title: Childhood florid follicular hyperplasia with immunoglobulin light-chain restriction in the gastrointestinal tract.
abstract: OBJECTIVE
  Immunoglobulin light-chain expression is used routinely as an indirect marker of clonality for recognizing B cell lymphoproliferative disorders.
  
  
  RESULTS
  Here we describe four floral follicular hyperplasia cases in the gastrointestinal tract (appendix and rectum) of children (4 to 6 years). Immunohistochemical studies revealed lambda light-chain restriction that was associated with polyclonal IgH pattern. Clinical features and follow-up of the patients did not reveal any other systemic symptoms, laboratory abnormalities or organ alterations.
  
  
  CONCLUSIONS
  Recognition of this phenomenon is useful in the diagnosis of nodular lymphoid hyperplasia of the gastrointestinal tract, for avoiding overdiagnosis of lymphoid malignancies, and raises concerns that the identification of light-chain restriction is not necessarily a marker of monoclonality.
authors.affiliation: Department of Pathology, Hospital Virgen de la Salud, Toledo, Spain; Department of Pathology, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Spain.
authors.forename: Azahara
authors.initials: A
authors.lastname: Martinez-Lopez
authors.forename: Santiago
authors.initials: S
authors.lastname: Montes-Moreno
authors.forename: Rafael
authors.initials: R
authors.lastname: Ramos
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Afonso-Martin
authors.forename: Francisco
authors.initials: F
authors.lastname: Mazorra
authors.forename: Sonia
authors.initials: S
authors.lastname: Gonzalez de Villambrosia
authors.forename: Ana
authors.initials: A
authors.lastname: Batlle
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Grogan
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Piris
mesh_terms: D001065:Appendix / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000276:immunology / Q000473:pathology; D007147:Immunoglobulin Light Chains; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008232:Lymphoproliferative Disorders / Q000276:immunology / Q000473:pathology*; D008297:Male; D060885:Multiplex Polymerase Chain Reaction; D012007:Rectum / Q000473:pathology*
chemical_list: D007147:Immunoglobulin Light Chains
keywords: children; clonality; follicular hyperplasia; gastrointestinal tract; lambda-chain restriction; light-chain restriction; monotypia; reactive