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Kido T, Ishimoto H, Ishii H, Hara K, Ozasa M, Kawabata H, Kawanami T, Suzuki Y, Yoshikawa H, Hara A, Sakamoto N, Matsumoto N, Yoshii C, Fukuoka J, Fujita M, Nakazato M, Kadota J, Mukae H, Yatera K. Combined detection of lymphocyte clonality and MALT1 translocations in bronchoalveolar lavage fluid for diagnosing pulmonary lymphomas. Sci Rep 2021; 11:23430. [PMID: 34873224 PMCID: PMC8648835 DOI: 10.1038/s41598-021-02861-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 11/22/2021] [Indexed: 12/03/2022] Open
Abstract
Diagnosis of pulmonary lymphoma using small tissue samples is difficult and often requires surgical procedures; thus, a less invasive sampling method is desirable. We previously showed that pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma can be diagnosed by detecting MALT lymphoma translocation gene 1 (MALT1) translocations in bronchoalveolar lavage fluid (BALF) cells. Analysis of B-cell clonality based on immunoglobulin heavy chain (IGH) gene rearrangements was also reportedly useful for diagnosing pulmonary lymphoma. The aim of this prospective multicenter study was to evaluate the yet unknown diagnostic potential of combined detection of MALT1 translocations and clonality using BALF. We analyzed B- and T-cell clonality based on IGH and T-cell receptor (TCR) rearrangements together with MALT1 translocations using BALF of patients with clinically suspected pulmonary lymphomas. In total, 39 patients were evaluated and categorized into three groups: B-cell lymphoma, lymphoproliferative disorders, and other diseases. IGH rearrangement detection for B-cell lymphoma diagnosis exhibited sensitivity and specificity of 88.9% and 90.0%, respectively. TCR rearrangements were not observed in patients with B-cell lymphomas. The presence of IGH rearrangements together with the absence of TCR rearrangements indicated 96.0% specificity for the diagnosis of B-cell lymphoma. The sensitivity and specificity of MALT1 translocations for diagnosing MALT lymphoma were 28.6% and 100%, respectively. The combined detection of lymphocyte clonality and MALT1 translocations using BALF is suitable for screening and diagnosis of B-cell lymphomas. Analysis of specific genes such as MALT1 should improve the precision of B-cell lymphoma diagnosis.
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Affiliation(s)
- Takashi Kido
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan. .,Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan.
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.,Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Hiroshi Ishii
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Kanako Hara
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Mutsumi Ozasa
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan.,Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroki Kawabata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yu Suzuki
- Department of Respiratory Medicine, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Hiroki Yoshikawa
- Department of Respiratory Medicine and Infectious Disease, Faculty of Medicine, Oita University, Yufu, Japan
| | - Atsuko Hara
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Nobuhiro Matsumoto
- Neurology, Respirology, Endocrinology and Metabolism, Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Chiharu Yoshii
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Masamitsu Nakazato
- Neurology, Respirology, Endocrinology and Metabolism, Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Junichi Kadota
- Department of Respiratory Medicine and Infectious Disease, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.,Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Diamantidis MD, Papaioannou M, Hatjiharissi E. Primary gastric non-Hodgkin lymphomas: Recent advances regarding disease pathogenesis and treatment. World J Gastroenterol 2021; 27:5932-5945. [PMID: 34629810 PMCID: PMC8475005 DOI: 10.3748/wjg.v27.i35.5932] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/27/2021] [Accepted: 08/30/2021] [Indexed: 02/06/2023] Open
Abstract
Primary gastric lymphomas (PGLs) are distinct lymphoproliferative neoplasms described as heterogeneous entities clinically and molecularly. Their main histological types are diffuse large B-cell lymphoma (DLBCL) or mucosa-associated lymphoma tissue. PGL has been one of the main fields of clinical research of our group in recent years. Although gastric DLBCLs are frequent, sufficient data to guide optimal care are scarce. Until today, a multidisciplinary approach has been applied, including chemotherapy, surgery, radiotherapy or a combination of these treatments. In this minireview article, we provide an overview of the clinical manifestations, diagnosis and staging of these diseases, along with their molecular pathogenesis and the most important related clinical published series. We then discuss the scientific gaps, perils and pitfalls that exist regarding the aforementioned studies, in parallel with the unmet need for future research and comment on the proper methodology for such retrospective studies. Aiming to fill this gap, we retrospectively evaluated the trends in clinical presentation, management and outcome among 165 patients with DLBCL PGL who were seen in our institutions in 1980-2014. The study cohort was divided into two subgroups, comparing the main 2 therapeutic options [cyclophosphamide doxorubicin vincristine prednisone (CHOP) vs rituximab-CHOP (R-CHOP)]. A better outcome with immunochemotherapy (R-CHOP) was observed. In the next 2 mo, we will present the update of our study with the same basic conclusion.
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Affiliation(s)
- Michael D Diamantidis
- Department of Hematology, Thalassemia and Sickle Cell Disease Unit, General Hospital of Larissa, Larissa 41221, Thessaly, Greece
| | - Maria Papaioannou
- Division of Hematology, First Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
| | - Evdoxia Hatjiharissi
- Division of Hematology, First Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
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Juárez-Salcedo LM, Sokol L, Chavez JC, Dalia S. Primary Gastric Lymphoma, Epidemiology, Clinical Diagnosis, and Treatment. Cancer Control 2018; 25:1073274818778256. [PMID: 29779412 PMCID: PMC6028178 DOI: 10.1177/1073274818778256] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Primary gastric lymphoma (PGL) is the most common extranodal non-Hodgkin lymphoma and represents a wide spectrum of disease, ranging from indolent low-grade marginal zone lymphoma or mucosa-associated lymphoid tissue (MALT) lymphoma to aggressive diffuse large B-cell lymphoma. The PGL is a relatively rare cancer and easily misdiagnosed due to its unspecific symptoms of the digestive tract. The medical literature and ongoing clinical trials were reviewed on the clinical presentation, diagnosis, prognosis, prevention, and treatment of PGL. Primary gastric lymphoma is an event in the course of cancer with a variable clinical presentation and a wide differential diagnosis. Chronic gastritis secondary to Helicobacter pylori (H pylori) infection has been considered a major predisposing factor for MALT lymphoma. Magnetic resonance imaging and endoscopic ultrasonography have helped in staging of these cancers. The clinical course and prognosis of this disease are dependent on histopathological subtype and stage at the time of diagnosis. A global therapeutic approach to the cure of PGL has completely changed over the past 10 years, including innovative and conservative options to reduce treatment toxicity. Due to the rarity of PGL, many aspects of this neoplasm are still controversial. The incidence of this disease is increasing, making it necessary for clinicians to understand the clinical symptoms, workup, and treatment of these lymphomas.
