Nodal Marginal Zone Lymphoma with Aberrant CD10 Expression: A Case Report and Literature Review
Keywords:
CD10, nodal marginal zone lymphoma, follicular lymphoma with a diffuse patternAbstract
CD10+ nodal marginal zone lymphoma is very rare, with only one case report in the English literature currently. Here we report a case of nodal marginal zone lymphoma with strong CD10 expression occurring in a 76 year-old female with extensive lymphadenopathy. The lymph node biopsy showed a population of small lymphocytes diffusely infiltrating into the interfollicular areas and colonizing disrupted follicles. Immunohistochemical staining revealed that these small lymphocytes were positive for CD20, PAX-5, Bcl-2 and bright CD10. Bcl-6, Cyclin D1 and CD43 were negative in this population of cells. In contrast, the residual germinal center B-cells demonstrated expression of CD10 and Bcl-6 and negative staining for Bcl-2. Flow cytometry study demonstrated a CD10+CD20+ kappa-restricted B-cell lymphoma. FISH studies for translocation of IgH, Bcl-2 and Bcl-6 were negative. Therefore, a diagnosis of CD10+ nodal marginal zone lymphoma was established. This rare disease entity illustrates a possible diagnostic pitfall within the group of mature small B-cell lymphomas, especially for follicular lymphomas with a diffuse pattern. The clinical significance of CD10 positivity in nodal marginal zone lymphomas is unknown. More cases and additional clinical follow up are required to address this question.
References
Wang E, West D, Kulbacki E. An unusual nodal marginal zone lymphoma with bright CD10 expression: a potential diagnostic pitfall. Am J Hematol. 2010;85(7):546-548.
Yuan CM, Vergilio JA, Zhao XF, Smith TK, Harris NL, Bagg A. CD10 and BCL6 expression in the diagnosis of angioimmunoblastic T-cell lymphoma: utility of detecting CD10+ T cells by flow cytometry. Human Pathol. 2005;36(7):784-791.
Attygalle AD, Diss TC, Munson P, Isaacson PG, Du MQ, Dogan A. CD10 expression in extranodal dissemination of angioimmunoblastic T-cell lymphoma. Am J Surg Pathol. 2004;28(1):54-61.
Morice WG, Hodnefield JM, Kurtin PJ, Hanson CA. An unusual case of leukemic mantle cell lymphoma with a blastoid component showing loss of CD5 and aberrant expression of CD10. Am J Clin Pathol. 2004;122(1):122-127.
Zanetto U, Dong H, Huang Y, et al. Mantle cell lymphoma with aberrant expression of CD10. Histopathol. 2008;53(1):20-29.
Lian DW, Chau YP, Lee LK, Teo C, Yap WM, Chuah KL. Ocular mantle cell lymphoma with aberrant CD10 expression: a potential diagnostic pitfall. Pathol. 2009;41(7):704-706.
Swerdlow SH, Campo, E., Harris, N.L., Jaffe, E.S., Pileri, S.A., Stein, H., Thiele, J., Vardiman, J.W. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, Fourth Edition. 2008.
Kojima M, Yamanaka S, Yoshida T, et al. Histological variety of floral variant of follicular lymphoma. APMIS. 2006;114(9):626-632.
Torlakovic EE, Aamot HV, Heim S. A marginal zone phenotype in follicular lymphoma with t(14;18) is associated with secondary cytogenetic aberrations typical of marginal zone lymphoma. J Pathol. 2006;209(2):258-264.
Yegappan S, Schnitzer B, Hsi ED. Follicular lymphoma with marginal zone differentiation: microdissection demonstrates the t(14;18) in both the follicular and marginal zone components. Mod Pathol. 2001;14(3):191-196.
Navarro A, Royo C, Hernandez L, Jares P, Campo E. Molecular pathogenesis of mantle cell lymphoma: new perspectives and challenges with clinical implications. Semin Hematol. 2011;48(3):155-165.
