Duodenum, Follicular lymphoma, CD23 stain

Duodenum, Follicular lymphoma, H&E stain
Details
Disease Category
Gender
Clinical History

Duodenum biopsy.

Case Discussion

Primary gastrointestinal follicular lymphoma (FL) is a rare, indolent subtype of FL accounting for approximately 1-3% of primary GI lymphomas. The site most commonly involved is the second portion of the duodenum.

Histologically, compact, neoplastic follicles with attenuated/absent mantle zones are seen mainly in the lamina propria, with rare extension into the submucosa.

Similar to nodal FL, most GI FLs are positive for CD20, CD79a, CD10, BCL-6 and BCL-2. What is unique about duodenal FLs is the presence of the “hollow” pattern of staining seen with CD21 and CD23. This is due to the peripheral arrangement of the follicular dendritic cells with relative sparing of the follicular centre. In contrast, the follicular dendritic cells are scattered throughout the neoplastic follicles in nodal FL.

Cytogenetically, similar to nodal FL, duodenal FL is characterized by the t(14;18)(q32;q21) translocation between IgH and BCL2 genes, which is present in up to 90% of cases.

This slide shows H&E stain. See Related Content for CD20, CD10, BCL6, BCL2, and CD23 stains.

Diagnosis
Follicular lymphoma, Grade 1-2
Duodenum, Follicular lymphoma, CD20 stain
Details
Disease Category
Gender
Clinical History

Duodenum biopsy.

Case Discussion

Primary gastrointestinal follicular lymphoma (FL) is a rare, indolent subtype of FL accounting for approximately 1-3% of primary GI lymphomas. The site most commonly involved is the second portion of the duodenum.

Histologically, compact, neoplastic follicles with attenuated/absent mantle zones are seen mainly in the lamina propria, with rare extension into the submucosa.

Similar to nodal FL, most GI FLs are positive for CD20, CD79a, CD10, BCL-6 and BCL-2. What is unique about duodenal FLs is the presence of the “hollow” pattern of staining seen with CD21 and CD23. This is due to the peripheral arrangement of the follicular dendritic cells with relative sparing of the follicular centre. In contrast, the follicular dendritic cells are scattered throughout the neoplastic follicles in nodal FL.

Cytogenetically, similar to nodal FL, duodenal FL is characterized by the t(14;18)(q32;q21) translocation between IgH and BCL2 genes, which is present in up to 90% of cases.

This slide shows CD20 stain. See Related Content for H&E, CD10, BCL6, BCL2, and CD23 stains.

Diagnosis
Follicular lymphoma, Grade 1-2
Duodenum, Follicular lymphoma, CD10 stain
Details
Disease Category
Gender
Clinical History

Duodenum biopsy.

Case Discussion

Primary gastrointestinal follicular lymphoma (FL) is a rare, indolent subtype of FL accounting for approximately 1-3% of primary GI lymphomas. The site most commonly involved is the second portion of the duodenum.

Histologically, compact, neoplastic follicles with attenuated/absent mantle zones are seen mainly in the lamina propria, with rare extension into the submucosa.

Similar to nodal FL, most GI FLs are positive for CD20, CD79a, CD10, BCL-6 and BCL-2. What is unique about duodenal FLs is the presence of the “hollow” pattern of staining seen with CD21 and CD23. This is due to the peripheral arrangement of the follicular dendritic cells with relative sparing of the follicular centre. In contrast, the follicular dendritic cells are scattered throughout the neoplastic follicles in nodal FL.

Cytogenetically, similar to nodal FL, duodenal FL is characterized by the t(14;18)(q32;q21) translocation between IgH and BCL2 genes, which is present in up to 90% of cases.

This slide shows CD10 stain. See Related Content for H&E, CD20, BCL6, BCL2, and CD23 stains.

Diagnosis
Follicular lymphoma, Grade 1-2
Duodenum, Follicular lymphoma, BCL6 stain
Details
Disease Category
Gender
Clinical History

Duodenum biopsy.

Case Discussion

Primary gastrointestinal follicular lymphoma (FL) is a rare, indolent subtype of FL accounting for approximately 1-3% of primary GI lymphomas. The site most commonly involved is the second portion of the duodenum.

Histologically, compact, neoplastic follicles with attenuated/absent mantle zones are seen mainly in the lamina propria, with rare extension into the submucosa.

Similar to nodal FL, most GI FLs are positive for CD20, CD79a, CD10, BCL-6 and BCL-2. What is unique about duodenal FLs is the presence of the “hollow” pattern of staining seen with CD21 and CD23. This is due to the peripheral arrangement of the follicular dendritic cells with relative sparing of the follicular centre. In contrast, the follicular dendritic cells are scattered throughout the neoplastic follicles in nodal FL.

Cytogenetically, similar to nodal FL, duodenal FL is characterized by the t(14;18)(q32;q21) translocation between IgH and BCL2 genes, which is present in up to 90% of cases.

This slide shows BCL6 stain. See Related Content for H&E, CD20, CD10, BCL2, and CD23 stains.

Diagnosis
Follicular lymphoma, Grade 1-2
Duodenum, Follicular lymphoma, BCL2 stain
Details
Disease Category
Gender
Clinical History

Duodenum biopsy.

Case Discussion

Primary gastrointestinal follicular lymphoma (FL) is a rare, indolent subtype of FL accounting for approximately 1-3% of primary GI lymphomas. The site most commonly involved is the second portion of the duodenum.

Histologically, compact, neoplastic follicles with attenuated/absent mantle zones are seen mainly in the lamina propria, with rare extension into the submucosa.

Similar to nodal FL, most GI FLs are positive for CD20, CD79a, CD10, BCL-6 and BCL-2. What is unique about duodenal FLs is the presence of the “hollow” pattern of staining seen with CD21 and CD23. This is due to the peripheral arrangement of the follicular dendritic cells with relative sparing of the follicular centre. In contrast, the follicular dendritic cells are scattered throughout the neoplastic follicles in nodal FL.

Cytogenetically, similar to nodal FL, duodenal FL is characterized by the t(14;18)(q32;q21) translocation between IgH and BCL2 genes, which is present in up to 90% of cases.

This slide shows BCL2 stain. See Related Content for H&E, CD20, CD10, BCL6, and CD23 stains.

Diagnosis
Follicular lymphoma, Grade 1-2
Duodenum, Follicular lymphoma, CD23 stain
Details
Disease Category
Gender
Clinical History

Duodenum biopsy.

Case Discussion

Primary gastrointestinal follicular lymphoma (FL) is a rare, indolent subtype of FL accounting for approximately 1-3% of primary GI lymphomas. The site most commonly involved is the second portion of the duodenum.

Histologically, compact, neoplastic follicles with attenuated/absent mantle zones are seen mainly in the lamina propria, with rare extension into the submucosa.

Similar to nodal FL, most GI FLs are positive for CD20, CD79a, CD10, BCL-6 and BCL-2. What is unique about duodenal FLs is the presence of the “hollow” pattern of staining seen with CD21 and CD23. This is due to the peripheral arrangement of the follicular dendritic cells with relative sparing of the follicular centre. In contrast, the follicular dendritic cells are scattered throughout the neoplastic follicles in nodal FL.

Cytogenetically, similar to nodal FL, duodenal FL is characterized by the t(14;18)(q32;q21) translocation between IgH and BCL2 genes, which is present in up to 90% of cases.

This slide shows CD23 stain. See Related Content for H&E, CD20, CD10, BCL6, and BCL2 stains.

Diagnosis
Follicular lymphoma, Grade 1-2