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Affiliation(s)
| | - Lubomir Sokol
- 2 Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA
| | - Julio C Chavez
- 2 Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA
| | - Samir Dalia
- 3 Hematology/Oncology, Mercy Clinic Oncology and Hematology-Joplin, MO, USA
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Kelley SR. Mucosa-associated lymphoid tissue (MALT) variant of primary rectal lymphoma: a review of the English literature. Int J Colorectal Dis 2017; 32:295-304. [PMID: 27995323 DOI: 10.1007/s00384-016-2734-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2016] [Indexed: 02/08/2023]
Abstract
PURPOSE Primary rectal lymphoma (PRL) is the third most common cause of rectal cancer following adenocarcinoma (90-95 %) and carcinoid (5 %). The most common variant of PRL is the mucosa-associated lymphoid tissue (MALT) type. To date, no study has been able to recommend an optimal treatment algorithm for this rare disease. The aim of our study was to review the English literature on primary rectal MALT lymphoma. METHODS A review of the English literature was conducted to identify articles describing the MALT variant of PRL. RESULTS Fifty-one cases were identified. A complete response was achieved in 12 of 19 cases treated with Helicobacter pylori eradication therapy, 5 of 6 with radiation, 2 of 4 cases with chemotherapy, 2 of 4 with endoscopic resection, 6 of 8 cases with surgical resection, and all 8 with combination therapies. Cases failing initial therapies were responsive to various second-line treatments. Two cases spontaneously regressed with observation alone. CONCLUSION Complete regression of primary rectal MALT lymphoma was achieved using various therapeutic strategies, although the numbers of different treatment modalities are too small to draw definitive conclusions.
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Affiliation(s)
- Scott R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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Kido T, Yatera K, Noguchi S, Sakurai Y, Nagata S, Kozaki M, Tokuyama S, Ogoshi T, Kawanami T, Yoshii C, Mukae H. Detection of MALT1 Gene Rearrangements in BAL Fluid Cells for the Diagnosis of Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma. Chest 2012; 141:176-182. [DOI: 10.1378/chest.11-0068] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Niino D, Yamamoto K, Tsuruta O, Maeda T, Yakushijin Y, Aoki R, Kimura Y, Hashikawa K, Kiyasu J, Takeuchi M, Sugita Y, Ohshima K. Regression of rectal mucosa-associated lymphoid tissue (MALT) lymphoma after antibiotic treatments. Pathol Int 2010; 60:438-42. [PMID: 20518898 DOI: 10.1111/j.1440-1827.2010.02538.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Only a few reports have described regression of rectal mucosa-associated lymphoid tissue (MALT) lymphoma after antibiotic treatment are generally found to be successful for gastric tumors. We examined eight rectal MALT lymphomas treated with antibiotic treatments to determine whether they regressed after treatment. We also discuss the relationship between rectal MALT lymphomas and MALT1 gene genetic abnormalities. Eight patients who had undergone antibiotic treatments were followed up with colonoscopy after initiation of the treatment. In five of the eight cases (63%) endoscopic examination showed that the rectal tumor had disappeared, which was confirmed histologically. Polymerase chain reaction for immunoglobulin heavy chain identified a monoclonal band in seven of eight cases (88%). Of the eight cases analyzed with fluorescence in situ hybridization (FISH) for MALT1 translocation, two demonstrated MALT1 gene genetic abnormality. These cases tended to be resistant to antibiotic treatment. Investigation and analysis of a large number of rectal MALT lymphomas are needed to establish suitable standards for antibiotic treatment.
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Affiliation(s)
- Daisuke Niino
- Department of Pathology, School of Medicine, Kurume University, Asahi-machi, Kurume, Japan.
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Wedgwood A, Medeiros LJ, Romaguera JE. CD20+ nodal marginal zone B-cell lymphoma with CD20–recurrence as an intracranial dural-based mass. Leuk Lymphoma 2009; 47:2253-6. [PMID: 17071504 DOI: 10.1080/10428190600783288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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8
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Toracchio S, Ota H, de Jong D, Wotherspoon A, Rugge M, Graham DY, Samani A, El-Zimaity HMT. Translocation t(11;18)(q21;q21) in gastric B-cell lymphomas. Cancer Sci 2009; 100:881-7. [PMID: 19320643 PMCID: PMC11158581 DOI: 10.1111/j.1349-7006.2009.01128.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Translocation t(11;18)(q21;q21) is the most frequent chromosomal aberration reported in gastric mucosa-associated lymphoid tissue (MALT) lymphomas. Intriguingly, this translocation has been reported only rarely in diffuse large B-cell lymphomas; it has been proposed that t(11;18)-positive tumors rarely progress to diffuse large B-cell lymphomas. We examined the frequency of chromosomal translocation t(11;18)(q21;q21) in mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma of the stomach. Paraffin-embedded tissues from patients with gastric B-cell lymphomas were selected retrospectively. The presence of the t(11;18)(q21;q21) was determined using reverse transcriptase-polymerase chain reaction and/or fluorescence in situ hybridization. beta-Actin transcript was also determined to evaluate the integrity and efficiency of RNA (cDNA) recovery from paraffin-embedded tissues. We analyzed 53 gastric B-cell lymphomas (33 diffuse large B-cell and 20 mucosa-associated lymphoid tissue) obtained from Italy, the USA, or Japan. Beta-actin transcript was amplified in 50 cases (94%), including 19 mucosa-associated lymphoid tissue and 31 diffuse large B-cell lymphomas (five with mucosa-associated lymphoid tissue components). The t(11;18) translocation was detected in 19% (6 of 31) cases with diffuse large B-cell lymphoma versus 26% (five of 19) with mucosa-associated lymphoid tissue lymphoma (P = 0.72). One of five diffuse large B-cell lymphomas with a mucosa-associated lymphoid tissue component showed the t(11;18)(q21;q21). In conclusion, translocation t(11;18)(q21;q21) was found in both mucosa-associated lymphoid tissue lymphomas and diffuse large B-cell lymphomas of the stomach at approximately equivalent frequencies; its presence does not exclude progression to diffuse large B-cell lymphoma.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 18/genetics
- Female
- Humans
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/metabolism
- Lymphoma, B-Cell/pathology
- Male
- Middle Aged
- Oncogene Proteins, Fusion/metabolism
- Stomach Neoplasms/genetics
- Stomach Neoplasms/metabolism
- Stomach Neoplasms/pathology
- Translocation, Genetic/genetics
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Affiliation(s)
- Sonia Toracchio
- Department of Medicine, Section of Gastroenterology, Baylor College of Medicine, and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
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9
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Kim WY, Kim JH, Ko H, Kim YA, Jeon YK, Kim CW. Clinicopathologic Study of Chromosomal Aberrations in Gastric Lymphomas of Korean Patients. KOREAN JOURNAL OF PATHOLOGY 2009. [DOI: 10.4132/koreanjpathol.2009.43.1.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Wook Youn Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Ho Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Hyoungsuk Ko
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Young A Kim
- Department of Pathology, Seoul National University Boramae Hospital, Seoul, Korea
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Chul-Woo Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
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10
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Zinzani PL, Poletti V, Zompatori M, Tani M, Spaggiari L, Tomassetti S, Broccoli A, Derenzini E, Baccarani M. Bronchus-associated lymphoid tissue lymphomas: an update of a rare extranodal maltoma. ACTA ACUST UNITED AC 2008; 7:566-72. [PMID: 18186964 DOI: 10.3816/clm.2007.n.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Mucosa-associated lymphoid tissue (MALT) lymphomas were first described by Isaacson and Wright in 1983 in a small series of patients with low-grade B-cell gastrointestinal lymphomas. Although MALT lymphomas occur most frequently in the stomach, they have also been described in various non-gastrointestinal sites, such as the salivary gland, conjunctiva, thyroid, orbit, lung, breast, kidney, skin, liver, uterus, and prostate. The risk of a diagnostic dilemma is reduced by the favorable prognosis of this low-grade lymphoma and its tendency to remain localized to the primary site for a long time. On therapeutic grounds, in contrast to nodal lymphomas, low-grade MALT lymphomas also respond favorably to local treatments, such as surgery and/or local radiation therapy. The outcome and prognosis of low-grade MALT lymphomas are more favorable than those for other extranodal lymphomas. The purpose of this review is to point out the state of the art regarding bronchus-associated lymphoid tissues lymphomas in terms of etiology, pathogenesis, clinics, and therapeutics, including our single-center experience of 23 cases.
