MUM1/IRF4, CD138, and CD38, and negative for CD20. plasmablastic lymphoma (pbl) is an aggressive b-cell malignancy highly associated with hiv. protocols.39-41 Antibodies and an outline of immu-nohistochemical procedures . The current World Health Organization (WHO) classification includes several subtypes, based on a combination of clinical, immunohistochemical, and genetic differences. MUM1 is through to contribute to the regulation of immunoglobulin gene expression in the final step (late centrocyte) of B-cell differentiation within germinal centre light zones, initiated by centrocyte-follicular dendritic cell contact. Marked cell-to-cell variation in size and shape. 1996 - 2022 Humpath.com - Human pathology Site Map . 2. . . An atypical lymphoid infiltrate with numerous MUM1+, CD10-, BCL-6- immunoblasts should raise the suspicion of a reactive process, such as infectious mononucleosis, and warrants additional consideration before a diagnosis of lymphoma is made. At this stage bcl-6 is downregulated. Abstract. MUM1 and Ki67 Expression Best Predictors of Treatment Response in Diffuse Large B Cell Lymphoma Not Otherwise Specified. CD138, and IRF4/MUM1 but are negative for CD30 (in contrast with anaplastic large cell lymphoma cases) and . The size ranges for hyperplastic polyps, serrated adenomas, and tra-ditional adenomas were 4.5-10 mm (mean 5.5 mm), 3-30 mm (mean 10.5 mm), and 3-25 mm (mean 8.0 mm), respec-tively. BCL6 and MUM1 based on Hans classification. Follicular arrangement = follicular lymphoma. B-cell lymphomas with features intermediate between distinct pathologic entities. Admixed plasma cells and a background of reticulin fibrosis are present. . Correspondence. mostly medium-sized lymphoid cells with irregular nuclear outlines. Contact Us Store Terms and Conditions Registered User Agreement Privacy Policy Help Outlines the days the test is performed. Features: Large lymphoid cells: >= 2x the diameter of a small lymphocytes. . . The tumor cells have large, eccentrically placed, round to oval nuclei with vesicular chromatin and a single prominent nucleolus. A new monoclonal antibody (MUM1p) was used to study the cell/tissue expression of human MUM1/IRF4 protein, the product of the homologous gene involved in the myeloma-associated t(6;14) (p25;q32). Marker is expressed in lymphoid and some nonlymphoid malignancies including classic Hodgkin lymphoma, diffuse large B cell lymphoma (nongerminal center B cell-like subtype . The overall pass rate was relatively low but increased significantly compared to the result obtained in the recent run 48, 2016 (see Table 2). MUM1, PAX5, Oct-2, Bob.1, CD138, LMP1, CD10 and BCL-6. Extramedullary plasmacytomas (EMPs) are neo-plasms of plasma cells at varying stages of . MUM1/IRF4-positive lymphoid cells were uncommon in either follicular or interfollicular areas or paracortex. The quantity of this factor varies within the hematopoietic system in a lineage and stage-specific way. There is abundant eosinophilic cytoplasm which is sometimes foamy or vacuolated. Amer J Clin Pathol 2015 Oct;144(2,1):A147. However, the differences of clinical characteristics and prognosis between DP and other GCB (GCB excluding DP) are unknown. Extramedullary plasmacytomas (EMPs) are neo-plasms of plasma cells at varying stages of . The only MUM1/IRF4-positive nonplasmacytic tumors were 10 B-cell lymphomas and 1 anaplastic lymphoma. Definition Clonal plasma cell proliferation that is immunophenotypically and cytologically identical to plasma cell myeloma, but manifests as localized disease Diagnostic Criteria Osseous plasmacytoma/solitary plasmacytoma of bone Solitary lytic bone lesion consisting of clonal plasma cells Background Detection of B cell clonality is useful for assisting in the diagnosis of B cell lymphomas. The diagnosis of plasmablastic myeloma was favored over The IRTA1 and IRTA2 (immunoglobulin superfamily receptor translocation-associated 1 and 2) genes encode new members of the immunoglobulin receptor superfamily, which have been recently identified through their involvement in chromosomal translocations affecting band 1q21 in various types of B-cell tumors. In diseased cells, blasts in transient myeloproliferative disorder are positively stained. of the Pathology Department, Niigata University Medical School, Japan. Sundram and colleagues reported positivity in 92% of 36 conventional melanomas, which compared favorably to HMB-45 (78%) and melan A (75%). 