Immunoarchitectural patterns in splenic marginal zone lymphoma: correlations with chromosomal aberrations, IGHV mutations, and survival. A study of 76 cases. Issue 6 (24th April 2013)

• Record Type: Journal Article
• Authors: Traverse‐Glehen, Alexandra; Bachy, Emmanuel; Baseggio, Lucile; Callet‐Bauchu, Evelyne; Gazzo, Sophie; Verney, Aurélie; Hayette, Sandrine; Jallades, Laurent; Ffrench, Martine; Salles, Gilles; Coiffier, Bertrand; Felman, Pascale; Berger, Francoise
• Is Part Of: Histopathology. Volume 62:Issue 6(2013)
• Page Start: 876
• Page End: 893
• Publication Date: 2013-04-24
• Subjects: Histology, Pathological -- Periodicals; 611.018
• DOI: 10.1111/his.12092
• Languages: English
• ISSNs: 0309-0167

Abstract

<abstract abstract-type="main" xml:lang="en" id="his12092-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="his12092-sec-0001" sec-type="section"> <title>Aims</title> <p>To describe 76 cases of splenic marginal zone lymphoma (SMZL), including correlations with clinical and other characteristics.</p> </sec> <sec id="his12092-sec-0002" sec-type="section"> <title>Methods and results</title> <p>Patients were predominantly female, with a median age of 62 years. The main clinical presentation was splenomegaly, except for eight cases presenting with evolution of autoimmune disorders or spontaneous splenic rupture. White pulp infiltration was nodular, with a monophasic (42%) or biphasic (53%) pattern, and associated diffuse or nodular infiltration of the red pulp, except for four cases which had atrophic white pulp. Plasmacytic differentiation and the <italic>MYD88</italic> L265P mutation were observed in 18% and 5% of the cases, respectively. Histological progression was considered in cases with a significant association of large cells with Ki67 > 30% and macronodular architecture (<italic>P</italic> = 0.001). Other significant correlations were found between del7q (44%) and del6q (17%) (<italic>P</italic> = 0.018), IGHV1‐2*04 segment usage (35%) (<italic>P</italic> = 0.001) and unmutated <italic>IGHV</italic> (39%) (<italic>P</italic> = 0.019), and between CD5 expression (27%) and higher lymphocytosis (<italic>P</italic> <italic>=</italic> 0.002). Patients requiring intensive chemotherapy after splenectomy because of clinical and/or histological progression had significantly shorter overall survival (<italic>P</italic> = 0.012).</p> </sec> <sec id="his12092-sec-0003" sec-type="section"> <title>Conclusions</title> <p>We report the histological spectrum of SMZL, and discuss the differential diagnosis and requirement for molecular and cytogenetic analysis in atypical cases.</p> </sec> </abstract>