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Affiliation(s)
- Pier Luigi Zinzani
- Institute of Hematology and Medical Oncology, L. & A. Seràgnoli, University of Bologna, Italy.
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11
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Kobayashi T, Takahashi N, Hagiwara Y, Tamaru JI, Kayano H, Jin-nai I, Bessho M, Niitsu N. Successful radiotherapy in a patient with primary rectal mucosa-associated lymphoid tissue lymphoma without the API2-MALT1 fusion gene: a case report and review of the literature. Leuk Res 2007; 32:173-5. [PMID: 17570523 DOI: 10.1016/j.leukres.2007.04.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Revised: 04/25/2007] [Accepted: 04/29/2007] [Indexed: 02/04/2023]
Abstract
Primary rectal MALT lymphoma is rare comprising less than 1% of MALT lymphomas. A 26-year-old man was referred to our hospital because of constipation and abdominal fullness. Colonoscopy revealed multiple submucosal tumors in rectum. Histopathological examination showed dense proliferation of small lymphoid cells, but lymphoepithelial lesions were not observed. The cells were CD5(-), CD10(-), CD20(+) and cyclinD1(-). The patient was diagnosed as having MALT lymphoma. The patient was negative for API2-MALT1 gene, and radiotherapy was performed and CR was achieved. With the accumulation of cases, establishment of a treatment strategy for primary rectal MALT lymphoma is expected in the future.
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Affiliation(s)
- Taisuke Kobayashi
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
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12
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Nozaki K, Nomura S, Shimizu N, Hiki N, Yoshizawa N, Aikou S, Kubota K, Yamaguchi H, Kurosaka H, Shinozaki A, Mafune KI, Fukayama M, Kaminishi M. Helicobacter pylori-negative / API2-MALT1 translocation-negative low-grade MALT lymphoma. Gastric Cancer 2007; 9:229-34. [PMID: 16952043 DOI: 10.1007/s10120-006-0367-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 02/10/2006] [Indexed: 02/07/2023]
Abstract
A 71-year-old man with a Helicobacter pylori infection-negative and API2-MALT1 translocation-negative extranodal marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type of the stomach has been followed conservatively for over 5 years. The lesion has shown no major morphological changes or malignant progression into a diffuse large-cell type during the time course. The absence of genetic translocation of API2-MALT1 was confirmed with fluorescence in situ hybridization (FISH). The prognosis of H. pylori-negative and API2-MALT1 translocation-negative low-grade MALT lymphoma is unknown, and a standard treatment for such lymphoma has yet to be defined. The case of MALT lymphoma negative for both of the above factors that we report has shown no obvious rapid progression or malignant change over the long-term course. Although curative operation and/or chemoradiotherapy should still be discussed as the treatment of choice, the treatment of this type of lymphoma must be carefully determined on a case-by-case basis, according to its biological status and prognosis.
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MESH Headings
- Aged
- Gastroscopy/methods
- Helicobacter pylori/isolation & purification
- Humans
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/metabolism
- Lymphoma, B-Cell, Marginal Zone/microbiology
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/genetics
- Lymphoma, Non-Hodgkin/microbiology
- Male
- Oncogene Proteins, Fusion/genetics
- Stomach Neoplasms/diagnosis
- Stomach Neoplasms/metabolism
- Stomach Neoplasms/microbiology
- Translocation, Genetic
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Affiliation(s)
- Koji Nozaki
- Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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13
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Remstein ED, Dogan A, Einerson RR, Paternoster SF, Fink SR, Law M, Dewald GW, Kurtin PJ. The incidence and anatomic site specificity of chromosomal translocations in primary extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) in North America. Am J Surg Pathol 2007; 30:1546-53. [PMID: 17122510 DOI: 10.1097/01.pas.0000213275.60962.2a] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Several balanced translocations have been identified in extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) but there are few data regarding their frequency in different anatomic sites or the frequency of translocations involving BCL6 or kappa or lambda immunoglobulin light chain genes (IGK or IGL), particularly in patients from geographic regions other than Europe and Japan. One hundred thirty-three paraffin-embedded North American primary MALT lymphoma specimens from diverse anatomic sites were studied by fluorescence in situ hybridization (FISH) using probes for API2-MALT1, IGH-MALT1, IGH-BCL10, IGH-FOXP1, IGH, +/- centromeres 3, 7, 12, and 18, and a subset (n=74) were analyzed using FISH probes for IGK, IGL, and BCL6. Translocations were mutually exclusive and were detected in 26% of cases (17% API2-MALT1, 5% IGH-MALT1, 3% IGH-unknown translocation partner, and 1% IGH-BCL10). Aneuploidy was associated with IGH-MALT1 and IGH-BCL10 but only rarely with API2-MALT1. There was striking site specificity, with API2-MALT1 showing a marked predilection for lung and intestine, and IGH-MALT1 and IGH-BCL10 occurring almost exclusively in lung. Twenty-three percent of translocation-negative primary MALT lymphomas from diverse sites showed complete/partial trisomy 18. No MALT lymphomas with translocations involving IGK, IGL, BCL6, or FOXP1 were identified. This FISH panel detected cytogenetic abnormalities in half of all MALT lymphomas, and translocations arose preferentially in MALT lymphomas of the lung and gastrointestinal tract. Differences in incidence and anatomic site specificity of translocations between North American and non-North American cases may reflect geographic variability of infectious or other etiologic factors.
