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TOX expression in cutaneous B-cell lymphomas.

Schrader AM, Jansen PM, Willemze R - Arch. Dermatol. Res. (2016)

Bottom Line: Thymocyte selection-associated high-mobility group box (TOX) is aberrantly expressed in cutaneous T-cell lymphomas.In conclusion, TOX is expressed not only by neoplastic T-cells, but also by both reactive and neoplastic follicle center (germinal center) B-cells and a proportion of BCL6(+) PCDLBCL,LT and secondary cutaneous BCL6(+) DLBCL.The functional significance of TOX expression in reactive and neoplastic B-cells remains to be elucidated.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Leiden University Medical Center, P.O. box 9600, 2300 RC, Leiden, The Netherlands. a.m.r.schrader@lumc.nl.

ABSTRACT
Thymocyte selection-associated high-mobility group box (TOX) is aberrantly expressed in cutaneous T-cell lymphomas. In a recent study, TOX expression was noted unexpectedly in the follicle center (germinal center) B-cells of reactive lymph nodes and tonsils, used as external controls. To evaluate whether TOX is also expressed by cutaneous B-cell lymphomas, TOX immunohistochemistry was performed on skin biopsies of 44 patients with primary and secondary cutaneous B-cell proliferations. TOX was expressed not only in the reactive follicle center cells of lymph nodes, tonsils, cutaneous lymphoid hyperplasia, and primary cutaneous marginal zone lymphomas, but also by the neoplastic follicle center cells of 16/17 patients with primary cutaneous follicle center lymphoma (PCFCL) and 7/7 patients with cutaneous manifestations of systemic follicular lymphoma (FL). Notably, TOX showed a very similar expression pattern as BCL6, a marker of germinal center B-cells. In 4/10 patients with a BCL6(+) primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL,LT) and in 2/2 patients with a secondary cutaneous BCL6(+) diffuse large B-cell lymphoma (DLBCL), TOX was expressed by more than 50 % of the neoplastic B-cells. In contrast, in 3/3 BCL6(-) PCDLBCL,LT, TOX was completely negative or weakly expressed by a minor proportion of the neoplastic B-cells. In conclusion, TOX is expressed not only by neoplastic T-cells, but also by both reactive and neoplastic follicle center (germinal center) B-cells and a proportion of BCL6(+) PCDLBCL,LT and secondary cutaneous BCL6(+) DLBCL. The functional significance of TOX expression in reactive and neoplastic B-cells remains to be elucidated.

No MeSH data available.


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Histopathology of a patient with primary cutaneous diffuse large B-cell lymphoma, leg type. Hematoxylin–eosin staining (a) shows diffuse infiltration of the dermis by sheets of CD20+ (b) centroblasts and immunoblasts with many mitotic and apoptotic figures (inset in a). These blastic B-cells stain positive for BCL6 (c) and TOX (d) (a–d ×100, and insetsa–d ×400)
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Fig3: Histopathology of a patient with primary cutaneous diffuse large B-cell lymphoma, leg type. Hematoxylin–eosin staining (a) shows diffuse infiltration of the dermis by sheets of CD20+ (b) centroblasts and immunoblasts with many mitotic and apoptotic figures (inset in a). These blastic B-cells stain positive for BCL6 (c) and TOX (d) (a–d ×100, and insetsa–d ×400)

Mentions: Thirteen patients with PCDLBCL,LT and two patients with secondary cutaneous involvement of systemic DLBCL were evaluated. In general, approximately two-third of the PCDLBCL,LT showed BCL6 expression in more than 50 % of the neoplastic B-cells [12]. In our current series, 10/13 patients (79 %) with PCDLBCL,LT were positive for BCL6. Four of these cases (40 %) expressed TOX in more than 50 % of the neoplastic B-cells (Fig. 3). Intensity was strong in 3/4 cases (75 %) and dim in 1/4 cases (25 %). In the other six patients with a BCL6+ PCDLBCL,LT and in the three patients with a BCL6− PCDLBCL,LT, TOX was expressed by a minor proportion of the neoplastic B-cells or was completely negative. The two patients with secondary cutaneous involvement of systemic DLBCL, both BCL6+, showed either strong (n = 1) or weak (n = 1) TOX expression in more than 75 % of the neoplastic B-cells. In the group of patients with PCDLBCL,LT, there was no relationship between expression of TOX and the clinical course of the patients (data not shown).Fig. 3


TOX expression in cutaneous B-cell lymphomas.

