title: Diagnostic and prognostic value of BCL2 rearrangement in 53 patients with follicular lymphoma presenting as primary skin lesions.
abstract: OBJECTIVE
  To study the diagnostic value of BCL2 rearrangement in follicle center lymphoma (FCL) presenting as primary skin lesions, evaluate its prevalence and the prognostic value in primary cutaneous FCL (PCFCL), and assess prognostic factors in PCFCL.
  
  
  METHODS
  Fifty-three patients with a cutaneous presentation of FCL without a history of nodal lymphoma were selected retrospectively. Clinical and histologic data were collected together with staging and follow-up data. A fluorescence in situ hybridization (FISH) test for BCL2 split probes was performed on skin biopsy specimens.
  
  
  RESULTS
  Initial staging procedures identified 47 PCFCLs and six cases of secondary skin involvement of FCL (SSIFCL). FISH detected seven cases carrying a BCL2 rearrangement: four (8.5%) of 47 PCFCLs and three (50%) of six SSIFCLs. These seven cases coexpressed BCL2 and CD10. In PCFCL, cutaneous relapse rate was 42.6%. A small/medium centrocytic cell population was associated with a higher probability of skin relapse in univariate (P = .008) and multivariate (P = .028) analysis, and BCL2 rearrangement detection was associated with secondary extracutaneous spreading (P = .05).
  
  
  CONCLUSIONS
  We observed that BCL2 rearrangement in PCFCL is rare, associated with initial positivity of staging (diagnostic value) or with secondary extracutaneous spreading (prognostic value). In selected cases with BCL2-CD10 coexpression, FISH testing could detect patients with poor outcome and require closer monitoring.
authors.affiliation: From the Dermatology Department, CHU de Bordeaux, Bordeaux, France; EA2406 Histology and Molecular Pathology of Tumours, University of Bordeaux, Bordeaux, France; anne.pham-ledard@chu-bordeaux.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Pham-Ledard
authors.affiliation: Clinical Epidemiology Unit, CHU de Bordeaux, Bordeaux, France; and.
authors.forename: Anne
authors.initials: A
authors.lastname: Cowppli-Bony
authors.affiliation: Clinical Epidemiology Unit, CHU de Bordeaux, Bordeaux, France; and.
authors.forename: Adélaïde
authors.initials: A
authors.lastname: Doussau
authors.affiliation: EA2406 Histology and Molecular Pathology of Tumours, University of Bordeaux, Bordeaux, France;
authors.forename: Martina
authors.initials: M
authors.lastname: Prochazkova-Carlotti
authors.affiliation: EA2406 Histology and Molecular Pathology of Tumours, University of Bordeaux, Bordeaux, France; Pathology Department, CHU de Bordeaux, Bordeaux, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Laharanne
authors.affiliation: From the Dermatology Department, CHU de Bordeaux, Bordeaux, France;
authors.forename: Thomas
authors.initials: T
authors.lastname: Jouary
authors.affiliation: EA2406 Histology and Molecular Pathology of Tumours, University of Bordeaux, Bordeaux, France;
authors.forename: Marc-Antoine
authors.initials: MA
authors.lastname: Belaud-Rotureau
authors.affiliation: EA2406 Histology and Molecular Pathology of Tumours, University of Bordeaux, Bordeaux, France; Pathology Department, CHU de Bordeaux, Bordeaux, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Vergier
authors.affiliation: EA2406 Histology and Molecular Pathology of Tumours, University of Bordeaux, Bordeaux, France; Pathology Department, CHU de Bordeaux, Bordeaux, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Merlio
authors.affiliation: From the Dermatology Department, CHU de Bordeaux, Bordeaux, France; EA2406 Histology and Molecular Pathology of Tumours, University of Bordeaux, Bordeaux, France;
authors.forename: Marie
authors.initials: M
authors.lastname: Beylot-Barry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D004273:DNA, Neoplasm / Q000235:genetics; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D015321:Gene Rearrangement; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008224:Lymphoma, Follicular / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016133:Polymerase Chain Reaction; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics*; D012008:Recurrence; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000235:genetics* / Q000473:pathology
chemical_list: C000595707:BCL2 protein, human; D015415:Biomarkers; D004273:DNA, Neoplasm; D019253:Proto-Oncogene Proteins c-bcl-2
keywords: BCL2 rearrangement; FISH; Follicular lymphoma; Primary cutaneous follicle center lymphoma; Translocation t(14;18)