title: A retrospective study of patients with follicular lymphoma (FL): identification of in situ FL or FL-like B cells of uncertain significance in lymph nodes resected at the time of previous surgery for carcinomas.
abstract: OBJECTIVE
  In situ follicular lymphoma (iFL)/intrafollicular neoplasia and follicular lymphoma (FL)-like B cells of uncertain significance represent proliferation of Bcl-2/t(14;18)-positive B cells solely in the germinal centres. The condition is interpreted as an early event in the multi-step lymphomagenesis of FL. The aim of this study is to examine the issue more specifically.
  
  
  METHODS
  We reviewed medical history of FL patients in whom thoracoabdominal surgery with lymphadenectomy had been performed for management of carcinomas. These previously resected lymph nodes as well as the current FL nodes were analysed by immunohistochemistry, fluorescent in situ hybridisation, and PCR amplification with direct sequencing.
  
  
  RESULTS
  We studied four such FL patients from a total of 150 patients with FL; all had iFL in the previously resected lymph nodes. Clonal relation was verified and suggested in one case each. The time from lymphadenectomy to the diagnosis of FL was 23-120 months. There appeared to be a reverse correlation between the rate of Bcl-2-positive follicle proliferation and the time from surgery to diagnosis of FL.
  
  
  CONCLUSIONS
  Although the rate for development of FL in individuals having iFL has been reported to be low from prospective studies, the present data indicate that follow-up studies for a longer period is necessary; the rate of Bcl-2-positive follicle proliferation could be a factor to predict development of FL in prospective studies. Such a retrospective study may contribute to elucidate mechanism(s) involved in lymphomagenesis of FL.
authors: Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, Japan.
authors: Kohei
authors: K
authors: Morita
authors: Division of Pathology and Laboratory Medicine, The Japan Baptist Hospital, Kyoto, Japan.
authors: Hirokazu
authors: H
authors: Nakamine
authors: Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, Japan.
authors: Tokiko
authors: T
authors: Nakai
authors: Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, Japan.
authors: Masato
authors: M
authors: Takano
authors: Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, Japan.
authors: Maiko
authors: M
authors: Takeda
authors: Department of Surgical Pathology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors: Yasunori
authors: Y
authors: Enomoto
authors: Oncology Center, Nara Medical University Hospital, Kashihara, Nara, Japan.
authors: Yumi
authors: Y
authors: Yoshii
authors: Oncology Center, Nara Medical University Hospital, Kashihara, Nara, Japan.
authors: Masatoshi
authors: M
authors: Kanno
authors: Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, Japan.
authors: Chiho
authors: C
authors: Ohbayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000595:Amino Acid Sequence; D001402:B-Lymphocytes / Q000276:immunology* / Q000473:pathology; D001483:Base Sequence; D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D002277:Carcinoma / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D049109:Cell Proliferation; D005260:Female; D005784:Gene Amplification; D015321:Gene Rearrangement; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000737:chemistry / Q000276:immunology* / Q000473:pathology; D008224:Lymphoma, Follicular / Q000737:chemistry / Q000235:genetics / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis / Q000235:genetics; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: C000595707:BCL2 protein, human; D014408:Biomarkers, Tumor; D007143:Immunoglobulin Heavy Chains; D019253:Proto-Oncogene Proteins c-bcl-2
keywords: FISH; LYMPH NODES; LYMPHOMA; PCR