Monoclonal proliferation of germinal center cells (incipient follicular lymphoma) in an axillary lymph node of a melanoma patient.
A monoclonal proliferation of germinal center cells within a lymph node follicle was incidentally discovered during the staging surgical procedures in a patient with Clark III-level cutaneous melanoma. In one of the 19 axillary lymph nodes examined, we identified a single morphologically atypical lymphoid follicle, predominantly composed of medium-sized cells and immunoreactive for B-cell antigens and for the markers of germinal center origin CD10 and bcl-6. A monoclonal rearrangement of the immunoglobulins heavy chains (IgH) was documented by polymerase chain reaction after laser capture microdissection. The cells of the aberrant follicle expressed the bcl-2 protein at higher levels than the surrounding T lymphocytes in the absence of bcl-2 gene rearrangement. We propose for this lesion the designation of incipient follicular lymphoma. The present findings also confirm the previously reported association between melanoma and lymphoproliferative disorders.
Pruneri
G
G
Department of Pathology and Laboratory Medicine, European Institute of Oncology and University of Milan, School of Medicine, Milan, Italy.
Mazzarol
G
G
Manzotti
M
M
Viale
G
G
D001365:Axilla; D014408:Biomarkers, Tumor / Q000032:analysis; D002999:Clone Cells; D004273:DNA, Neoplasm / Q000032:analysis; D004210:Dissection; D018858:Germinal Center / Q000737:chemistry / Q000473:pathology*; D006801:Humans; D007124:Immunoenzyme Techniques; D008197:Lymph Node Excision; D008224:Lymphoma, Follicular / Q000150:complications / Q000473:pathology*; D008297:Male; D008545:Melanoma / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D008846:Micromanipulation; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000473:pathology*; D016133:Polymerase Chain Reaction; D011230:Precancerous Conditions / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D012878:Skin Neoplasms / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000601:surgery
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm