CD10 and BCL-6 expression in paraffin sections of normal lymphoid tissue and B-cell lymphomas

Am J Surg Pathol. 2000 Jun;24(6):846-52. doi: 10.1097/00000478-200006000-00010.


In this study the authors explored the value of immunostaining for follicular center B-cell markers, BCL-6 and CD10, in paraffin sections as a tool for the differential diagnosis of B-cell lymphomas. The cases studied comprised reactive lymphoid hyperplasia (RLH; n = 19), follicular lymphoma (FL; n = 50), low-grade mucosa-associated lymphoid tissue (MALT) lymphoma (n = 24), mantle cell lymphoma (n = 19), splenic marginal zone lymphoma (n = 13), diffuse large B-cell lymphoma (DLBCL; n = 54), Burkitt's lymphoma (BL; n = 20), nodular lymphocyte predominance Hodgkin's disease (NLPHD; n = 16), and classic Hodgkin's disease (CHD; n = 13). In RLH, CD10 and BCL-6 were expressed almost exclusively by the follicular center cells. In contrast in FL, the expression of CD10 (39/50) and BCL-6 (34/36) was seen in both follicular and interfollicular neoplastic B cells. Marginal zone/MALT lymphomas and mantle cell lymphoma were always negative. In DLBCL the expression was variable for both CD10 (21/54) and BCL-6 (39/47), with some tumors, including cases of transformed follicular lymphoma (9/10), coexpressing CD10 and BCL-6, and others expressing only BCL-6, and a small group expressing neither marker, possibly reflecting the underlying primary pathogenetic events such as the rearrangement of BCL-2 or BCL-6 genes. BL was always both CD10 and BCL-6 positive. In NLPHD the L&H cells expressed BCL-6 (11/13) but not CD10, whereas in CHD BCL-6 expression was seen in half of the cases. This study demonstrates that both CD10 and BCL-6 are reliable markers of follicular center B-cell differentiation. CD10 and BCL-6 immunostaining have an important role in differential diagnosis of FL from RLH and other low-grade B-cell lymphomas. The results also suggest that a CD10/BCL-6 expression pattern may be helpful in identifying main subsets of DLBCL. However, additional studies comparing genotype with immunophenotype are required.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers
  • Biomarkers, Tumor
  • Biopsy
  • Burkitt Lymphoma / diagnosis
  • Burkitt Lymphoma / genetics
  • Burkitt Lymphoma / pathology
  • Diagnosis, Differential
  • Histological Techniques
  • Hodgkin Disease / diagnosis
  • Hodgkin Disease / genetics
  • Hodgkin Disease / pathology
  • Humans
  • Hyperplasia / diagnosis
  • Hyperplasia / pathology
  • Immunohistochemistry
  • Immunophenotyping
  • Lymphoma, B-Cell / diagnosis*
  • Lymphoma, B-Cell / genetics*
  • Lymphoma, B-Cell / pathology
  • Lymphoma, B-Cell, Marginal Zone / diagnosis
  • Lymphoma, B-Cell, Marginal Zone / genetics
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • Lymphoma, Follicular / diagnosis
  • Lymphoma, Follicular / genetics
  • Lymphoma, Follicular / pathology
  • Lymphoma, Non-Hodgkin / diagnosis
  • Lymphoma, Non-Hodgkin / genetics
  • Lymphoma, Non-Hodgkin / pathology
  • Neprilysin / analysis*
  • Paraffin
  • Proto-Oncogene Proteins / analysis*
  • Splenic Neoplasms / diagnosis*
  • Splenic Neoplasms / genetics*
  • Splenic Neoplasms / pathology


  • Biomarkers
  • Biomarkers, Tumor
  • Proto-Oncogene Proteins
  • Paraffin
  • Neprilysin