Bermudez Glenda, González de Villambrosía Sonia, Martínez-López Azahara, Batlle Ana, Revert-Arce José B, Cereceda Company Laura, Ortega Bezanilla César, Piris Miguel A, Montes-Moreno Santiago
*Pathology and Haematology Departments ‡Biobanco Valdecilla, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander †Pathology Department, Hospital Virgen de la Salud, Toledo, Spain.
Am J Surg Pathol. 2016 Jul;40(7):943-9. doi: 10.1097/PAS.0000000000000628.
Follicular lymphoma in situ (FLIS) and mantle cell lymphoma in situ (MCLIS) are histopathologic findings of undetermined clinical significance. We studied a series of 341 consecutive lymph node resection specimens from patients diagnosed with colorectal (201 cases) and breast (140 cases) adenocarcinoma between 1998 and 2000. Incidental and isolated FLIS was identified in 11/341 patients (3.23%), whereas incidental and isolated MCLIS was found in 2/341 patients (0.59%). None of these cases developed overt lymphoma. A second series of 17 cases of FLIS (16 cases) and MCLIS (1 case) from consultation files was analyzed. Five cases with incidental and isolated FLIS were identified. None of these cases developed overt lymphoma. Overall, none of the 16 cases with incidental and isolated FLIS in both series developed overt FL after a median follow-up of 54 months (range, 7 to 187 mo). However, 12 of these cases with a clinical suspicion of lymphoproliferative disorder showed the association (in different lymph nodes) or combination (in the same sample) of FLIS or MCLIS with other lymphoid neoplasms (FL, splenic marginal zone lymphoma, nodal marginal zone lymphoma, Hodgkin lymphoma, diffuse large B-cell lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, multiple myeloma). In conclusion, the clinical relevance of FLIS and MCLIS seems to strictly depend on the clinical context. Incidental FLIS or MCLIS seem to have a very low risk for transformation, which recommends careful clinical examination after histopathologic diagnosis and conservative management with follow-up for a limited period of time.
原位滤泡性淋巴瘤（FLIS）和原位套细胞淋巴瘤（MCLIS）是临床意义未明的组织病理学表现。我们研究了1998年至2000年间连续341例经诊断为结直肠癌（201例）和乳腺癌（140例）腺癌患者的淋巴结切除标本。在341例患者中有11例（3.23%）发现了偶然的孤立性FLIS，而在341例患者中有2例（0.59%）发现了偶然的孤立性MCLIS。这些病例均未发展为明显的淋巴瘤。对会诊档案中的第二组17例FLIS（16例）和MCLIS（1例）病例进行了分析。确定了5例偶然的孤立性FLIS病例。这些病例均未发展为明显的淋巴瘤。总体而言，两组中16例偶然的孤立性FLIS病例在中位随访54个月（范围7至187个月）后均未发展为明显的FL。然而，其中12例临床怀疑有淋巴增殖性疾病的病例显示FLIS或MCLIS与其他淋巴样肿瘤（FL、脾边缘区淋巴瘤、淋巴结边缘区淋巴瘤、霍奇金淋巴瘤、弥漫性大B细胞淋巴瘤、慢性淋巴细胞白血病/小淋巴细胞淋巴瘤、多发性骨髓瘤）存在关联（在不同淋巴结）或合并存在（在同一样本中）。总之，FLIS和MCLIS的临床相关性似乎严格取决于临床背景。偶然的FLIS或MCLIS似乎转化风险非常低，这建议在组织病理学诊断后进行仔细的临床检查，并在有限时间内进行随访的保守管理。
