title: Follicular lymphoma with prominent Dutcher body formation: a pathologic study of 3 cases in comparison with nodal or splenic lymphoplasmacytic lymphoma and marginal zone lymphoma.
abstract: Dutcher bodies have been described in lymphoid neoplasms with plasmacytic differentiation, including plasma cell myeloma, lymphoplasmacytic lymphoma, and marginal zone lymphoma. We report a pathologic study of 3 cases of follicular lymphoma with extensive Dutcher body formation in comparison with lymphoplasmacytic lymphoma and marginal zone lymphoma. Of 3 cases, 1 showed a follicular growth pattern, whereas the other 2 cases demonstrated only a vague nodular appearance highlighted by immunohistochemical analysis. Cells containing Dutcher bodies were counted at 25, 90, or 110 per high-power field in each case, respectively. In 2 cases, cells with Dutcher bodies were clustered in an intrafollicular distribution, a possible histopathologic clue for follicular lymphoma. Immunoglobulin M κ was identified as the component of Dutcher bodies in all 3 cases, implying a possible molecular basis for the formation of Dutcher bodies in B-cell lymphomas. All 3 cases had cytogenetic changes supporting the diagnosis of follicular lymphoma, including dual rearrangement of BCL2 and BCL6, rearrangement of BCL2 with trisomy 3 (BCL6), and isolated BCL6 rearrangement. We emphasize immunohistochemical analyses with anti-κ/λ and anti-immunoglobulin heavy-chain isotypes to characterize Dutcher bodies and document clonality in addition to the routine lymphoma workup and indicated cytogenetic studies in B-cell lymphomas with prominent Dutcher bodies.
authors.affiliation: Department of Pathology, Duke University Medical Center Box 3712, Duke Hospital South, Durham, NC 27710, USA. endi.wang@duke.edu
authors.forename: Endi
authors.initials: E
authors.lastname: Wang
authors.forename: Maggie
authors.initials: M
authors.lastname: Stoecker
authors.forename: James
authors.initials: J
authors.lastname: Burchette
authors.forename: Catherine
authors.initials: C
authors.lastname: Rehder
mesh_terms: D000368:Aged; D005260:Female; D015321:Gene Rearrangement; D006801:Humans; D007075:Immunoglobulin M / Q000235:genetics / Q000378:metabolism; D007145:Immunoglobulin kappa-Chains / Q000235:genetics / Q000378:metabolism; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D045586:Intranuclear Inclusion Bodies / Q000378:metabolism / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D008224:Lymphoma, Follicular / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013160:Splenic Neoplasms / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D008258:Waldenstrom Macroglobulinemia / Q000235:genetics / Q000276:immunology / Q000473:pathology*
chemical_list: D007075:Immunoglobulin M; D007145:Immunoglobulin kappa-Chains