69 The proliferation index is generally high, but it is highly variable and not required for the diagnosis . Involved in the differentiation of B cells and T cells. Immunoglobulin M multiple myeloma and Waldenström macroglobulinemia are two different hematological diseases with the common finding of an immunoglobulin M monoclonal gammopathy of unknown significance. Mucopurulent debris occurs within the . The MUM1 antibody is specific for the MUM1/IRF4 protein that is overexpressed in late plasma-cell-directed stages of B-cell differentiation. WM is an IgM-secreting lymphoplasmacytic lymphoma that is more likely characterized by enlarged adenopathy, hepatomegaly and/or splenomegaly, anemia, IgM component-related symptoms such as hyperviscosity and peripheral neuropathy, and sometimes constitutional symptoms [ 3, 4 ]. Clonality assessment can be accomplished through evaluation of KAPPA and LAMBDA light chain expression. A splenectomy is performed. Background Plasmablastic lymphoma (PBL) is a rare subtype of non-Hodgkin's lymphoma. Outlines the days the test is performed. Attach the green pathology address label and the pink Immunostain Technical Only label included in the kit to the outside of the transport container. Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) . 6, 7). Aberrant phenotype is infrequent but not rare, and does not rule out a diagnosis of MCL in an otherwise typical case. 1 Indicating that simply using CD38 and CD138 positivity to differentiate between . In addition, expressions of c-MYC, BCL2 and BCL6 were detected by IHC. were retrieved from the original archived formal pathology reports and patients' case notes. MUM1 CHL EBV-LMP CHL Classic Hodgkin Lymphoma: Expanded Panel •T-l and cytotoxic markers, ALK cel (HL vs. ALCL) •BOB-, OCT1 -2, CD79a, MUM-1 (CHL vs. T/HRBCL or NLPHL) •LMP(CHL vs. other, particularly -1 in children and elderly) Prognostic Significance of Immunohistochemical Markers in cHL •Worse prognosis -CD68+ host cells -CD20+ H/RS cells Supplemental studies Immunohistology Keratin positive CD138 positive (CD138 stains many carcinomas) MUM1 and kappa/lambda light chain negative E cadherin negative Conventional and micropapillary are positive Signet ring carcinoma is negative also Histochemistry Mucin stains may reveal intracytoplasmic lumens Differential Diagnosis IRF4/MUM1 is positive in 18-39% of MYC-BCL2 DHLs.60, 67 MYC is positive in 84% of MYC-BCL2 DHLs and 73% of cases show double expression of MYC and BCL2 in one large series. The source included primary diagnostic material and second opinion referrals from pathology departments across the United States and 17 departments of pathology in Wales over a total period of 15 years. Bone marrow from 54 patients was studied to type the underlying lymphoproliferative disorder better. MUM1 is a powerful tool for understanding the histogenesis of B-cell lymphomas. Immunohistochemical staining is essential in evaluating diffuse large B-cell lymphoma and many related large B-cell lymphomas . The . Advances in interventional technology have enhanced the ability to safely sample deep-seated suspicious lesions by fine-needle aspiration procedures. Hodgkin lymphoma (HL) has been classified into classical HL (cHL) (Stein et al., 2008), which accounts for 95% of all cases, and the less common nodular lymphocyte predominant HL (NLPHL) (Poppema et al., 2008). PBL has been reported in several other countries . Chronic endometritis (CE) is reported to occur in 3% to 10% of women undergoing endometrial biopsy for abnormal uterine bleeding. Abbreviated NLPHL. The gene expression subgroups are: Germinal center B-cell like (GCB), and activated B-cell like (ABC). Disease. It represents approximately 30% of diffuse large B-cell