Signet-ring cell lymphoma

clinicopathologic, immunohistochemical, and fluorescence in situ hybridization studies of 7 cases

Shanxiang Zhang, Jihong Sun, Yanan Fang, Mehdi Nassiri, Lanting Liu, Jiehao Zhou, Ryan Stohler, Haki Choi, Gail H. Vance

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Context Signet-ring cell lymphoma (SRCL) is a rare morphologic variant of non–Hodgkin lymphoma. Although it was initially reported as a rare morphologic variant of follicular lymphoma (FL), SRCL has to date been described in most types of non–Hodgkin lymphoma, mostly as single-case reports. Objective To study SRCL systematically by immunohistochemical stains and fluorescent in situ hybridization analyses. Design Seven SRCL cases were stained for CD3, CD5, CD20, PAX-5, CD10, CD21, CD23, cyclin D1, BCL2, BCL6, Ki-67, and MUM-1, and were analyzed by fluorescent in situ hybridization for BCL2, BCL6, MYC, and MALT1 rearrangements. Clinical information and patient outcome were reviewed in all patients. Results The patients were 3 women and 3 men, ranging in age from 31 to 75 years (average 60.3 years). The lesions involved lymph nodes, tonsil, parotid gland, soft tissue, and breast. There were 4 FLs, 1 diffuse large B-cell lymphoma (DLBCL), 1 DLBCL with FL, and 1 DLBCL with marginal zone lymphoma. All cases had typical signet-ring cell morphology. They were positive for CD20 and BCL-2, and had low-to-intermediate Ki-67 proliferation index (10%-40%) except in the parotid DLBCL with FL (70%). BCL-6 was detected in all but 1 FL (6/7). Fluorescent in situ hybridization detected IGH/BCL2 translocation in 1 FL, increased BCL6 copy number in another FL, BCL6 rearrangement, and increased copy number of MYC and MALT1 in the DLBCL with marginal zone lymphoma. Conclusions The FL with signet-ring cell morphology (1/5) tends to lack IGH/BCL2 translocation, and an extended immunohistochemical study is recommended for correct diagnosis and classification of SRCL.

Original languageEnglish (US)
Pages (from-to)38-42
Number of pages5
JournalAnnals of Diagnostic Pathology
Volume26
DOIs
StatePublished - Feb 1 2017

Fingerprint

Follicular Lymphoma
Fluorescence In Situ Hybridization
Lymphoma
Lymphoma, Large B-Cell, Diffuse
Marginal Zone B-Cell Lymphoma
Non-Hodgkin's Lymphoma
Palatine Tonsil
Cyclin D1
Parotid Gland
B-Cell Lymphoma
Breast
Coloring Agents
Lymph Nodes

Keywords

  • B-cell lymphoma
  • Clinicopathologic features
  • Non-Hodgkin lymphoma
  • Signet ring cell lymphoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Signet-ring cell lymphoma : clinicopathologic, immunohistochemical, and fluorescence in situ hybridization studies of 7 cases. / Zhang, Shanxiang; Sun, Jihong; Fang, Yanan; Nassiri, Mehdi; Liu, Lanting; Zhou, Jiehao; Stohler, Ryan; Choi, Haki; Vance, Gail H.

In: Annals of Diagnostic Pathology, Vol. 26, 01.02.2017, p. 38-42.

Research output: Contribution to journalArticle

Zhang, Shanxiang ; Sun, Jihong ; Fang, Yanan ; Nassiri, Mehdi ; Liu, Lanting ; Zhou, Jiehao ; Stohler, Ryan ; Choi, Haki ; Vance, Gail H. / Signet-ring cell lymphoma : clinicopathologic, immunohistochemical, and fluorescence in situ hybridization studies of 7 cases. In: Annals of Diagnostic Pathology. 2017 ; Vol. 26. pp. 38-42.
@article{beaaff6c88b14979b70fc75c27db8377,
title = "Signet-ring cell lymphoma: clinicopathologic, immunohistochemical, and fluorescence in situ hybridization studies of 7 cases",
abstract = "Context Signet-ring cell lymphoma (SRCL) is a rare morphologic variant of non–Hodgkin lymphoma. Although it was initially reported as a rare morphologic variant of follicular lymphoma (FL), SRCL has to date been described in most types of non–Hodgkin lymphoma, mostly as single-case reports. Objective To study SRCL systematically by immunohistochemical stains and fluorescent in situ hybridization analyses. Design Seven SRCL cases were stained for CD3, CD5, CD20, PAX-5, CD10, CD21, CD23, cyclin D1, BCL2, BCL6, Ki-67, and MUM-1, and were analyzed by fluorescent in situ hybridization for BCL2, BCL6, MYC, and MALT1 rearrangements. Clinical information and patient outcome were reviewed in all patients. Results The patients were 3 women and 3 men, ranging in age from 31 to 75 years (average 60.3 years). The lesions involved lymph nodes, tonsil, parotid gland, soft tissue, and breast. There were 4 FLs, 1 diffuse large B-cell lymphoma (DLBCL), 1 DLBCL with FL, and 1 DLBCL with marginal zone lymphoma. All cases had typical signet-ring cell morphology. They were positive for CD20 and BCL-2, and had low-to-intermediate Ki-67 proliferation index (10{\%}-40{\%}) except in the parotid DLBCL with FL (70{\%}). BCL-6 was detected in all but 1 FL (6/7). Fluorescent in situ hybridization detected IGH/BCL2 translocation in 1 FL, increased BCL6 copy number in another FL, BCL6 rearrangement, and increased copy number of MYC and MALT1 in the DLBCL with marginal zone lymphoma. Conclusions The FL with signet-ring cell morphology (1/5) tends to lack IGH/BCL2 translocation, and an extended immunohistochemical study is recommended for correct diagnosis and classification of SRCL.",
keywords = "B-cell lymphoma, Clinicopathologic features, Non-Hodgkin lymphoma, Signet ring cell lymphoma",
author = "Shanxiang Zhang and Jihong Sun and Yanan Fang and Mehdi Nassiri and Lanting Liu and Jiehao Zhou and Ryan Stohler and Haki Choi and Vance, {Gail H.}",
year = "2017",
month = "2",
day = "1",
doi = "10.1016/j.anndiagpath.2016.10.002",
language = "English (US)",
volume = "26",
pages = "38--42",
journal = "Annals of Diagnostic Pathology",
issn = "1092-9134",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Signet-ring cell lymphoma

