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Blood, 15 June 2008, Vol. 111, No. 12, pp. 5433-5439.
Prepublished online as a Blood First Edition Paper on February 13, 2008; DOI 10.1182/blood-2007-11-124792.


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PLENARY PAPER

Clonally related follicular lymphomas and histiocytic/dendritic cell sarcomas: evidence for transdifferentiation of the follicular lymphoma clone

Andrew L. Feldman1,2, Daniel A. Arber3, Stefania Pittaluga1, Antonio Martinez4, Jerome S. Burke5, Mark Raffeld1, Mireia Camos4, Roger Warnke3, and Elaine S. Jaffe1

1 Laboratory of Pathology, National Cancer Institute, Bethesda, MD; 2 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; 3 Department of Pathology, Stanford University, Stanford, CA; 4 University of Barcelona, Barcelona, Spain; and 5 Department of Pathology, Alta Bates Summit Medical Center, Berkeley, CA

Rare cases of histiocytic and dendritic cell (H/DC) neoplasms have been reported in patients with follicular lymphoma (FL), but the biologic relationship between the 2 neoplasms is unknown. We studied 8 patients with both FL and H/DC neoplasms using immunohistochemistry, fluorescence in situ hybridization (FISH) for t(14;18), and polymerase chain reaction (PCR)/sequencing of BCL2 and IGH rearrangements. There were 5 men and 3 women (median age, 59 years). All cases of FL were positive for t(14;18). The H/DC tumors included 7 histiocytic sarcomas, 5 of which showed evidence of dendritic differentiation, and 1 interdigitating cell sarcoma. Five H/DC tumors were metachronous, following FL by 2 months to 12 years; tumors were synchronous in 3. All 8 H/DC tumors showed presence of the t(14;18) either by FISH, or in 2 cases by PCR with the major breakpoint region (MBR) probe. PCR and sequencing identified identical IGH gene rearrangements or BCL2 gene breakpoints in all patients tested. All H/DC tumors lacked PAX5, and up-regulation of CEBPβ and PU.1 was seen in all cases tested. These results provide evidence for a common clonal origin of FL and H/DC neoplasms when occurring in the same patient, and suggest that lineage plasticity may occur in mature lymphoid neoplasms.


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Related Article in Blood Online:

Follicular lymphomas and histiocytic/dendritic neoplasms related?
Jonathan Said
Blood 2008 111: 5418-5419. [Full Text] [PDF]





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