lymphomas, and is characterized by the expression of CD44, PKCbeta1, Cyclin D2, BCL-2, and IRF4/MUM1 genes. Essential features EMA (aka MUC1) a glycoprotein that provides barrier function Overexpression is common in malignancies and leads to tumorigenesis Immunohistochemical stain is positive in most carcinomas, often used alongside other cytokeratin stains The aetiology and the pathogenesis of PC-MZL are poorly understood, as it generally lacks the chromosomal translocations . Immunohistochemical analysis using antibodies specific for CD10, BCL6, and MUM1 has been proposed as a surrogate for gene expression profiling. PathologyOutlines.com, free, updated outline surgical pathology clinical pathology pathologist jobs, conferences, fellowships, books A 79-year-old apparently healthy man presented with an isolated, persistent oral lesion. These procedures often yield scant amounts of diagnostic material, yet there is an increasing demand for the performance of more ancillary tests, especially immunohistochemistry and, not infrequently, molecular assays, to increase . Nodular lymphocyte-predominant Hodgkin lymphoma. Molecular genetics: Immunoglobulin heavy- and light-chain genes are rearranged. Nuclear outlines may be irregular or multilobated, and multinucleated cells may be present. We reviewed a panel of markers (including MUM1/IRF4, CD10, BCL-6 and BCL-2) that was found to be particularly helpful in distinguishing the large activated cells of infectious mononucleosis from. Pan-T markers are negative. acterized by the strong expression of IRF4/MUM1 and BCL6, and approximately 50% of the cases express BCL2 and CD10. Shipping Instructions. . Immunohistochemical expression A subset of germinal centre B cells +/-Prominent nucleoli, may be peripheral and/or multiple. The MUM1 antibody is specific for the MUM1/IRF4 protein that is overexpressed in late plasma-cell-directed stages of B-cell differentiation. Only 3 cases showed 10% to 20% of tumoral cells positive for . Thirty-two percent of the cases showed a MUM1+/BCL-6-/CD10- phenotype and 56% had a triple-negative-pattern. Interestingly, this effect was due entirely to the poor OS of MUM1+ FL in the ICT S9800/S9911group (HR 5.53, 95% CI 2.07-14.75, P=.0006). Ki-67 labeling index is high (>20%). BCL6 and MUM1 based on Hans classification. Despite This field reflects the day that the . No one case showed CD10 positivity in 30% or more neoplastic cells. The disease typically follows an indolent clinical course. 1 a fraction of large b-cell lymphomas (lbcl) share a plasmablastic differentiation with an aggressive behavior, refractoriness to chemotherapy, and poor prognosis in most cases. Germinal Center / pathology Humans In Situ . The majority of immunoblasts in all cases were CD20+ B cells with a post-germinal center immunophenotype (strongly positive for MUM1/IRF4 (18/18), CD10− (18/18 negative) and BCL-6− (16/18 . Abstract. ( 236 ) Only 1 of 8 spindle cell/desmoplastic melanomas was positive, though. The only MUM1/IRF4-positive nonplasmacytic tumors were 10 B-cell lymphomas and 1 anaplastic lymphoma. The latter accounts for only about 5% of the loose label of Hodgkin lymphoma and shows a sufficiently different biology and immunophenotype that is essentially a . Modern Pathology - Expression of . Both had MUM1 and H&E while Group I also had accompanying CD138 stains. MUM1 expression was observed in 67% of the BCL-6 positive cases. protocols.39-41 Antibodies and an outline of immu-nohistochemical procedures . Table 2. Diffuse large B-cell lymphoma is the most commonly diagnosed subtype of lymphoma worldwide. EBVMCU usually presents as an isolated ulcerative lesion, most commonly involving the oral mucosa but also appearing in skin or gastrointestinal tract. From the Departments of Pathology and Microbiology, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha; Departments of Pathology and Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada; Department of Pathology, Norwegian Radium Hospital, Oslo, Norway; Department of Pathology, University of Würzburg, Germany; Department of . However, clinical