Myeloid nuclear differentiation antigen: an aid in differentiating lymphoplasmacytic lymphoma and splenic marginal zone lymphoma in bone marrow biopsies at presentation.
Antigens, Differentiation
Antigens, Nuclear
/ genetics
Biomarkers
Biopsy
Bone Marrow
/ pathology
Humans
Leukemia, Lymphocytic, Chronic, B-Cell
/ pathology
Lymphoma, B-Cell, Marginal Zone
/ diagnosis
Mutation
Myeloid Differentiation Factor 88
/ genetics
Splenic Neoplasms
/ diagnosis
Waldenstrom Macroglobulinemia
/ diagnosis
Bone marrow biopsy
Immunohistochemistry
Lymphoplasmacytic lymphoma
MNDA
Splenic marginal zone lymphoma
Journal
Human pathology
ISSN: 1532-8392
Titre abrégé: Hum Pathol
Pays: United States
ID NLM: 9421547
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
07
01
2022
revised:
16
03
2022
accepted:
16
03
2022
pubmed:
28
3
2022
medline:
25
5
2022
entrez:
27
3
2022
Statut:
ppublish
Résumé
The differential diagnosis between lymphoplasmacytic lymphoma (LPL) and marginal zone B-cell lymphoma, particularly splenic type (SMZL), can be challenging on onset of bone marrow biopsy (BMB) since morphology and phenotype are not specific and clinical features can overlap or be mildly developed at diagnosis. The LPL-specific L265P mutation in the MYD88 gene is not available in all laboratories, and genetic aberrancies identified in SMZL (del7q, mutations of NOTCH2 and KLF2) are seldom searched in routine practice. The study aim is to investigate the potential role of myeloid nuclear differentiation antigen (MNDA) expression in this specific differential diagnosis. We report MNDA reactivity in 559 patients with small B-cell lymphoma including bone marrow biopsies from 90 LPL and 91 SMZL cases. MYD88 p.Leu265Pro mutation status was assessed and confirmed as positive in 24 of 90 LPL cases, which served as the test set. MNDA staining was negative in 23 of 24 LPL cases in the test set (96%). In the 157 remaining cases (66 LPL, 91 SMZL), which served as the validation set, the MYD88 p.Leu265Pro mutation was unavailable and MNDA was more frequently expressed in SMZL (p < 0.00001). In addition, immunohistochemical features more consistent with SMZL (i.e., presence of CD23+ follicular dendritic cell meshworks, polytypic plasma cells, DBA44 reactivity) were more often present in MNDA-positive cases (statistically significant for 2 such parameters). On the widest case series so far published focusing on LPL and SMZL immunohistochemical diagnosis at onset of BMB, we demonstrated that MNDA expression significantly support the diagnosis of SMZL. This observation may be of particular help in cases where the MYD88 p.Leu265Pro mutational status and/or SMZL-related genetic aberrations are unavailable.
Identifiants
pubmed: 35339566
pii: S0046-8177(22)00072-7
doi: 10.1016/j.humpath.2022.03.008
pii:
doi:
Substances chimiques
Antigens, Differentiation
0
Antigens, Nuclear
0
Biomarkers
0
Myeloid Differentiation Factor 88
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
67-75Informations de copyright
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