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Case Reports
. 2004 Sep 1;10(17):2602-4.
doi: 10.3748/wjg.v10.i17.2602.

Detection of BCL2-IGH rearrangement on paraffin-embedded tissue sections obtained from a small submucosal tumor of the rectum in a patient with recurrent follicular lymphoma

Naohisa Yoshida  1 , Kenichi Nomura, Yosuke Matsumoto, Kazuhiro Nishida, Naoki Wakabayashi, Hideyuki Konishi, Shoji Mitsufuji, Keisho Kataoka, Takeshi Okanoue, Masafumi Taniwaki
Affiliations
Case Reports

Detection of BCL2-IGH rearrangement on paraffin-embedded tissue sections obtained from a small submucosal tumor of the rectum in a patient with recurrent follicular lymphoma

Naohisa Yoshida et al. World J Gastroenterol. .

Abstract

A 59-year-old woman was admitted to our hospital because of recurrent follicular lymphoma (FL). Colonoscopic examination revealed a rectal submucosal tumor (SMT) without any erosions and ulcers. In this patient, it was difficult to distinguish non-Hodgkin's lymphoma (NHL) invasion from other disorders of the colon including carcinoid tumor merely based on endoscopic findings. Histopathologic and immunohistochemical studies on biopsy specimens showed an infiltration of atypical lymphocytes that were positive for CD20 and BCL2 but negative for UCHL-1. Fluorescence in situ hybridization on paraffin-embedded tissue sections (T-FISH) identified a translocation of BCL2 with IGH gene. Based on these findings, the tumor was defined as an invasion of FL. T-FISH method is useful for the detection of a monoclonality of atypical lymphocytes in an SMT of the gastrointestinal tract, and particularly for the detection of chromosomal translocations specific to lymphoma subtypes.

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Figures

Figure 1
Figure 1
Endoscopic examination revealed a small submucosal tumor on rectum.
Figure 2
Figure 2
Double-contrast barium enema revealed no definite deformity of the GI wall at the lesion.
Figure 3
Figure 3
Endoscopic ultrasonography showed that the tumor was confined at the second layer of the colonic wall.
Figure 4
Figure 4
Histopathological studies showed aggregated atypical lymphocytes (A). Immunohistochemical analysis revealed that these lymphocytes were positive for CD20 and BCL2 (B and C).
Figure 5
Figure 5
T-FISH detected fusion signals of IGH and BCL2 genes in nuclei as indicated by arrows.
See this image and copyright information in PMC

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