characteristics of the two entities can overlap. . Nuclear staining varied in intensity among cells of the same tumor. MUM1 is also nearly always expressed by melanomas, though only rarely in spindle cell and desmoplastic variants. Pathology demonstrated Ki-67 score greater than 90%, CD56 and CD138 positivity on immunohistochemistry, and Lambda light chain restriction. However, except for rare examples of lymphoma-specific immunohistochemistry, such as cyclin D1 in mantle cell lymphoma and annexin A1 in hairy cell leukemia, immunohistochemical profiles of mature B-cell lymphomas . MUM1/IRF4 protein is a member of the interferon regulatory factor (IRF) family of transcriptional factors initially described as downstream regulators of interferon signaling. Shih-Sung Chuang, MD, Hongtao Ye, MD, PhD, Ming-Qing Du, MD, PhD, Chin-Li Lu, MS, Ahmet Dogan, MD, PhD, Pin-Pen Hsieh, MD, Wan-Ting Huang, MD, Yun-Chih Jung, MD, Histopathology and Immunohistochemistry in Distinguishing Burkitt Lymphoma From Diffuse Large B-Cell Lymphoma With Very High Proliferation Index and With or Without a Starry-Sky Pattern: A Comparative Study With EBER and FISH . The results indicate that MUM1 is positive in 33/36 (92%) cases of melanoma (21/22 [95%] conventional primary melanomas and 12/14 [86%] metastatic melanomas). Empyemas progress from an acute phase with fluid that is thin and can be drained completely with a chest tube or small bore catheter. . In this report, we describe two cases of immunoglobulin M neoplasm with the same histological bone marrow presentation but . Disease. From the Department of Pathology, University of Mississippi Medical Center, Jackson. Most cases have IGH/IRF4 rearrangement and BCL6 alterations (Figure 1). 2. . If diagnostic consultation by a pathologist is required order PATHC / Pathology Consultation. MUM1 was expressed in the nuclei and cytoplasm of plasma cells and a small percentage of germinal center … Primary mediastinal large B-cell lymphoma (PMLBCL) is a rare, aggressive, distinct subtype of large B-cell lymphoma localized in anterosuperior mediastinum. Clinics and Pathology. John R. Goldblum MD, in Rosai and Ackerman's Surgical Pathology, 2018 Lymphoblastic Lymphoma. Not follicular/nodular arrangement. Macroscopically, the mass is gray-white and firm. Lymphoma, B-Cell / pathology Multiple Myeloma / genetics . A variant of cHL which resembles NLPHL, in terms of nodular growth and lymphocyte-richness, and mimics cHL, in terms of the . IRF4/MUM1 protein is expressed in tumor cell nuclei. 67 Compared with MYC-BCL2 DHL, cases of MYC-BCL6 DHL express . MUM1 protein is an excellent marker for Hodgkin and Reed-Sternberg cells of classical Hodgkin lymphoma in combination with CD30. This field reflects the day that . BCL-6 expression was observed in 12% of the cases and MUM1 in 35%. . CD5 is present in about 10% of cases. Different types of mature B-cell lymphomas, including plasma cell neoplasms, exhibit distinct immunohistochemical profiles, which enable them to be correctly diagnosed. Characterized by its aggressive nature and plasmacytic differentiation, PBL remains a therapeutic and diagnostic challenge; it generally has a poor prognosis with very few long-term survivors and most patients dying within 2 years from initial presentation. . Immunohistochemical investigation All tissue biopsies were fixed routinely in 10% buffered formalin, embedded in paraffin, and cut . Herein we evaluated a new . Nordic Immunohistochemical Quality Control, MUM1 run 58 2020 Page 2 of 9 Performance history This was the third NordiQC assessment of MUM1. immunohistochemistry; lymphoma; MUM1/IRF4; pathology; plasmacytoma. Search for more papers by this author Context: Gene expression profiling of diffuse large B-cell lymphoma using complementary DNA microarrays has revealed 2 major prognostic groups in Western countries: germinal center B-cell-like and nongerminal center B-cell-like lymphomas. If diagnostic consultation by a pathologist is required order PATHC / Pathology Consultation. A surface light chain restriction of kappa or lambda is present. Although