Related Experiment Video
Updated: Jul 20, 2026
Combining Reflectance Confocal Microscopy with Optical Coherence Tomography for Noninvasive Diagnosis of Skin Cancers via Image Acquisition
Published on: August 18, 2022
[Cutaneous B cell processes with nodular pattern]
Ana M Chirife1, Erica Rojas Bilbao, Liliana Giménez
1Departamento de Patología, Instituto de Oncología Angel H. Roffo, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
Insights
Distinguishing between cutaneous lymphomas with nodular patterns, like follicular lymphoma (LFC) and marginal zone lymphoma (LMC), is challenging. Histology and immunohistochemistry are valuable tools for accurate differential diagnosis of these B-cell lymphomas.
Area of Science:
- Dermatopathology
- Hematopathology
- Oncology
Context:
- Cutaneous lymphomas are typically low-grade malignant neoplasms with a favorable prognosis.
- Nodular pattern germinal center lymphomas include follicular lymphoma (LFC) and extranodal marginal zone B-cell lymphoma (LMC), which are difficult to differentiate from each other and from reactive processes.
- Accurate diagnosis is crucial for appropriate patient management and treatment strategies.
Purpose:
- To evaluate the incidence of nodular pattern B-cell lymphomas in cutaneous infiltrates.
- To assess the diagnostic value of histology and immunohistochemistry in differentiating LFC, LMC, and reactive hyperplasias (HLC).
- To analyze specific immunohistochemical markers (CD20, CD10, bcl-2, bcl-6) for differential diagnosis.
Summary:
- Out of 56 cutaneous lymphoid infiltrates, 24 were B-cell origin, with 10 exhibiting a nodular pattern (4 LFC, 3 LMC, 3 HLC).
- Histological features included convergent follicles in LFC, prominent mantles with monocitoid cells in LMC, and macrophages in HLC germinal centers.
- Immunohistochemistry revealed distinct marker profiles: LFC (CD20+, CD10+, bcl-6+), LMC (CD20+, bcl-2-, CD10+/-, bcl-6+ in follicle; bcl-2+, CD10-/+, bcl-6- in interfollicular area), and HLC (bcl-2-, bcl-6+, CD10- in follicle; bcl-2+, bcl-6-, CD10- in interfollicular zone).
Impact:
- Lymphoid B-cell processes with a nodular pattern are identified as unusual in cutaneous infiltrates.
- Histology and immunohistochemistry are confirmed as effective methods for the differential diagnosis of these lymphomas.
- The study aids in distinguishing between neoplastic lymphomas and non-tumoral lymphoid hyperplasias, improving diagnostic accuracy in dermatopathology.
Abstract:
Cutaneous lymphomas are low grade malignant neoplasms with favourable prognosis. Those related to the germinal centre with nodular pattern may be: follicular lymphomas (LFC) or extranodal marginal zone B-cell lymphomas (LMC). They are difficult to tell apart, and from reactive processes like cutaneous follicular hyperplasia and cutis immunocytomas. The objective of this study was to check the incidence and the value of both histology and immunohistochemistry in differential diagnosis. Fifty six patients with cutaneous lymphomas were selected within the period 1995-2004. The biopsies were studied with hematoxilin eosin and immunohistochemistry. Thirty two out of the fifty six cutaneous lymphoid infiltrates were of T origin (57.1%) and twenty four of B origin (42.8%), ten out of this last figure (17.7%) were lymphoid processes with nodular pattern Four LFC, three LMC and three HLC were diagnosed. Convergent follicles with scarce mantle and germinal centres with monomorph celullarity were observed in the LFC. Among the LMC, follicles with prominent mantle and nests of monocitoid cells in the mantle, interfollicular zone and in the germinal centers observed. In the HLC macrophages with detritus were found in the germinal centers. LFC showed: CD20 (+), CD 10 (+), bcl-2 (+) or (-), and bcl-6 (+) in the follicle and in the interfollicular area. LMC showed: CD 20 (+), bcl-2 (-), CD 10 (+/-), and bcl-6 (+) in the follicle, and bcl-2 (+), CD10 (-/+) and bcl-6 (-) in the interfollicular area. The HLC results were: bcl-2 (-), bcl-6 (+) and CD 10 (-) in the follicle and bcl-2 (+), bcl-6 (-) and CD 10 (-) in the interfollicular zone. We conclude that lymphoid B cell processes with nodular pattern are unusual. Histology and immunohistochemistry proved to be useful in the differential diagnosis of these lymphomas, and for differentiating these from lymphoid hyperplasias or non tumoral hyperplasias.
Related Concept Videos
01:30Skin Cancer
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...
01:11Papillary Dermis
The dermis might be considered the "core" of the integumentary system, as distinct from the epidermis and hypodermis. It contains blood and lymph vessels, nerves, and other structures, such as hair follicles and sweat glands. The dermis is made of two layers of connective tissue that comprise an interconnected mesh of elastin and collagenous fibers, produced by fibroblasts.
Papillary Layer
The papillary layer is made of loose, areolar connective tissue, which means the collagen and...
01:15Reticular Dermis
Reticular Layer
Underlying the papillary layer is the much thicker reticular layer, composed of dense, irregular connective...
01:18Lymphoid Cells and Tissues
Lymphoid cells consist of various types of immune system cells. These include B and T lymphocytes, which are responsible for producing antibodies and killing infected cells, respectively. Dendritic cells act as messengers between the innate and adaptive...
01:23Detailed Structure and Function of Lymph Nodes
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...
01:06Multipotency and Niche of Bulge Stem Cell