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In situ localization of follicular lymphoma: evidence for subclinical systemic disease with detection of an identical BCL-2/IGH fusion gene in blood and lymph node

Leukemia volume 23, pages 1176–1179 (2009)Cite this article

In situ localization of follicular lymphoma (ISLFL) is a recently identified pathologic entity in which monoclonal follicle center cells that show strong staining for bcl-2 colonize reactive germinal centers that are negative for bcl-2. Whether this finding represents a preneoplastic event or an early stage of follicular lymphoma (FL) remains unclear. We present a case of a 60-year-old male with ISLFL in a mesenteric lymph node. Although there was no clinical or additional pathologic evidence of FL, peripheral blood testing by PCR amplification detected the same BCL-2/IGH gene rearrangement found in the mesenteric lymph node. This case provides further insight into the pathophysiology of early FL.

A 60-year-old male was examined for a prolonged history of dyspepsia. Gastroscopy showed moderate chronic duodenitis. Computed tomography imaging of the abdomen revealed central mesenteric lymphadenopathy (subcentimeter) with associated mesenteric fat stranding. Laparoscopic biopsy of the mesenteric lymph node was undertaken.

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Acknowledgements

We are grateful to Dr Rena Buckstein for her careful review of this manuscript and suggested revisions. We also acknowledge the laboratory funding and support provided by the Simmond′s Family, Uxbridge, Ontario, Canada.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, Odette Cancer Centre, University of Toronto, Toronto, ON, Canada

    M C Cheung, K R Imrie & N L Berinstein

  2. Department of Pathology, University Health Network, Toronto, ON, Canada

    D Bailey

  3. Department of Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    N Pennell & Z Ghorab

  4. Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada

    D Amato

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  1. M C Cheung
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  2. D Bailey
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Correspondence to M C Cheung.

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Cheung, M., Bailey, D., Pennell, N. et al. In situ localization of follicular lymphoma: evidence for subclinical systemic disease with detection of an identical BCL-2/IGH fusion gene in blood and lymph node. Leukemia 23, 1176–1179 (2009). https://doi.org/10.1038/leu.2009.9

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