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MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Adaptor Proteins, Signal Transducing/metabolism
- Aneuploidy
- B-Cell CLL-Lymphoma 10 Protein
- Caspases/genetics
- Genetic Markers/genetics
- Humans
- Immunoglobulin Light Chains/genetics
- In Situ Hybridization, Fluorescence
- Incidence
- Intestinal Neoplasms/genetics
- Intestinal Neoplasms/pathology
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/immunology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Protein
- Neoplasm Proteins/genetics
- North America
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Organ Specificity
- Tissue Array Analysis
- Translocation, Genetic/genetics
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Affiliation(s)
- Ellen D Remstein
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN 55905, USA.
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14
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Sagaert X, Laurent M, Baens M, Wlodarska I, De Wolf-Peeters C. MALT1 and BCL10 aberrations in MALT lymphomas and their effect on the expression of BCL10 in the tumour cells. Mod Pathol 2006; 19:225-32. [PMID: 16341151 DOI: 10.1038/modpathol.3800523] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Among the genetic abnormalities reported to occur in mucosa-associated lymphoid tissue (MALT) lymphomas, the three translocations t(11;18)(q21;q21), t(1;14)(p22;q32) and t(14;18)(q32;q21) are of particular interest because they appear to be specific for, or at least closely related to this type of B-cell non-Hodgkin's lymphoma. These translocations affect the MALT1 (18q21) and BCL10 (1p22) genes. We retrieved 77 consecutive biopsies of MALT lymphomas (documented with frozen material) over a 10-year period and investigated these cases for the presence of these three translocations with fluorescence in situ hybridisation, along with the immunohistochemical analysis of the intracellular localisation of the BCL10 protein. The above-listed translocations occurred mutually exclusive and were detected in 10, 1 and 3% of the cases, respectively (the latter incidence being much lower than in the previously reported studies by one single group). These genetic rearrangements corresponded well with the aberrant subcellular localisation of the BCL10 protein as found by immunohistochemistry: t(11;18)(q21;q21) and (1;14)(p22;q32) were marked by a, respectively, moderate to strong nuclear BCL10 staining pattern while t(14;18)(q32;q21)-positive MALT lymphomas were characterised by a perinuclear BCL10 staining pattern. This study further supports the close interaction between the MALT1 and BCL10 proteins in the pathogenesis of MALT lymphomas and may indicate that BCL10 immunohistochemistry is a simple technique to identify those MALT lymphoma cases with an underlying genetic aberration.
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MESH Headings
- Adaptor Proteins, Signal Transducing/analysis
- Adaptor Proteins, Signal Transducing/genetics
- B-Cell CLL-Lymphoma 10 Protein
- Caspases
- Chromosomes, Human, Pair 1/genetics
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 18/genetics
- Gene Rearrangement
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Karyotyping
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/metabolism
- Lymphoma, B-Cell, Marginal Zone/pathology
- Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Protein
- Neoplasm Proteins/genetics
- Translocation, Genetic
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Affiliation(s)
- Xavier Sagaert
- Division of Morphology and Molecular Pathology, Katholieke Universiteit Leuven, Leuven, Belgium.
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15
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Farinha P, Gascoyne RD. Molecular pathogenesis of mucosa-associated lymphoid tissue lymphoma. J Clin Oncol 2005; 23:6370-8. [PMID: 16155022 DOI: 10.1200/jco.2005.05.011] [Citation(s) in RCA: 146] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Extranodal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT) type occur in a number of anatomic sites, but share overlapping morphologic and immunophenotypic features. Helicobacter pylori infection has been identified as an etiologic factor in gastric MALT lymphoma, and a growing list of other infectious organisms have recently been shown to be associated with MALT lymphomas at other anatomic sites. Although cause and effect has not been established for most of these infectious agents, our understanding of the biology has significantly improved, in part through the application of standard cytogenetic analyses. The common karyotypic alterations that characterize MALT lymphomas include the trisomies 3 and 18, the translocations t(11;18)(q21;q21), t(1;14)(p22;q32), t(14;18)(q32;q21), t(3;14)(q27;q32), and the recently described t(3;14)(p14.1;q32). This apparent complexity of cytogenetic alterations that have now been implicated in the pathogenesis of extranodal MALT lymphoma serves as a paradigm for molecular cross talk in neoplastic disease. Recent data have shown that at least three of the disparate translocations affect a common signaling mechanism, and thus unify all three under a common pathogenesis, resulting in the constitutive activation of the nuclear factor kappa B (NF-kappaB) pathway. It may be that the new MALT-related translocation involving the FOXP1 gene and other as yet undiscovered translocations may all have in common increased NF-kappaB signaling.
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MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Adaptor Proteins, Signal Transducing/metabolism
- B-Cell CLL-Lymphoma 10 Protein
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 18/genetics
- Female
- Gene Expression Regulation, Neoplastic
- Genetic Predisposition to Disease
- Humans
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/physiopathology
- Male
- Molecular Biology
- Mutation
- Prognosis
- Sensitivity and Specificity
- Severity of Illness Index
- Translocation, Genetic
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Affiliation(s)
- Pedro Farinha
- Department of Pathology, British Columbia Cancer Agency, 600 W 10th Ave, Vancouver, BC V5Z 4E6, Canada
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16
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Nakagawa M, Hosokawa Y, Yonezumi M, Izumiyama K, Suzuki R, Tsuzuki S, Asaka M, Seto M. MALT1 contains nuclear export signals and regulates cytoplasmic localization of BCL10. Blood 2005; 106:4210-6. [PMID: 16123224 DOI: 10.1182/blood-2004-12-4785] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
MALT1, BCL10 (B-cell lymphoma 10), and API2 (apoptosis inhibitor 2)-MALT1 are key molecules in mucosa-associated lymphoid tissue (MALT) lymphomagenesis. We previously reported that MALT1 and API2-MALT1 were localized only in cytoplasm, where we suggested that both molecules were likely to be active. In the study presented here, we further examined the localization-determining region by generating various mutants and were able to demonstrate that there were nuclear export signal (NES)-containing domains in the MALT1 C-terminal region. The use of leptomycin B, an NES-specific inhibitor, demonstrated that both MALT1 and API2-MALT1 were predominantly retained in the nuclei, indicating that these molecules were shuttling between nucleus and cytoplasm in an NES-dependent manner. It was also found that MALT1 was involved in the nuclear export of BCL10, which is originally localized in both nucleus and cytoplasm. These results correlate well with the nuclear BCL10 expression pattern in both t(1;14) and t(11;18) MALT lymphomas. The nucleocytoplasmic shuttling of MALT1 and BCL10 complex may indicate that these molecules are involved not only in the nuclear factor kappaB (NF-kappaB) pathway but also in other biologic functions in lymphocytes.
