Expression of HGAL in primary cutaneous large B-cell lymphomas: Evidence for germinal center derivation of primary cutaneous follicular lymphoma

Xiuyan Xie, Uma Sundram, Yaso Natkunam, Sabine Kohler, Richard T. Hoppe, Youn H. Kim, James R. Cook, Jefferey Hammel, Steven H. Swerdlow, Juan Guitart, Marc D. Smith, David Bosler, Catherine Listinsky, Izidore S. Lossos, Eric D. Hsi

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13 Scopus citations

Abstract

The classification of primary cutaneous large B-cell lymphoma (PCLBCL) is based on standard morphology, immunohistochemistry, and clinical presentation. There are two major subtypes in the current WHO-EORTC classification: follicle center lymphoma and diffuse large B-cell lymphoma, leg-type (DLBCL-LT). The goals of this study were to examine a series of DLBCLs to determine (1) whether the immunohistochemical paradigm of germinal center B-cell and non-germinal center B-cell types of systemic DLBCL could be applied to PCLBCL; (2) whether application of the newly described germinal center B-cell marker, human germinal center-associated lymphoma (HGAL) also discriminates between these types as a further support for germinal center B-cell origin for primary cutaneous center lymphoma; and (3) whether any of these biologic markers were of prognostic significance. To this end, 32 cases of diffuse PCLBCL (22 primary cutaneous follicular center lymphomas and 10 DLBCL-LT) were classified based on the WHO-EORTC criteria and studied for expression of CD20, BCL2, BCL6, CD10, MUM-1, and HGAL by immunohistochemistry. Results were correlated with clinical features. HGAL and BCL6 expression and germinal center B-cell phenotype were associated with primary cutaneous follicular center lymphoma. The combination of HGAL and BCL6 positivity had the highest sensitivity (88%) and specificity (100%) for predicting subtype compared to either marker alone. Both HGAL and BCL6 were associated with the germinal center B-cell phenotype. The correlation of HGAL expression with the germinal center B-cell phenotype demonstrates the role of this marker in the classification of cutaneous large B-cell lymphomas. BCL6 expression was the only immunohistochemical marker associated with overall survival. Characterizing PCLBCLs with markers of B-cell maturation stage is a useful framework for studying, classifying, and clinically stratifying these lymphomas.

Original languageEnglish (US)
Pages (from-to)653-659
Number of pages7
JournalModern Pathology
Volume21
Issue number6
DOIs
StatePublished - Jun 8 2008

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Keywords

  • HGAL
  • Immunohistochemistry
  • Lymphoma
  • Primary cutaneous diffuse large B-cell lymphoma
  • Primary cutaneous lymphoma
  • Skin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Xie, X., Sundram, U., Natkunam, Y., Kohler, S., Hoppe, R. T., Kim, Y. H., Cook, J. R., Hammel, J., Swerdlow, S. H., Guitart, J., Smith, M. D., Bosler, D., Listinsky, C., Lossos, I. S., & Hsi, E. D. (2008). Expression of HGAL in primary cutaneous large B-cell lymphomas: Evidence for germinal center derivation of primary cutaneous follicular lymphoma. Modern Pathology, 21(6), 653-659. https://doi.org/10.1038/modpathol.2008.30