In-situ follicular neoplasia: a clinicopathological spectrum
Gurdip S Tamber
Department of Pathology, McGill University, Alma, Quebec, Canada
Search for more papers by this authorMyriam Chévarie-Davis
Department of Pathology, Hôpital Maisonneuve-Rosemont, Alma, Quebec, Canada
Search for more papers by this authorMargaret Warner
Division of Hematology, Department of Medicine, McGill University Health Centre, Alma, Quebec, Canada
Search for more papers by this authorChantal Séguin
Division of Hematology, Department of Medicine, McGill University Health Centre, Alma, Quebec, Canada
Search for more papers by this authorCarole Caron
Department of Pathology, Hôtel Dieu D’Alma, Alma, Quebec, Canada
Search for more papers by this authorCorresponding Author
René P Michel
Department of Pathology, McGill University, Alma, Quebec, Canada
Address for correspondence: Dr René P. Michel, Department of Pathology, McGill University, 1001 Décarie Blvd, Room E04-1456, Montreal, QC, H3A 3J1, Canada. e-mail: [email protected]
Search for more papers by this authorGurdip S Tamber
Department of Pathology, McGill University, Alma, Quebec, Canada
Search for more papers by this authorMyriam Chévarie-Davis
Department of Pathology, Hôpital Maisonneuve-Rosemont, Alma, Quebec, Canada
Search for more papers by this authorMargaret Warner
Division of Hematology, Department of Medicine, McGill University Health Centre, Alma, Quebec, Canada
Search for more papers by this authorChantal Séguin
Division of Hematology, Department of Medicine, McGill University Health Centre, Alma, Quebec, Canada
Search for more papers by this authorCarole Caron
Department of Pathology, Hôtel Dieu D’Alma, Alma, Quebec, Canada
Search for more papers by this authorCorresponding Author
René P Michel
Department of Pathology, McGill University, Alma, Quebec, Canada
Address for correspondence: Dr René P. Michel, Department of Pathology, McGill University, 1001 Décarie Blvd, Room E04-1456, Montreal, QC, H3A 3J1, Canada. e-mail: [email protected]
Search for more papers by this authorAbstract
Aims
In-situ follicular neoplasia (ISFN) occurs in approximately 2–3% of reactive lymph nodes, and is currently set apart from ‘partial involvement by follicular lymphoma’ (PFL). ISFN can progress to overt lymphoma, but precise parameters with which to assess this risk and its association with related diseases remain incompletely understood. The aim of this study was to explore these parameters.
Methods and results
We reviewed 11 cases of ISFN and one of PFL between 2003 and 2018. Ten patients had ISFN in the lymph nodes, and one had ISFN in the spleen. Haematoxylin and eosin and immunohistochemical stains were reviewed. Involvement of follicles by ISFN was scored with a three-tier scheme. Of five patients with low ISFN scores, one had chronic myelomonocytic leukaemia, one had mycosis fungoides, and three were free of haematopoietic disease. Among them, four are alive and one was lost to follow-up. Of the six ISFN patients with high scores, two had concurrent marginal zone lymphomas, one had concurrent diffuse large B-cell lymphoma (DLBCL), one had Castleman-like disease, one had progressive transformation of germinal centres with IgG4-related disease, and one had no haematopoietic disease; all are alive except for one who died of concurrent DLBCL. The patient with PFL developed DLBCL 7 years after diagnosis.
Conclusions
On the basis of this limited series, we conclude that only cases with high scores are associated with an overt lymphoma or an abnormal lymphoid process, and that scoring may be a useful parameter with which to assess the risk of associated lymphoma, and deserves further study. We also performed a comprehensive review of the literature.
Graphical Abstract
Conflicts of interest
All of the authors have no conflicts of interest to declare.
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