Schrader AM, Jansen PM, Willemze R - Arch. Dermatol. Res. (2016)

Histopathology of a patient with primary cutaneous diffuse large B-cell lymphoma, leg type. Hematoxylin–eosin staining (a) shows diffuse infiltration of the dermis by sheets of CD20+ (b) centroblasts and immunoblasts with many mitotic and apoptotic figures (inset in a). These blastic B-cells stain positive for BCL6 (c) and TOX (d) (a–d ×100, and insetsa–d ×400)
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Related In: Results  -  Collection

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Fig3: Histopathology of a patient with primary cutaneous diffuse large B-cell lymphoma, leg type. Hematoxylin–eosin staining (a) shows diffuse infiltration of the dermis by sheets of CD20+ (b) centroblasts and immunoblasts with many mitotic and apoptotic figures (inset in a). These blastic B-cells stain positive for BCL6 (c) and TOX (d) (a–d ×100, and insetsa–d ×400)
Mentions: Thirteen patients with PCDLBCL,LT and two patients with secondary cutaneous involvement of systemic DLBCL were evaluated. In general, approximately two-third of the PCDLBCL,LT showed BCL6 expression in more than 50 % of the neoplastic B-cells [12]. In our current series, 10/13 patients (79 %) with PCDLBCL,LT were positive for BCL6. Four of these cases (40 %) expressed TOX in more than 50 % of the neoplastic B-cells (Fig. 3). Intensity was strong in 3/4 cases (75 %) and dim in 1/4 cases (25 %). In the other six patients with a BCL6+ PCDLBCL,LT and in the three patients with a BCL6− PCDLBCL,LT, TOX was expressed by a minor proportion of the neoplastic B-cells or was completely negative. The two patients with secondary cutaneous involvement of systemic DLBCL, both BCL6+, showed either strong (n = 1) or weak (n = 1) TOX expression in more than 75 % of the neoplastic B-cells. In the group of patients with PCDLBCL,LT, there was no relationship between expression of TOX and the clinical course of the patients (data not shown).Fig. 3

Bottom Line: Thymocyte selection-associated high-mobility group box (TOX) is aberrantly expressed in cutaneous T-cell lymphomas.In conclusion, TOX is expressed not only by neoplastic T-cells, but also by both reactive and neoplastic follicle center (germinal center) B-cells and a proportion of BCL6(+) PCDLBCL,LT and secondary cutaneous BCL6(+) DLBCL.The functional significance of TOX expression in reactive and neoplastic B-cells remains to be elucidated.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Leiden University Medical Center, P.O. box 9600, 2300 RC, Leiden, The Netherlands. a.m.r.schrader@lumc.nl.

ABSTRACT
Thymocyte selection-associated high-mobility group box (TOX) is aberrantly expressed in cutaneous T-cell lymphomas. In a recent study, TOX expression was noted unexpectedly in the follicle center (germinal center) B-cells of reactive lymph nodes and tonsils, used as external controls. To evaluate whether TOX is also expressed by cutaneous B-cell lymphomas, TOX immunohistochemistry was performed on skin biopsies of 44 patients with primary and secondary cutaneous B-cell proliferations. TOX was expressed not only in the reactive follicle center cells of lymph nodes, tonsils, cutaneous lymphoid hyperplasia, and primary cutaneous marginal zone lymphomas, but also by the neoplastic follicle center cells of 16/17 patients with primary cutaneous follicle center lymphoma (PCFCL) and 7/7 patients with cutaneous manifestations of systemic follicular lymphoma (FL). Notably, TOX showed a very similar expression pattern as BCL6, a marker of germinal center B-cells. In 4/10 patients with a BCL6(+) primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL,LT) and in 2/2 patients with a secondary cutaneous BCL6(+) diffuse large B-cell lymphoma (DLBCL), TOX was expressed by more than 50 % of the neoplastic B-cells. In contrast, in 3/3 BCL6(-) PCDLBCL,LT, TOX was completely negative or weakly expressed by a minor proportion of the neoplastic B-cells. In conclusion, TOX is expressed not only by neoplastic T-cells, but also by both reactive and neoplastic follicle center (germinal center) B-cells and a proportion of BCL6(+) PCDLBCL,LT and secondary cutaneous BCL6(+) DLBCL. The functional significance of TOX expression in reactive and neoplastic B-cells remains to be elucidated.

No MeSH data available.


Related in: MedlinePlus