it is a rare disease, PC-MZL accounts for 20- 40% of all primary cutaneous B-cell lymphoma in Western Countries. Hodgkin lymphoma, abbreviated HL, is a haematological malignancy.If not otherwise specified, Hodgkin lymphoma generally refers to classical Hodgkin lymphoma (CHL) rather than nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). Institute of Pathology, University Hospital Tübingen, Eberhard‐Karls‐University of Tübingen and Comprehensive Cancer Center, Tübingen, Germany . Since then, new antibodies specific to germinal center B-cells have been developed, which . Histologically normal mucosa from the mar-gins of the specimens served as control tissue. Amer J Clin Pathol 2015 Oct;144(2,1):A147. Empyema is an infection of the pleural space and commonly an exudate. Outlines the days the test is performed. Conclusions: MUM1 is expressed in a subset (approximately 15%) of FL. Significant risk for transformation into diffuse large B cell lymphoma (DLBCL); 10-year cumulative transformation rate (to DLBCL) in one study was 12%. Staining was performed with an automated immunostaining system, either DAKO . Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore Chee Leong Cheng & Leonard Tan SingHealth Duke-NUS Blood Cancer Centre, Singapore, Singapore The diagnosis is based on the presence of plasma cells (PCs) in the endometrium. In the current study, we have examined MUM1 protein expression in 61 melanocytic lesions and compared the diagnostic usefulness of this marker with that of anti-S100, HMB45, and anti-MelanA. Our results sustain the usefulness of the selected set of TFs to diagnose and distinguish NLPHL from cHL since Pax-5, Oct-2, BOB.1 and Bcl-6 are consistently expressed by lymphocyte predominant (LP) cells and . . Alexandra C. Hristov, Associate Professor, Departments of Pathology and Dermatology, 2800 Plymouth Road, Building 35, Ann Arbor, MI 48109-2800. Lymphoblastic lymphoma occurs primarily in children and young adults in whom it has a particular predilection for the thymic region. In this series, MUM1 expression appears to identify a group of FL patients with shorter OS in the context of ICT. Immunohistochemical investigation All tissue biopsies were fixed routinely in 10% buffered formalin, embedded in paraffin, and cut . Visit the ExpertPath Support Center.. Email: ahristov@med.umich.edu. Context.—. 312 It is usually of immature (precursor) T-cell type, but a certain degree of phenotypic heterogeneity occurs including cases of precursor B-cell and natural killer . Twenty-two cases of NLPHL were studied for the immunohistochemical expression of Pax-5, Oct-2, BOB.1, Bcl-6 protein and MUM1/IRF-4. Bone marrow biopsies showed circumscribed intra-parenchymatous nodules with small monotonous monoclonal B . We're here if you need help. Classic Hodgkin Lymphoma: Pathology • Diagnosis established by the identification of Reed-Sternberg cells and variants in the appropriate milieu • Reedternberg cell: Multi-S -nucleate or multilobate large cell with each nucleus or lobe containing a prominent eosinophilic nucleolus with a modest rim of amphiphilic cytoplasm • MUM1 Expression in Follicular Lymphoma Is a Poor Prognostic Marker in Patients Treated with Immunochemotherapy (SWOG 9800/9911) but Not Chemotherapy Alone (SWOG 8809): A Southwest Oncology Group Correlative Science Study Eric D Hsi, MD, Lisa Rimsza, MD, Bryan H Goldman, MS, James R. Cook, MD, PhD, Raymond R. Tubbs, DO, Oliver W. Press, MD, PhD, From pathogenesis to pathology. CD42b stains normal platelets, megakaryocytes, and megakaryoblasts. were retrieved from the original archived formal pathology reports and patients' case notes. Context.