Duodenal-type follicular lymphoma:a clinicopathological study of 5 cases
Objective:To elucidate the clinicopathological characteristics in duodenal-type follicular lymphoma(D-FL).Methods:The endoscopy,pathomorphology,immunohistochemistry,fluorescence in situ hybridization(FISH),next generation sequencing(NGS)features of 5 patients with D-FL were analyzed.Results:The lesions appeared as multiple nodules or polypoid lesions by endoscopic findings.Microscopically,the lesions demonstrated neoplastic follicles without mantle zones in the mucosa and submucosa.The neoplastic cells also infiltrated the lami-na propria outside of the follicles.The neoplastic follicles were composed almost uniformly of centrocytes and only infrequent centroblasts.Immunohistochemically,the neoplastic cells typically expressed CD20,BCL2 and CD10.The Ki-67 proliferation index was less than 5％.CD21 stain revealed that the follicular dendritic mesh work was lo-cated in the peripheral part of the follicles.The t(14;18)(q32;q21)translocation was found by FISH in the 5 ca-ses.Characteristic genetic mutations including CCL20,MADCAM1,CCR6,PCDHGA3,PCDHGA8,PCDHGB4 genes were detected by NGS.Conclusion:D-FL is a unique subtype of follicular lymphoma.Its clinical,patho-morphology,immunophenotype,and molecular genetics are different from nodal classic follicular lymphoma.D-FL is an indolent lymphoma with a good prognosis.
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