title: Splenic follicular lymphoma: clinicopathologic characteristics of a series of 32 cases.
abstract: The spleen is frequently involved in B-cell lymphomas other than splenic marginal zone lymphoma. Here we describe a series of follicular lymphoma (FL) cases diagnosed in the spleen, consisting of 32 patients who presented clinically with splenomegaly, and slight or no peripheral lymphadenopathy. The splenic specimen had a micronodular pattern, germinal center cytologic composition, and frequent presence of marginal zone-like cells at the periphery of the nodules. Twenty cases showed absence or only partial/weak bcl2 protein expression, and 12 cases had homogeneous and strong positive bcl2 expression. The incidences of t(14;18)(q32;q21), CD10 expression, low histologic grade, and low proliferative index were significantly more frequent in FL bcl2-positive cases than in FL bcl2-negative cases. Splenic FL cases showed frequent relapses, with an overall survival of 55% at 5 years. No significant differences in survival were found between bcl2-negative and bcl2-positive cases. Splenic FL cases could be divided into 2 main variants: one was similar to classic FL with t(14;18) and CD10 expression, whereas the other was characterized by a higher proliferation index and histologic grade, and was more frequently diagnosed as a disease restricted to the spleen. Recognition of the distinct nature of these tumors should facilitate appropriate studies for determining the best therapy for such cases.
authors.affiliation: Pathology Department, Hospital Virgen de la Salud, Toledo, Spain.
authors.forename: Manuela
authors.initials: M
authors.lastname: Mollejo
authors.forename: María S
authors.initials: MS
authors.lastname: Rodríguez-Pinilla
authors.forename: Santiago
authors.initials: S
authors.lastname: Montes-Moreno
authors.forename: Patrocinio
authors.initials: P
authors.lastname: Algara
authors.forename: Ahmet
authors.initials: A
authors.lastname: Dogan
authors.forename: Juan C
authors.initials: JC
authors.lastname: Cigudosa
authors.forename: Rocío
authors.initials: R
authors.lastname: Juarez
authors.forename: Teresa
authors.initials: T
authors.lastname: Flores
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Forteza
authors.forename: Alberto
authors.initials: A
authors.lastname: Arribas
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Piris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049109:Cell Proliferation; D002883:Chromosomes, Human, Pair 14; D002887:Chromosomes, Human, Pair 18; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D053208:Kaplan-Meier Estimate; D016393:Lymphoma, B-Cell / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D008224:Lymphoma, Follicular / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015260:Neprilysin / Q000032:analysis; D016133:Polymerase Chain Reaction; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis / Q000235:genetics; D012008:Recurrence; D013160:Splenic Neoplasms / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D013163:Splenomegaly; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019253:Proto-Oncogene Proteins c-bcl-2; D015260:Neprilysin