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Affiliation(s)
- Masao Nakagawa
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan
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17
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Streubel B, Simonitsch-Klupp I, Müllauer L, Lamprecht A, Huber D, Siebert R, Stolte M, Trautinger F, Lukas J, Püspök A, Formanek M, Assanasen T, Müller-Hermelink HK, Cerroni L, Raderer M, Chott A. Variable frequencies of MALT lymphoma-associated genetic aberrations in MALT lymphomas of different sites. Leukemia 2004; 18:1722-6. [PMID: 15356642 DOI: 10.1038/sj.leu.2403501] [Citation(s) in RCA: 262] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Although several recurrent genetic aberrations are known to occur in MALT lymphoma, no comprehensive study on the most prevalent MALT lymphoma-associated genetic aberrations is available. We therefore screened 252 primary MALT lymphomas for translocations t(11;18)(q21;q21), t(14;18)(q32;q21), and t(1;14)(p22;q32), and trisomies 3 and 18. The above-listed translocations occurred mutually exclusively and were detected overall in 13.5, 10.8, and 1.6% of the cases; trisomy 3 and/or 18 occurred in 42.1%. The frequency at which the translocations occurred varied markedly with the primary site of disease. The t(11;18)(q21;q21) was mainly detected in pulmonary and gastric tumors, whereas the t(14;18)(q32;q21) was most commonly found in lesions of the ocular adnexa/orbit, skin, and salivary glands. Trisomies 3 and 18 each occurred most frequently in intestinal and salivary gland MALT lymphomas. Our results demonstrate that the three translocations and trisomies 3 and 18 occur at markedly variable frequencies in MALT lymphoma of different sites.
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MESH Headings
- Chromosome Aberrations
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 18/genetics
- Chromosomes, Human, Pair 3/genetics
- Gene Frequency
- Genetic Variation
- Humans
- In Situ Hybridization, Fluorescence
- Lymphoma, B-Cell, Marginal Zone/classification
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/pathology
- Organ Specificity
- Translocation, Genetic
- Trisomy/genetics
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Affiliation(s)
- B Streubel
- Institute of Pathology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
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18
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Pileri SA, Zinzani PL, Went P, Pileri A, Bendandi M. Indolent lymphoma: the pathologist's viewpoint. Ann Oncol 2004; 15:12-8. [PMID: 14679113 DOI: 10.1093/annonc/mdh002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Indolent lymphomas have recently been the object of numerous studies, which have focused on new aspects relevant both for the better comprehension of their histogenesis and the identification of new therapeutic strategies. As marginal-zone lymphoma (MZL) represents the category of indolent lymphomas that has obtained more benefit from such an approach, the authors focused on the most recent achievements and not yet solved controversies in this area. In spite of their postulated common derivation, the three categories of MZL of the WHO Classification appear dissimilar. In fact, they show significant molecular differences among them as well as a certain heterogeneity within each group. By no means, there is a cogent need of more refined tools to revise these neoplasms and to produce a more rational grouping. The recent identification of the IRTA gene family corresponding to IG-like receptors differentially expressed in B-cells might contribute to their better understanding.
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Affiliation(s)
- S A Pileri
- Pathologic Anatomy and Unit of Haematopathology, Institute of Haematology and Clinical Oncology 'L. & A. Seràgnoli', Bologna University, Bologna, Italy.
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19
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Adachi A, Tamaru JI, Kaneko K, Kuroda H, Miura I, Kojima T, Hoshino S, Ichinohasama R, Itoyama S. No evidence of a correlation between BCL10 expression and API2-MALT1 gene rearrangement in ocular adnexal MALT lymphoma. Pathol Int 2004; 54:16-25. [PMID: 14674990 DOI: 10.1111/j.1440-1827.2004.01580.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the present study, 62 cases of ocular adnexal lymphoproliferative disorders were reviewed clinicopathologically. Of them, 51 were extranodal marginal zone B-cell lymphoma (MALT lymphoma), five were diffuse large B-cell lymphoma (DLBCL), one was peripheral T-cell lymphoma, one was NK/T cell lymphoma, nasal type, and four were reactive lymphoid hyperplasia. These lymphoma cases showed a favorable clinical course and localized disease, except for the case of NK/T cell lymphoma, although 19 cases (32.8%) had a recurrence of disease. To clarify the correlation between BCL10 protein expression and API2-MALT1 gene rearrangement, the 51 cases of MALT lymphoma and 5 cases of DLBCL were analyzed by immunohistochemical and RT-PCR methods. Nuclear BCL10 expression was identified in 58% of MALT lymphoma cases, but not in any DLBCL cases. There was no evidence of a correlation between aberrant nuclear BCL10 expression and the clinical parameters examined in the present study. API2-MALT1 transcription was not demonstrated in either the MALT lymphoma cases or the DLBCL cases studied using a multiplex one-tube reverse transcriptase-PCR method. These findings indicate that the nuclear expression of BCL10 is unlikely to correlate with the API2-MALT1 fusion gene in ocular adnexal MALT lymphoma.
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MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Adaptor Proteins, Signal Transducing/metabolism
- Adult
- Aged
- Aged, 80 and over
- B-Cell CLL-Lymphoma 10 Protein
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Cell Nucleus/metabolism
- Female
- Gene Expression Regulation, Neoplastic
- Gene Rearrangement
- Humans
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/metabolism
- Lymphoma, B-Cell, Marginal Zone/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Orbital Neoplasms/genetics
- Orbital Neoplasms/metabolism
- Orbital Neoplasms/pathology
- RNA, Messenger/metabolism
- RNA, Neoplasm/analysis
- Retrospective Studies
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Affiliation(s)
- Akiko Adachi
- Department of Pathology, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan.