T2 - clinicopathologic, immunohistochemical, and fluorescence in situ hybridization studies of 7 cases

AU - Zhang, Shanxiang

AU - Sun, Jihong

AU - Fang, Yanan

AU - Nassiri, Mehdi

AU - Liu, Lanting

AU - Zhou, Jiehao

AU - Stohler, Ryan

AU - Choi, Haki

AU - Vance, Gail H.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Context Signet-ring cell lymphoma (SRCL) is a rare morphologic variant of non–Hodgkin lymphoma. Although it was initially reported as a rare morphologic variant of follicular lymphoma (FL), SRCL has to date been described in most types of non–Hodgkin lymphoma, mostly as single-case reports. Objective To study SRCL systematically by immunohistochemical stains and fluorescent in situ hybridization analyses. Design Seven SRCL cases were stained for CD3, CD5, CD20, PAX-5, CD10, CD21, CD23, cyclin D1, BCL2, BCL6, Ki-67, and MUM-1, and were analyzed by fluorescent in situ hybridization for BCL2, BCL6, MYC, and MALT1 rearrangements. Clinical information and patient outcome were reviewed in all patients. Results The patients were 3 women and 3 men, ranging in age from 31 to 75 years (average 60.3 years). The lesions involved lymph nodes, tonsil, parotid gland, soft tissue, and breast. There were 4 FLs, 1 diffuse large B-cell lymphoma (DLBCL), 1 DLBCL with FL, and 1 DLBCL with marginal zone lymphoma. All cases had typical signet-ring cell morphology. They were positive for CD20 and BCL-2, and had low-to-intermediate Ki-67 proliferation index (10%-40%) except in the parotid DLBCL with FL (70%). BCL-6 was detected in all but 1 FL (6/7). Fluorescent in situ hybridization detected IGH/BCL2 translocation in 1 FL, increased BCL6 copy number in another FL, BCL6 rearrangement, and increased copy number of MYC and MALT1 in the DLBCL with marginal zone lymphoma. Conclusions The FL with signet-ring cell morphology (1/5) tends to lack IGH/BCL2 translocation, and an extended immunohistochemical study is recommended for correct diagnosis and classification of SRCL.

AB - Context Signet-ring cell lymphoma (SRCL) is a rare morphologic variant of non–Hodgkin lymphoma. Although it was initially reported as a rare morphologic variant of follicular lymphoma (FL), SRCL has to date been described in most types of non–Hodgkin lymphoma, mostly as single-case reports. Objective To study SRCL systematically by immunohistochemical stains and fluorescent in situ hybridization analyses. Design Seven SRCL cases were stained for CD3, CD5, CD20, PAX-5, CD10, CD21, CD23, cyclin D1, BCL2, BCL6, Ki-67, and MUM-1, and were analyzed by fluorescent in situ hybridization for BCL2, BCL6, MYC, and MALT1 rearrangements. Clinical information and patient outcome were reviewed in all patients. Results The patients were 3 women and 3 men, ranging in age from 31 to 75 years (average 60.3 years). The lesions involved lymph nodes, tonsil, parotid gland, soft tissue, and breast. There were 4 FLs, 1 diffuse large B-cell lymphoma (DLBCL), 1 DLBCL with FL, and 1 DLBCL with marginal zone lymphoma. All cases had typical signet-ring cell morphology. They were positive for CD20 and BCL-2, and had low-to-intermediate Ki-67 proliferation index (10%-40%) except in the parotid DLBCL with FL (70%). BCL-6 was detected in all but 1 FL (6/7). Fluorescent in situ hybridization detected IGH/BCL2 translocation in 1 FL, increased BCL6 copy number in another FL, BCL6 rearrangement, and increased copy number of MYC and MALT1 in the DLBCL with marginal zone lymphoma. Conclusions The FL with signet-ring cell morphology (1/5) tends to lack IGH/BCL2 translocation, and an extended immunohistochemical study is recommended for correct diagnosis and classification of SRCL.

KW - B-cell lymphoma

KW - Clinicopathologic features

KW - Non-Hodgkin lymphoma

KW - Signet ring cell lymphoma

UR - http://www.scopus.com/inward/record.url?scp=84995801919&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995801919&partnerID=8YFLogxK

U2 - 10.1016/j.anndiagpath.2016.10.002

DO - 10.1016/j.anndiagpath.2016.10.002

M3 - Article

VL - 26

SP - 38

EP - 42

JO - Annals of Diagnostic Pathology

JF - Annals of Diagnostic Pathology

SN - 1092-9134

ER -