BCL-2 is consistently expressed in hyperplastic marginal zones of the spleen, abdominal lymph nodes, and ileal lymphoid tissue

Am J Surg Pathol. 2003 Jul;27(7):888-94. doi: 10.1097/00000478-200307000-00003.

Abstract

BCL-2 is an antiapoptotic protein overexpressed in follicular lymphomas, principally as a result of the t(14;18)(q32;q21), and useful in distinguishing follicular lymphoma (usually BCL-2 positive) from follicular hyperplasia (BCL-2 negative). BCL-2 is also overexpressed in other lymphoma types without the t(14;18), including marginal zone B-cell lymphoma, because of other, poorly understood mechanisms. It has been suggested that BCL-2 immunoreactivity can distinguish between malignant (BCL-2 positive) and reactive (BCL-2 negative) marginal zone B cells. In this study, we evaluated 26 spleen, 10 abdominal lymph node, and 3 ileum specimens with marginal zone B-cell hyperplasia for BCL-2 expression immunohistochemically. We also analyzed these cases using polymerase chain reaction methods to evaluate for the presence of clonal rearrangements of the immunoglobulin heavy chain gene (IgH) using consensus V FRIII and J region primers, and the t(14;18) involving both the major breakpoint and the minor cluster regions of the bcl-2 gene. All (100%) cases of splenic, abdominal lymph node, and ileal marginal zone hyperplasia displayed strong BCL-2 reactivity in the marginal zone B cells. In all cases analyzed, IgH polymerase chain reaction demonstrated a polyclonal pattern, and bcl-2/JH DNA fusion sequences were not detected. Our results indicate that BCL-2 is consistently expressed by reactive marginal zone B cells of the spleen, abdominal lymph nodes, and ileal lymphoid tissue and should not be used as a criterion for discriminating between benign and malignant marginal zone B-cell proliferations involving these sites.

MeSH terms

  • Abdomen / pathology
  • Adolescent
  • Adult
  • Aged
  • B-Lymphocytes / metabolism
  • B-Lymphocytes / pathology
  • Child
  • Child, Preschool
  • Clone Cells
  • DNA / analysis
  • Diagnosis, Differential
  • Female
  • Gene Rearrangement, B-Lymphocyte, Heavy Chain / genetics
  • Humans
  • Hyperplasia
  • Ileum / metabolism
  • Ileum / pathology
  • Immunohistochemistry
  • Lymph Nodes / metabolism*
  • Lymph Nodes / pathology
  • Lymphoid Tissue / metabolism*
  • Lymphoma, B-Cell / metabolism
  • Lymphoma, B-Cell / pathology
  • Middle Aged
  • Polymerase Chain Reaction
  • Proto-Oncogene Proteins c-bcl-2 / genetics
  • Proto-Oncogene Proteins c-bcl-2 / metabolism*
  • Spleen / metabolism*
  • Spleen / pathology
  • Translocation, Genetic

Substances

  • Proto-Oncogene Proteins c-bcl-2
  • DNA