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20
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Fung CY, Tarbell NJ, Lucarelli MJ, Goldberg SI, Linggood RM, Harris NL, Ferry JA. Ocular adnexal lymphoma: Clinical behavior of distinct World Health Organization classification subtypes. Int J Radiat Oncol Biol Phys 2003; 57:1382-91. [PMID: 14630277 DOI: 10.1016/s0360-3016(03)00767-3] [Citation(s) in RCA: 157] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the clinical behavior and treatment outcome of ocular adnexal lymphomas classified by the World Health Organization system, with emphasis on marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT). MATERIALS AND METHODS The clinicopathologic materials from 98 consecutive patients treated for ocular adnexal lymphoma were reviewed. Fourteen patients had prior lymphoma and 84 patients had primary disease (75% Stage I, 6% Stage III, and 19% Stage IV). Radiation (photons/electrons) was administered to 102 eyes to a median dose of 30.6 Gy. The mean follow-up was 82 months. RESULTS The most common subtypes among the primary patients were MALT (57%) and follicular (18%) lymphoma. The 5-year actuarial local control rate in 102 irradiated eyes was 98%. Among the low-grade lymphomas, the 5-year local control rate correlated with the radiation dose in the MALT lymphoma subgroup (n = 53): 81% for <30 Gy and 100% for > or =30 Gy (p <0.01). For the non-MALT low-grade lymphomas such as follicular lymphoma (n = 30), the local control rate was 100% regardless of dose. For 39 Stage I MALT lymphoma patients treated with radiation alone, the distant relapse-free survival rate was 75% at 5 years and 45% at 10 years. Distant relapses were generally isolated and successfully salvaged by local therapy. The overall survival for this subgroup was 81% at 10 years, with no deaths from lymphoma. CONCLUSIONS Dose-response data suggest that the optimal radiation dose for MALT lymphoma of the ocular adnexa is 30.6-32.4 Gy in 1.8-Gy fractions and follicular lymphoma is adequately controlled with doses in the mid-20 Gy range. The substantial risk of distant relapse in Stage I ocular adnexal MALT lymphoma underscores the importance of long-term follow-up for this disease and the need for additional comparative studies of MALT lymphoma of different anatomic sites.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Child
- Dose-Response Relationship, Radiation
- Eye Diseases/etiology
- Eye Neoplasms/mortality
- Eye Neoplasms/pathology
- Eye Neoplasms/radiotherapy
- Female
- Humans
- Lymphoma, B-Cell, Marginal Zone/mortality
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/radiotherapy
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/radiotherapy
- Lymphoma, Non-Hodgkin/mortality
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, Non-Hodgkin/radiotherapy
- Male
- Middle Aged
- Orbital Neoplasms/radiotherapy
- Orbital Neoplasms/secondary
- Radiotherapy/adverse effects
- Radiotherapy Dosage
- Recurrence
- Survival Rate
- Treatment Outcome
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Affiliation(s)
- Claire Y Fung
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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21
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Izumiyama K, Nakagawa M, Yonezumi M, Kasugai Y, Suzuki R, Suzuki H, Tsuzuki S, Hosokawa Y, Asaka M, Seto M. Stability and subcellular localization of API2-MALT1 chimeric protein involved in t(11;18) (q21;q21) MALT lymphoma. Oncogene 2003; 22:8085-92. [PMID: 14603249 DOI: 10.1038/sj.onc.1207002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
t(11; 18) (q21; q21) is a chromosomal aberration specific to low-grade mucosa-associated lymphoid tissue (MALT) lymphoma, and generates the chimeric product apoptosis inhibitor 2 (API2)-MALT1, which has been suggested to play an important role in MALT lymphomagenesis. However, little is known about the characteristics of API2, MALT1, and API2-MALT1 proteins. We therefore investigated the subcellular localization and stability of these products. API2 was localized in the nucleus and the cytoplasm, and MALT1 and API2-MALT1 in the cytoplasm only. Western blot analysis showed that the products of API2 and MALT1 were unstable, while the API2-MALT1 product was stable. The API2 deletion mutants at the end of the C-terminal and the MALT1 deletion mutants at the end of the N-terminal were stable compared with the full-length products. These results indicate that the domains responsible for protein instability are located in the end of the C-terminal of API2 and in that of the N-terminal of MALT1, and also that API2-MALT1 became stable because it lacks these domains. It has been suggested that NF-kappaB activation plays an important role in the tumorigenesis of MALT lymphoma. Our findings further suggest that the stabilized expression of API2-MALT1 products may continuously stimulate the NF-kappaB activating pathway, thus leading to MALT lymphomagenesis.
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MESH Headings
- Animals
- Apoptosis/genetics
- Apoptosis/physiology
- Blotting, Western
- Caspases
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 18
- Fluorescent Antibody Technique
- Genomic Instability
- Humans
- Inhibitor of Apoptosis Proteins
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/metabolism
- Microscopy, Fluorescence
- Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Protein
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Proteins/genetics
- Proteins/metabolism
- Recombinant Fusion Proteins/genetics
- Recombinant Fusion Proteins/metabolism
- Translocation, Genetic
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Affiliation(s)
- Koh Izumiyama
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan
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22
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Kunisaki Y, Muta T, Yamano Y, Kobayashi Y. Detection of Two Cell Populations Corresponding to Distinct Maturation Stages in API-2/MLT-Positive Mucosa-Associated Lymphoid Tissue Lymphoma Cells Proliferating in Pleural Effusion. Int J Hematol 2003; 78:357-61. [PMID: 14686495 DOI: 10.1007/bf02983562] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 66-year-old man was admitted to our hospital because of an intra-abdominal tumor and pleural effusion (PE). Immunoelectrophoresis of the serum showed immunoglobulin M (IgM) kappa paraprotein (7330 mg/dL). Abnormal plasmacytoid cells were seen in both the peripheral blood (PB) and the bone marrow (BM). Computed tomography scans showed extensive thickening of the gastric wall and bilateral massive PE without lymph node or pulmonary involvement. A histologic examination of the gastric mucosa showed a diffuse infiltration of small- to medium-sized lymphoid CD20-bearing cells, some of which showed a plasmacytoid morphology. Lymphoepithelial lesions were demonstrated with an immunohistochemical stain. The diagnosis was gastric mucosa-associated lymphoid tissue (MALT) lymphoma infiltrating to the PE, PB, and BM. The PE contained numerous lymphoid cells with plasmacytoid morphology that Southern blotting analysis showed to have a monoclonal IgH gene rearrangement pattern. The cells seemed to be divided into two populations according to their surface markers: mature B-cells (CD19+CD20+CD22+CD21+CD38-) and secretory B-cells (CD19+CD20(dim)CD22-CD21-CD38+). The reverse transcriptase-polymerase chain reaction technique detected the API-2/MLT transcript in the PE and PB. The patient had a good response to fludarabine treatment, which was followed with rituximab therapy. In general, gastric MALT lymphoma cells have a tendency to differentiate into plasma cells. In this article, we show that the cell character of API-2/MLT-positive MALT lymphoma is preserved even when the cells are disseminated. This is the first published case, to our knowledge, in which two differentiation stages of MALT lymphoma cells infiltrating into PE have been confirmed by flow cytometric analysis.