—. The results indicate that MUM1 is positive in 33/36 (92%) cases of melanoma (21/22 [95%] conventional primary melanomas and 12/14 [86%] metastatic melanomas). . Cases tested for EBV by in situ hybridization . immunohistochemistry; lymphoma; MUM1/IRF4; pathology; plasmacytoma. Context. Flow Diagnosis: DLBCL are CD45 positive and large (high FS) and express the pan B cell markers CD19, CD20, CD22 and CD79a. Nuclear grooves may be seen. Cytoplasm usually basophilic and moderate in abundance. Departments of Pathology and Dermatology, University of Michigan, Ann Arbor, Michigan, USA. Abstract: Primary cutaneous marginal zone lymphoma (PC-MZL) is a B-cell lymphoma arising in the skin. In addition, expressions of c-MYC, BCL2 and BCL6 were detected by IHC. A small number of cases show post-germinal center or plasma cell-associated markers such as CD38, VS38, and MUM1. . Primary chronic cold agglutinin disease is a rare hemolytic disease mediated by monoclonal IGHV4-34-encoded cold agglutinins with a predominant specificity for the blood group antigen I. MUM1 protein is an excellent marker for Hodgkin and Reed-Sternberg cells of classical Hodgkin lymphoma in combination with CD30. Despite its well known histological and clinical features, Hodgkin's lymphoma (HL) has recently been the object of intense research activity, leading to a better understanding of its phenotype, molecular characteristics, histogenesis, and possible mechanisms of lymphomagenesis. AKA lympho-histiocytic variant. Currently, only slide based methods are available for the majority of patient biopsies and do not detect light chain protein or mRNA in many B-cell lymphomas. In both groups combined, MUM1 detected plasma cells in 48% of the cases, while CD138 and H&E identified the cells in 23% and 15% of the biopsies, respectively. 2 they are characterized by a gradual expression of transcription factors … This process typically worsens as the fluid becomes more turbid and thick and begins to loculate. Purpose: Hans and coworkers previously developed an immunohistochemical algorithm with ∼80% concordance with the gene expression profiling (GEP) classification of diffuse large B-cell lymphoma (DLBCL) into the germinal center B-cell-like (GCB) and activated B-cell-like (ABC) subtypes. MUM1/IRF4 antigen was detected mostly in the nucleus, with slight and diffuse staining of the cytoplasm, in both normal and neoplastic plasma cells (Figs. Hartmann S et al: 24192382: 2014 Dr King is now with the Department of Pathology, Baylor Scott & White Medical Center/Texas A&M College of Medicine Health Science Center, Temple. . A minority of cases express CD30. Proportion of sufficient results for MUM1 in the three . It makes up 2-3% of non-Hodgkin lymphomas and affects young adults with a female . MUM1 / IRF4 is a nuclear marker that is normally expressed in activated B and T cells, plasma cells and melanocytes. . Although MUM1 is used as a post GC marker, cases with coexpression of CD10 and MUM1 (CD10 + MUM1 +, double positive or DP), which was classified as GCB subtype according to Hans algorithm, do exist. 1,2 IRTA2 expression was found to be deregulated in Burkitt lymphoma with 1q21 . MUM1 and Ki67 Expression Best Predictors of Treatment Response in Diffuse Large B Cell Lymphoma Not Otherwise Specified. If diagnostic consultation by a pathologist is required order PATHC / Pathology Consultation. CD42b is used in diagnosis of acute myeloid leukemia (AML)-M7, distinguishing AML-M7 (CD42b+) from acute myelosis with myelofibrosis (usually CD42b negative). In addition to having a clean background, MUM1 is a more sensitive stain than CD138 for detection of PCs in . Carbone A et al: 25644177: 2015: Array comparative genomic hybridization reveals similarities between nodular lymphocyte predominant Hodgkin lymphoma and T cell/histiocyte rich large B cell lymphoma. The patient remains disease free 12 months after the splenectomy. Different IHC and morphologic appearance than classic HL. This field reflects the day that the . It shares clinical, morphologic, and molecular genetic features with nodular sclerosing Hodgkin lymphoma. On H&E sections, there are scattered cells with large nucleoli that are CD30, CD15, MUM1, PAX5, and EBER positive, but are negative for CD45rb and cytokeratin AE1/3. Diffuse Large B-Cell Lymphoma Activated B-Cell Type Definition A biologic subset of diffuse large B-cell lymphomas with a unique molecular signature or expression profile. MUM1 is a powerful tool for understanding the histogenesis of B-cell lymphomas.