Follicular Lymphoma can be Distinguished from Benign Follicular Hyperplasia by Flow Cytometry Using Simultaneous Staining of Cytoplasmic BCL-2 and Cell Surface CD20.
The distinction between benign follicular hyperplasia (FH) and follicular lymphoma (FL) is sometimes problematic. We wanted to determine whether the expression of bcl-2 of FH was quantitatively different from that of FL, using surface CD20 expression as a discriminator of the various lymphoid compartments. Lymph node cell suspensions from 12 cases of FH and 17 cases of FL were analyzed by flow cytometry using a combined surface CD20 and intracellular bcl-2 staining. CD20- T cells in FH demonstrated the same bcl-2 expression as the CD20+ mantle cells, but the bright CD20+ germinal center cells showed near absence of bcl-2 expression. In contrast, the neoplastic cells of FL showed greater bcl-2 expression than the T cells of the same tumors and all cell populations of FH. This difference was particularly significant between the neoplastic B cells of FL and the germinal center cells of FH. The combined analysis of CD20 and bcl-2 should be useful for the differential diagnosis between FH and FL and particularly applicable to limited samples or when B-cell clonality is in question. Whether the quantitation of bcl-2 expression can be of further discriminatory value in malignant lymphomas remains to be determined.
Published In/Presented At
Cornfield, D. B., Mitchell, D. M., Almasri, N. M., Anderson, J. B., Ahrens, K. P., Dooley, E. O., & Braylan, R. C. (2000). Follicular lymphoma can be distinguished from benign follicular hyperplasia by flow cytometry using simultaneous staining of cytoplasmic bcl-2 and cell surface CD20. American Journal Of Clinical Pathology, 114(2), 258-263.
Medical Pathology | Pathology
Department of Pathology and Laboratory Medicine, Pathology Laboratory Medicine Faculty