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MESH Headings
- Aged
- Antigens, Differentiation, B-Lymphocyte/analysis
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- B-Lymphocytes/pathology
- Cell Adhesion Molecules/analysis
- Cell Differentiation
- Cell Division
- Humans
- Immunophenotyping
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/drug therapy
- Lymphoma, B-Cell, Marginal Zone/pathology
- Male
- Neoplasm, Residual
- Oncogene Proteins, Fusion/analysis
- Pleural Effusion, Malignant/pathology
- Stomach Neoplasms/diagnosis
- Stomach Neoplasms/drug therapy
- Stomach Neoplasms/pathology
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Affiliation(s)
- Yuya Kunisaki
- Department of Internal Medicine, Kyushu Kousei-Nenkin Hospital, Fukuoka, Japan.
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23
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Remstein ED, Kurtin PJ, Einerson RR, Paternoster SF, Dewald GW. Primary pulmonary MALT lymphomas show frequent and heterogeneous cytogenetic abnormalities, including aneuploidy and translocations involving API2 and MALT1 and IGH and MALT1. Leukemia 2003; 18:156-60. [PMID: 14574335 DOI: 10.1038/sj.leu.2403185] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
API2-MALT1 fusion and aneuploidy are common chromosomal abnormalities in MALT lymphoma. In studying their incidence and relationship in primary pulmonary MALT lymphomas, a translocation involving MALT1 and IGH was also identified. In all, 28 primary pulmonary MALT lymphomas were studied by fluorescence in situ hybridization using an API2-MALT1 probe and multiple centromeric probes, as well as IGH-BCL2, IGH-MALT1, and MALT1 breakapart probes in selected cases. Seven (25%) had API2-MALT1 fusion; all seven lacked aneuploidy except for two with trisomy 3 in a small clone. Three (11%) had IGH-MALT1 fusion; two also showed trisomy 3 and 12. A total of 11 (39%) had aneuploidy only, with trisomy 3 and 18 being the most common. Ectopic nuclear bcl-10 expression, which has been previously associated with API2-MALT1, was seen by immunohistochemistry in 86% of API2-MALT1 fusion-positive cases, one IGH-MALT1 fusion-positive case, two aneuploidy-only cases, and two normal cases. In primary pulmonary MALT lymphomas, cytogenetic abnormalities are common (75%) and heterogeneous, encompassing API2-MALT1 and IGH-MALT1, which are mutually exclusive, as well as aneuploidy, which may be present in the latter but is rare in the former. Ectopic nuclear bcl-10 expression is associated with API2-MALT1 but may also be seen in IGH-MALT1 fusion-positive, aneuploidy-only, and normal cases.
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MESH Headings
- Adaptor Proteins, Signal Transducing
- Aneuploidy
- Apoptosis
- B-Cell CLL-Lymphoma 10 Protein
- Carrier Proteins/genetics
- Caspases
- Centromere/genetics
- Chromosomes, Human, Pair 12
- Chromosomes, Human, Pair 18
- Chromosomes, Human, Pair 3
- DNA Probes
- Humans
- Immunoglobulin Heavy Chains/genetics
- In Situ Hybridization, Fluorescence
- Inhibitor of Apoptosis Proteins
- Karyotyping
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Lymphoma, B-Cell, Marginal Zone/genetics
- Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Protein
- Neoplasm Proteins/genetics
- Proteins/genetics
- Translocation, Genetic
- Trisomy
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Affiliation(s)
- E D Remstein
- Divisions of Anatomic Pathology and Hematopathology, Mayo Clinic, Rochester, MN 55905, USA
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24
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Suguro-Katayama M, Suzuki R, Kasugai Y, Nakamura T, Suzuki H, Hosokawa Y, Shiku H, Nakamura S, Seto M. Heterogeneous copy numbers of API2-MALT1 chimeric transcripts in mucosa-associated lymphoid tissue lymphoma. Leukemia 2003; 17:2508-12. [PMID: 14562112 DOI: 10.1038/sj.leu.2403179] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
T(11;18)(q21;q21) results in a chimeric transcript between API2 at 11q21 and MALT1 at 18q21 and is a characteristic chromosomal aberration of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). API2-MALT1 chimeric transcripts are present in approximately one-third of all cases of MALT lymphoma. MALT lymphoma is also known to have variations in histological features and tumor cell proportions. Real-time polymerase chain reaction (PCR) was used to examine number of API2-MALT1 copies in clinical samples for further investigation of the pathophysiology of MALT lymphoma. A total of 13 samples of MALT lymphoma contained API2-MALT1 transcripts from 1.7 x 10(-2) to 1.0 copies/beta-actin copy. These findings were compared to the proportions of tumor cells in genomic VDJ PCR products determined by Southern blotting. Tumor cell ratios varied widely among the patients' samples, and no significant correlation was found between transcript copy number and tumor cell ratio. These results suggest that copy numbers of API2-MALT1 do not reflect tumor cell proportions, and that the number of copies of API2-MALT1 in a tumor cell is different for each clinical sample.
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MESH Headings
- Adult
- Aged
- Blotting, Northern
- Blotting, Southern
- Colon/pathology
- Female
- Gene Dosage
- Humans
- Immunoglobulin Heavy Chains/genetics
- Lung/pathology
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/physiopathology
- Male
- Middle Aged
- Mucous Membrane/pathology
- Oncogene Proteins, Fusion/genetics
- Organ Specificity
- Pleural Cavity/pathology
- RNA, Messenger
- Recombinant Fusion Proteins/genetics
- Stomach/pathology
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Affiliation(s)
- M Suguro-Katayama
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
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25
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Affiliation(s)
- Amy Chadburn
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, New York, USA
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26
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Okabe M, Inagaki H, Ohshima K, Yoshino T, Li C, Eimoto T, Ueda R, Nakamura S. API2-MALT1 fusion defines a distinctive clinicopathologic subtype in pulmonary extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. THE AMERICAN JOURNAL OF PATHOLOGY 2003; 162:1113-22. [PMID: 12651604 PMCID: PMC1851247 DOI: 10.1016/s0002-9440(10)63908-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
t(11;18)(q21;q21) is associated with mucosa-associated lymphoid tissue (MALT)-type lymphoma and results in API2-MALT1 fusion. However, its clinicopathologic significance remains unclarified. API2-MALT1 fusion is detected most frequently in MALT lymphomas primarily involving the lung. We therefore screened 51 cases of pulmonary MALT lymphoma for API2-MALT1 fusion, and studied its relationship with clinicopathologic factors including the immunohistochemical expression of BCL10, another MALT lymphoma-associated molecule. The API2-MALT1 fusion transcript was detected in 21 of 51 (41%) cases, and was correlated with the absence of any underlying autoimmune disease, and with a normal serum lactate dehydrogenase, a "typical" histology without marked plasmacytic differentiation or an increased number of large cells, and aberrant nuclear BCL10 expression. However, its prognostic impact was not identified in the limited follow-up (6 to 187 months, median 27). These data suggest that the API2-MALT1 fusion may be a causative gene abnormality unrelated to autoimmune disease. In addition, this alteration may define a homogeneous MALT lymphoma subtype that is clinically more indolent and histologically more "typical." Aberrant nuclear BCL10 expression may have a possible role as a tool to screen for this API2-MALT1 fusion. A large-scale study with a long follow-up is necessary to establish the prognostic significance of API2-MALT1 fusion.
