Intrafollicular Neoplasia/In Situ Follicular Lymphoma in Association with Different Types of Lymphoid Neoplasm, Is There a Biological Link?
Azahara Martinez-Lopez, Santiago Montes-Moreno, Francisco Mazorra, Ana Batlle, Francisco Jimenez-Burgos, Yolanda Castro, Carlos Barrionuevo, Juan Cruz-Cigudosa, Agueda Bas-Vernal, Miguel A Piris. Hospital Universitario Marqués de Valdecilla, Santander, Spain; Hospital Santa Barbara, Puertollano, Spain; Hospital Universitario Gregorio Marañon, Madrid, Spain; Instituto de Enfermedades Neoplásicas, Lima, Peru; Spanish National Cancer Research Centre, Madrid, Spain; Hospital Universitario Virgen de Arrixaca, Murcia, Spain
Background: Intrafollicular neoplasm/in situ Follicular Lymphoma(FLIS) was first described in 2002. It is characterized by the presence of germinal centre cells that strongly express BCL2 protein and GC markers (CD10, BCL6), while most of the remaining lymph node shows a pattern of follicular hyperplasia. Previous studies indicate that it has a very low rate of progression and association to Follicular Lymphoma (FL) but there are few studies that describe the association with other lymphoid malignancies different from follicular lymphoma, thus the clinical significance remains uncertain.
Design: A series of seven cases showing FLIS diagnosis followed or associated with the diagnosis of lymphoma types different from follicular lymphoma has been reviewed. The series was obtained from a second opinion consultation archive, where five of the cases were previously reported.
Results: Seven patients with the diagnosis of FLIS had concurrent or subsequent different lymphoma types, different from Follicular lymphoma: Hodgkin Lymphoma (3 cases), Splenic Marginal Zone Lymphoma (2 cases), Nodal Marginal zone Lymphoma (1 case), Diffuse Large B-cell lymphoma (1 case), Myeloma (1 case). One of these patients developed three different lymphoma types, including HL, Myeloma and FL. In six cases evaluated by FISH, four had BCL2 translocations.
Conclusions: Diagnosis of FLIS may be associated with the development of lymphoid neoplasms different than follicular lymphoma. Patients receiving this diagnosis should be staged and followed taken into account this possibility. A subset of patients with the diagnosis of FLIS seems to develop multiple lymphoid neoplasms, a phenomenon that is worthy to explore.
Tuesday, March 5, 2013 1:00 PM
Poster Session IV # 251, Tuesday Afternoon