Parotid gland follicular lymphoma lacking both cytoplasmic and surface light chains: a rare case

Int J Clin Exp Pathol. 2014 Sep 15;7(10):7100-4. eCollection 2014.

Abstract

Immunoglobulin light chain (LC) restriction is detected in the majority of B-cell non-Hodgkin lymphoma (B-NHL) by flow cytometric immunophenotyping (FCI) and serves as a surrogate marker of monoclonality. Even though it is known a small percentage of mature B-NHLs lacking surface LC, deficiency of both cytoplasmic and surface LCs has been reported in only three B-NHL cases. We report a primary parotid gland follicular lymphoma in a 63-year-old man and the lymphoma cells were deficient of cytoplasmic/surface LCs. Compared to previous reports, we used a more sensitive FCI method by combining both monoclonal and polyclonal anti-LC antibodies. Lacking LCs poses as a pitfall for the initial diagnosis of B-NHL, as well as for detecting minimal residual disease. It is important to be aware of this rare immunophenotypic aberrancy.

Keywords: Follicular lymphoma; flow cytometry; immunoglobulin light chain; light chain negativity; parotid gland.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor / immunology*
  • Biopsy
  • Cell Membrane / immunology*
  • Cytoplasm / immunology*
  • Diagnosis, Differential
  • Flow Cytometry
  • Humans
  • Immunoglobulin Light Chains / analysis*
  • Immunohistochemistry
  • Immunophenotyping / methods
  • Lymphoma, B-Cell / diagnosis
  • Lymphoma, B-Cell / immunology*
  • Lymphoma, Follicular / diagnosis
  • Lymphoma, Follicular / immunology*
  • Male
  • Middle Aged
  • Parotid Neoplasms / diagnosis
  • Parotid Neoplasms / immunology*
  • Predictive Value of Tests

Substances

  • Biomarkers, Tumor
  • Immunoglobulin Light Chains