title: Myeloid cell nuclear differentiation antigen is expressed in a subset of marginal zone lymphomas and is useful in the differential diagnosis with follicular lymphoma.
abstract: The diagnosis of marginal zone lymphomas (MZL) is challenged by the lack of specific markers that distinguish them from other low-grade non-Hodgkin B-cell lymphomas. Myeloid cell nuclear differentiation antigen (MNDA) is a nuclear protein that labels myelomonocytic cells as well as B lymphocytes that localize to the marginal zone areas of splenic white pulp. We evaluated MNDA expression in a large series of B-cell lymphomas to assess the sensitivity and specificity of this antigen for the characterization of MZL. A total of 440 tissue sections containing extramedullary B-cell lymphomas and 216 bone marrow biopsies containing atypical or neoplastic lymphoid infiltrates were stained for MNDA by immunohistochemistry. Among the extramedullary lymphoma cases, approximately 67% of nodal MZL, 61% of extranodal MZL, and 24% of splenic MZL expressed MNDA. MNDA was also infrequently expressed in other B-cell neoplasms including mantle cell lymphoma (6%), chronic lymphocytic leukemia/small lymphocytic lymphoma (13%), follicular lymphoma (FL) (4%), lymphoplasmacytic lymphoma (25%), and diffuse large B-cell lymphoma (3%). In contrast, MNDA was only expressed in 2.3% of all bone marrow biopsies involved by lymphoid infiltrates, including 2 cases of FL and one case of MZL. Collectively, these data support the inclusion of MNDA in the diagnostic evaluation of extramedullary B-cell lymphomas, particularly those in which the differential diagnosis is between low-grade FL and MZL.
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 USA.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Metcalf
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 USA.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Monabati
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 USA.
authors.forename: Monika
authors.initials: M
authors.lastname: Vyas
authors.affiliation: Biotechnology Program, Spanish National Cancer Research Centre, Madrid 28029, Spain.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Roncador
authors.affiliation: Consultoria em Patologia, Botucatu, São Paulo 739, Brazil.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Gualco
authors.affiliation: Consultoria em Patologia, Botucatu, São Paulo 739, Brazil.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Bacchi
authors.affiliation: Department of Pathology, University of Menoufiya, Menoufiya, Egypt.
authors.forename: Sheren F
authors.initials: SF
authors.lastname: Younes
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 USA. Electronic address: yaso@stanford.edu.
authors.forename: Yasodha
authors.initials: Y
authors.lastname: Natkunam
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 USA.
authors.forename: Aharon G
authors.initials: AG
authors.lastname: Freud
mesh_terms: D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism*; D001402:B-Lymphocytes / Q000378:metabolism / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000378:metabolism* / Q000473:pathology; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D014157:Transcription Factors / Q000378:metabolism*
chemical_list: D015214:Antigens, Differentiation, Myelomonocytic; D014408:Biomarkers, Tumor; C075373:MNDA protein, human; D014157:Transcription Factors
keywords: B cell; Follicular lymphoma; Lymphoid neoplasia; Lymphoma; MNDA; Marginal zone lymphoma; Non–Hodgkin lymphoma