title: Presence of preserved reactive germinal centers in follicular lymphoma is a strong histopathologic indicator of limited disease stage.
abstract: Follicular lymphoma (FL) typically presents as a systemic disease (stages III/IV). We repeatedly observed in cases with conserved reactive follicle structures (so-called partial infiltration) an association with a limited clinical stage (I/II). In this study, we analyzed 53 lymph node biopsies of FL with conserved reactive follicle structures. In 44 cases (83%) of the patients with partial infiltration, a limited stage of disease (Ann Arbor stage I/II) was found, whereas only 9 of 53 cases (17%) suffered from a systemic disease. In those cases with at least one follicle totally spared by lymphoma, 95% of the patients (38 of 40 cases) presented with a limited stage (I/II) of disease, compared with only 20% (10 of 49 cases) in a control group with full-blown infiltration (P < 0.001). Analyzing systematically all 321 FL cases sent to the Reference Center Würzburg in the year 2001, reactive follicle remnants were detected in 34 of 321 (10.6%) cases with 26 of 34 (76%) tumors showing limited stage (I/II) disease, including all 18 cases with at least one totally spared follicle. Our results therefore show a clear association between the occurrence of preserved reactive follicles in FL and limited disease stage.
authors.affiliation: Pathologisches Institut, Universität Würzburg, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Adam
authors.forename: Tiemo
authors.initials: T
authors.lastname: Katzenberger
authors.forename: Miriam
authors.initials: M
authors.lastname: Eifert
authors.forename: M Michaela
authors.initials: MM
authors.lastname: Ott
authors.forename: Andreas
authors.initials: A
authors.lastname: Rosenwald
authors.forename: Hans Konrad
authors.initials: HK
authors.lastname: Müller-Hermelink
authors.forename: German
authors.initials: G
authors.lastname: Ott
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D001706:Biopsy; D002883:Chromosomes, Human, Pair 14; D002887:Chromosomes, Human, Pair 18; D003937:Diagnosis, Differential; D005260:Female; D018858:Germinal Center / Q000378:metabolism* / Q000473:pathology*; D006651:Histocytochemistry; D006689:Hodgkin Disease / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008198:Lymph Nodes / Q000473:pathology; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000706:statistics & numerical data; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D012189:Retrospective Studies; D014178:Translocation, Genetic
chemical_list: D014408:Biomarkers, Tumor; D007074:Immunoglobulin G; D019253:Proto-Oncogene Proteins c-bcl-2