title: Disappearance of CD21-positive follicular dendritic cells preceding the transformation of follicular lymphoma: immunohistological study of the transformation using CD21, p53, Ki-67, and P-glycoprotein.
abstract: Some follicular lymphomas histologically transform into diffuse aggressive lymphomas, the prognosis of which is poor. There are, however, no reliable histological criteria for predicting which cases will later undergo such transformation. In low-grade B-cell lymphomas, follicular dendritic cells form dense mesh-like networks that contain accumulating neoplastic B-cells. These are rare in high-grade lymphomas. We immunohistochemically analyzed CD21-positive follicular dendritic cells in 32 follicular lymphomas, including 3 transformed lymphomas, in addition to immunohistological study using P-glycoprotein, p53, and Ki-67. We found that the mesh-like networks in follicles are more clearly defined in low-grade lymphomas than in high-grade lymphomas (p = 0.015). Neoplastic follicles in 2 transformed lymphomas lost the networks of follicular dendritic cells before transformation despite the existence of morphologically clear follicles. This differed from the non-transformed cases of the same cytological grades. Prognosis was statistically better for patients with low-grade tumor than for those with high-grade tumor (p = 0.026), and there was a trend toward poorer survival among CD21-negative cases (p = 0.186). P-glycoprotein, p53, and Ki-67 expressions did not provide sufficient information to predict the transformation of follicular lymphoma. The presence of CD21-positive follicular dendritic cells in neoplastic follicles might help predict the potential of follicular lymphoma to transform to diffuse large B-cell lymphoma.
authors.affiliation: 2nd Department of Pathology, School of Medicine, Showa University, Tokyo, Japan. eshiozawa@aol.com
authors.forename: Eisuke
authors.initials: E
authors.lastname: Shiozawa
authors.forename: Toshiko
authors.initials: T
authors.lastname: Yamochi-Onizuka
authors.forename: Tadanori
authors.initials: T
authors.lastname: Yamochi
authors.forename: Yutsuki
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Naitoh
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kawakami
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nakamaki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tomoyasu
authors.forename: Miki
authors.initials: M
authors.lastname: Kushima
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Ota
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002471:Cell Transformation, Neoplastic; D020566:Dendritic Cells, Follicular / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D016393:Lymphoma, B-Cell / Q000473:pathology; D008224:Lymphoma, Follicular / Q000401:mortality / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017464:Receptors, Complement 3d / Q000378:metabolism*; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D017464:Receptors, Complement 3d; D016159:Tumor Suppressor Protein p53