CD10 expression in follicular lymphoma versus reactive follicular hyperplasia: evaluation in paraffin-embedded tissue
M E Barcus1, L S Karageorge, Y L Veloso
1Department of Pathology, Medical College of Virginia at Virginia Commonwealth University, Richmond, 23219, USA. mebarcus@hsc.vcu.edu
Insights
CD10 immunostaining on paraffin-embedded tissues aids in distinguishing reactive follicular hyperplasia from follicular lymphoma. This immunohistochemical marker shows significant differences in CD10 expression between these two conditions.
Area of Science:
- Hematology
- Immunohistochemistry
- Oncology
Background:
- Differentiating reactive follicular hyperplasia (RFH) from follicular lymphoma (FL) presents diagnostic challenges.
- Adjuvant studies are often necessary for accurate diagnosis.
- CD10 antibodies are now available for paraffin-embedded tissues, expanding their diagnostic utility.
Purpose of the Study:
- To evaluate the effectiveness of CD10 immunostaining in paraffin-embedded tissues for differentiating RFH from FL.
- To compare CD10 expression patterns in neoplastic and reactive follicular lesions.
Main Methods:
- Immunohistochemical staining using antibodies to CD3, CD20, BCL2, and CD10 was performed on 23 FL and 19 RFH cases.
- CD10 expression intensity was graded in paraffin-embedded tissue sections.
- Standard markers (CD3, CD20, BCL2) were used for control and appropriate staining confirmation.
Main Results:
- CD10 expression was observed in 87% of FL cases, with 70% showing strong positivity.
- In contrast, none of the RFH cases exhibited strong CD10 positivity; 26% showed weak staining, and 68% were negative.
- CD10 staining patterns differed significantly between FL and RFH, aiding in their differentiation.
Conclusions:
- Immunohistochemical staining for CD10 on paraffin-embedded tissue sections is a valuable tool for distinguishing between reactive and neoplastic follicular lesions.
- CD10 expression is a key differentiator, with strong positivity favoring follicular lymphoma.
- This method offers a reliable approach to improve diagnostic accuracy in challenging cases.
Abstract:
The differentiation of reactive follicular hyperplasia (RFH) from follicular lymphoma (FL) may be a diagnostic challenge and require the use of adjuvant studies. Antibodies to CD10 have been used with flow cytometry and frozen tissue sections and recently have become available for use with paraffin-embedded tissue. We sought to investigate the utility of CD10 in the differentiation of RFH from FL in paraffin-embedded tissue. Twenty-three cases of FL and 19 cases of RFH were evaluated after immunostaining with antibodies to CD3, CD20, BCL2, and CD10 antigens. Intensity of CD10 expression was graded. CD10 expression was present in 87% of cases of FL. Follicles demonstrated strong positivity in 70%. One CD10-positive case of FL showed equivocal staining for BCL2 and one an absence of staining for BCL2. Weaker but definite staining was present in 17%, and 13% were negative for CD10. In contrast, none of the cases of RFH was strongly positive for CD10 expression, with 26% demonstrating weak immunostaining, one case showing equivocal staining, and 68% being entirely negative. CD3, CD20, and BCL2 stained appropriately in all cases. These findings indicate that immunohistochemical staining of paraffin-embedded tissue sections for CD10 may help differentiate reactive from neoplastic follicular lesions.
