlarged lymph node. The recognition of in situ FL is of utmost importance because it is associated with localized early stage disease (stage I), which according to standard regimens is amenable to local radiation therapy with a good chance for inducing remission. To the best of our knowledge, this is the first such case reported in the English literature using innovative FISH technology on formalin-fixed, paraffin-embedded tissue in conjunction with other routine histological modalities to produce an initial diagnosis of in situ follicular lymphoma.
滤泡性淋巴瘤（FL，或滤泡性淋巴瘤原位定位）的主要鉴别诊断是滤泡增生。然而，当FL最初表现为单个淋巴结受累且仅部分累及该淋巴结时，这种鉴别颇具挑战性。换句话说，在以淋巴结反应性滤泡增生为主的情况下，仅存在少数淋巴瘤性滤泡。在福尔马林固定、石蜡包埋组织上使用荧光原位杂交（FISH）作为常规组织形态学和免疫组化评估的辅助手段，对于在主要表现为反应性滤泡增生的淋巴结中初步诊断原位滤泡性淋巴瘤很有价值。在本报告中，我们描述了对一名有单个持续性肿大淋巴结的看似健康个体进行原位FL初步诊断的经验。原位FL的识别至关重要，因为它与局限性早期疾病（I期）相关，根据标准方案，这种疾病适合局部放疗，诱导缓解的机会很大。据我们所知，这是英文文献中首例使用创新的FISH技术对福尔马林固定、石蜡包埋组织结合其他常规组织学方法进行原位滤泡性淋巴瘤初步诊断的病例。
