MNDA Is Expressed in a Subset of Marginal Zone Lymphomas and Is Useful in the Differential Diagnosis with Follicular Lymphoma
Aharon G Freud, Ahmad Monabati, Giovanna Roncador, Gabriela Gualco, Carlos Bacchi, Yasodha Natkunam. Stanford University, Stanford, CA; Spanish National Cancer Research Centre, Madrid, Spain; Consultoria em Patologia, Botucatu, Sao Paulo, Brazil
Background: The diagnosis of marginal zone lymphoma (MZL) is complicated by the lack of specific markers that distinguish it from other non-Hodgkin B cell lymphomas. Myeloid cell nuclear differentiation antigen (MNDA) is a nuclear protein that was recently shown to be expressed at high frequency in MZL. We evaluated MNDA expression in a series of extramedullary non-Hodgkin B cell lymphomas to assess the sensitivity and specificity of this antigen for the detection of MZL.
Design: Formalin-fixed paraffin embedded tissue sections from individual cases and tissue microarrays were stained for MNDA using a monoclonal antibody (clone 253, 1:50 dilution) on a Leica Bond-Max platform with EDTA antigen retrieval. Lymphoma diagnoses were confirmed by three hematopathologists using WHO 2008 criteria.
Results: A total of 405 B cell lymphomas were stained for MNDA. Approximately 69% of nodal MZL (NMZL), 56% of extranodal MZL (EMZL) and 20% of splenic MZL (SMZL) expressed MNDA. MNDA was infrequently expressed in mantle cell lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, high grade follicular lymphoma (FL), and diffuse large B cell lymphoma. No low grade FLs were positive for MNDA.
|Diagnosis||Number MNDA positive||Percent MNDA positive|
|Follicular lymphoma, grade 1-2||0/64||0%|
|Follicular lymphoma, grade 3||3/41||7%|
|Diffuse large B cell lymphoma||2/61||3%|
|Nodal marginal zone lymphoma||11/16||69%|
|Extranodal marginal zone lymphoma||19/34||56%|
|Splenic marginal zone lymphoma||4/20||20%|
|Chronic lymphocytic leukemia/small lymphocytic lymphoma||4/30||13%|
|Mantle cell lymphoma||9/139||6%|