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MESH Headings
- Adult
- Aged
- Caspases
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 18
- Female
- Humans
- Inhibitor of Apoptosis Proteins
- L-Lactate Dehydrogenase/blood
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/pathology
- Male
- Middle Aged
- Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Protein
- Neoplasm Proteins/genetics
- Oncogene Proteins, Fusion/genetics
- Proteins/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Transcription, Genetic
- Translocation, Genetic
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Affiliation(s)
- Mitsukuni Okabe
- Department of Pathology, Nagoya City University Medical School, Nagoya, Japan
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27
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Streubel B, Lamprecht A, Dierlamm J, Cerroni L, Stolte M, Ott G, Raderer M, Chott A. T(14;18)(q32;q21) involving IGH and MALT1 is a frequent chromosomal aberration in MALT lymphoma. Blood 2003; 101:2335-9. [PMID: 12406890 DOI: 10.1182/blood-2002-09-2963] [Citation(s) in RCA: 297] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
T(11;18)(q21;q21) is the most common structural abnormality in extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) leading to the fusion of the apoptosis inhibitor-2 (API2) gene and the MALT lymphoma-associated translocation (MALT1) gene. In 2 patients with MALT lymphoma of the liver and skin, respectively, t(14;18)(q32;q21) was observed by cytogenetic analysis. Subsequent fluorescence in situ hybridization (FISH) studies disclosed that the immunoglobulin heavy-chain locus (IGH) and the MALT1 gene were rearranged by this translocation. In order to screen a large series of MALT lymphomas for this aberration, a 2-color interphase FISH assay was established. Among a total of 66 cases, t(14;18)(q32;q21) involving IGH and MALT1 was detected in MALT lymphomas of the liver (4 of 4), skin (3 of 11), ocular adnexa (3 of 8), and salivary gland (2 of 11), but did not occur in MALT lymphomas of the stomach (n = 10), intestine (n = 9), lung (n = 7), thyroid (n = 4), or breast (n = 2). In total, 12 of 66 (18%) MALT lymphomas harbored t(14;18)(q32;q21); 7 additional cases of splenic marginal zone lymphoma tested negative. All of the 12 MALT lymphomas featuring the t(14;18)(q32;q21) were negative for t(11;18)(q21;q21) by reverse transcriptase-polymerase chain reaction (RT-PCR). However, trisomy 3 and/or 18 was found in 4 of 12 cases, suggesting that the t(14;18)(q32;q21) does not occur as the sole genetic abnormality. This study identifies IGH as a new translocation partner of MALT1 in MALT lymphomas, which tend to arise frequently at sites other than the gastrointestinal tract and lung. In contrast to t(11;18)(q21;q21)(+) MALT lymphomas, those with t(14;18)(q32;q21) may harbor additional genetic abnormalities.
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MESH Headings
- Caspases
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 14
- Chromosomes, Human, Pair 18
- Chromosomes, Human, Pair 3
- Eye Neoplasms/genetics
- Humans
- Immunoglobulin Heavy Chains/genetics
- In Situ Hybridization, Fluorescence
- Liver Neoplasms/genetics
- Lymphoma, B-Cell, Marginal Zone/genetics
- Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Protein
- Neoplasm Proteins/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Salivary Gland Neoplasms/genetics
- Skin Neoplasms/genetics
- Translocation, Genetic
- Trisomy
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Affiliation(s)
- Berthold Streubel
- Department of Pathology, Division of Oncology, Vienna General Hospital, University of Vienna, Vienna, Austria
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28
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Nakamura T, Nakamura S, Yokoi T, Suzuki H, Ohashi K, Seto M. Clinicopathologic comparison between the API2-MALT1 chimeric transcript-positive and -negative gastric low-grade B-cell lymphoma of mucosa-associated lymphoid tissue type. Jpn J Cancer Res 2002; 93:677-84. [PMID: 12079516 PMCID: PMC5927056 DOI: 10.1111/j.1349-7006.2002.tb01306.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Little is known about the clinicopathological differences between API2-MALT1 chimeric transcript-positive and -negative gastric low-grade B-cell lymphomas of mucosa-associated lymphoid tissue (MALT) type. The aim of this study was to clarify those differences in gastric MALT lymphoma. Twenty-three patients with gastric MALT lymphoma were enrolled in a unicenter study. Helicobacter pylori (H. pylori) infection status and clinical stages were investigated. Antibacterial treatment was performed for every patient. Responsiveness of MALT lymphoma to this treatment was assessed by means of regular follow-up endoscopy combined with biopsy. All cases were examined for API2-MALT1 chimeric transcript by means of RT-PCR and sequencing analyses. H. pylori infection status was assessed as positive in 20 patients and negative in three. With regard to responsiveness to antibacterial treatment, complete remission was observed in two patients, partial remission in 12 and no change in nine. API2-MALT1 chimeric transcript was detected in seven patients, all of whom showed no change in response to antibacterial treatment. API2-MALT1 positivity was found to be significantly correlated with responsiveness to antibacterial treatment (P = 0.0001), absence of H. pylori infection (P = 0.0198), and gross cobblestone mucosa observed endoscopically (P = 0.0198). For the other factors (age, sex, dominant site of lesion, high-grade component, infiltrated layer of gastric wall, nodal involvement or clinical stages), there were no differences between API2-MALT1 chimeric transcript-positive and -negative cases. Gastric API2-MALT1 chimeric transcript-positive MALT lymphoma generally features unresponsiveness to antibacterial treatment, and is thought to be unrelated to H. pylori infection in its pathogenesis. Our findings indicate the presence of different clinical subtypes in gastric MALT lymphomas.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Endoscopy
- Female
- Helicobacter pylori/metabolism
- Humans
- Lymphoma, B-Cell, Marginal Zone/metabolism
- Lymphoma, B-Cell, Marginal Zone/microbiology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Male
- Middle Aged
- Oncogene Proteins, Fusion/biosynthesis
- Oncogene Proteins, Fusion/genetics
- RNA, Messenger/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Stomach Neoplasms/metabolism
- Stomach Neoplasms/microbiology
- Stomach Neoplasms/pathology
- Translocation, Genetic
- Treatment Outcome
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Affiliation(s)
- Tsuneya Nakamura
- Department of Gastroenterology, Aichi Cancer Center Hospital, Chikusa-ku, Nagoya 464-8681.
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