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Updated: May 9, 2026
Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma
Published on: January 9, 2019
[Immunohistochemical patterns of follicular dendritic cell meshwork and Ki-67 in small B-cell lymphomas]
1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education); Department of Pathology, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Insights
Immunohistochemical analysis of follicular dendritic cell (FDC) meshwork and Ki-67 labeling index aids in differentiating small B-cell lymphomas (SBLs). These markers provide significant discriminatory power for accurate diagnosis of SBL subtypes.
Area of Science:
- Hematopathology
- Immunohistochemistry
- Oncology
Context:
- Small B-cell lymphomas (SBLs) are a heterogeneous group of lymphoid malignancies.
- Accurate differential diagnosis of SBL subtypes is crucial for appropriate treatment and prognosis.
- Distinguishing between SBLs based solely on morphology can be challenging.
Purpose:
- To investigate the immunohistochemical patterns of follicular dendritic cell (FDC) meshwork and Ki-67 labeling index in various SBLs.
- To assess the utility of these markers in the differential diagnosis of SBLs.
- To correlate FDC meshwork patterns and Ki-67 expression with specific SBL subtypes.
Summary:
- This study analyzed CD21, CD23, and Ki-67 immunohistochemistry in 68 SBL cases, including follicular lymphoma (FL), marginal zone lymphoma (MZL), mantle cell lymphoma (MCL), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).
- Distinct FDC meshwork patterns were observed: central in FL, peripheral in MZL, absent/scattered in CLL/SLL, and irregular/scattered in MCL.
- Ki-67 labeling index varied significantly across SBL subtypes, showing a decreasing trend from MCL to MZL, and exhibited characteristic distribution patterns.
Impact:
- Immunohistochemical FDC meshwork patterns and Ki-67 labeling index are valuable tools for differentiating SBLs.
- These findings can improve diagnostic accuracy and guide therapeutic decisions in SBL management.
- The study highlights the importance of integrating immunohistochemistry into the diagnostic workup of SBLs.
Objective:
To identify the immunohistochemical patterns of follicular dendritic cell (FDC) meshwork and Ki-67 labeling index in small B-cell lymphomas (SBLs) and their significance in differential diagnosis.
Methods:
Sixty-eight cases of SBLs were included collected from November 2008 to June 2012. The patterns of FDCs and Ki-67 expression were studied on paraffin sections by CD21, CD23 and Ki-67 immunohistochemistry. The characteristic staining patterns of FDCs and Ki-67 expression among different SBLs were analyzed statistically.
Results:
The age of SBL patients ranged from 28 to 85 years with a mean of 55.2 years. The male to female ratio was 1.2:1. Fifty-five cases involved only lymph nodes (80.9%), and the remaining cases involved multiple extra-nodal sites. Histological classification of the cases was made according to the 2008 WHO lymphoma classification criteria: 22 were low-grade follicular lymphomas (FLs, including grade 1 and grade 2), 19 marginal zone lymphomas (MZLs), 17 mantle cell lymphomas (MCLs), and 10 chronic lymphocytic leukemia/small lymphocytic lymphomas (CLL/SLLs). FDC meshwork limited to the central part of neoplastic follicles was characteristic for FL (90.9%, 20/22). The germinal center FDC meshwork was destroyed primarily at periphery in MZL (14/19). The absence or scattered FDC clusters were typical of SLL/ CLL. Irregular FDC was seen in 7/17 of MCL, while 7/17 MCL displayed FDC pattern similar to that of CLL/SLLs. The pattern of FDCs was a significantly diagnostic feature in distinguishing the four types of SBLs (P < 0.01). Ki-67 was also a statistically significant parameter (P < 0.05) with decreasing labeling index as the following: MCL, FL, SLL and MZL. Ki-67 showed scattered pattern in germinal centers with loss of polarity in FLs. MZL presented uniformly scattered positive pattern in interfollicullar areas. Ki-67 staining was uniform in MCL, but its labeling index varied from 5% to 90%. The Ki-67 index was higher in the morphological "proliferation centers" of all CLL/SLLs.
Conclusion:
Immunohistochemical staining patterns of FDC meshworks and Ki-67 labeling index offer a significant discriminatory power in the differential diagnoses among SBLs.
