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MNDA-positive Follicular Lymphoma is a heterogeneous disease: a case series study of 19 patients
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DOI：10.1007/s00428-026-04673-1.png)
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Abstract
En 中文
Myeloid cell nuclear differentiation antigen (MNDA) is a nuclear protein involved in key cellular processes. It is expressed in 78% of marginal zone lymphomas (MZLs), but only in 2.6–19% of follicular lymphomas (FLs). The role and implications of MNDA expression in the FL context remain poorly understood. To characterize, for the first time, the morphological, immunophenotypic, molecular, and clinical features of MNDA-positive FLs. We retrospectively analysed a series of 19 MNDA-expressing FLs. Histopathological features, immunohistochemistry, cytogenetic rearrangements, and mutational profiles were assessed. Clinical data, including disease grade and relapse patterns, were also reviewed. All the 19 MNDA-positive FLs showed a follicular growth pattern, and 57.9% were low-grade. MNDA expression appeared at relapse in four initially negative cases. Marginal zone or plasmacytic differentiation was seen in 26.1% of cases. All cases were BCL6-positive; 21% were P53-positive, and 63% showed high Ki67 (> 40%). BCL2 rearrangements were found in 57.9% andBCL6 in 44.4% of the individuals. BCL2-rearranged cases had a distinct mutational profile from non-rearranged individuals. TP53mutations were present in three BCL6-rearranged cases, two of which also featured BCL2-rearrangements. Marginal/plasmacytic characteristics were not associated with specific mutations. Extra nodal recurrence occurred in 21% of cases, including one located in the colon. FLs can express MNDA, giving rise to a biologically heterogeneous subgroup of FL cases with diverse clinical, morphological, and genetic characteristics. Further studies are needed to characterize them better.
Keywords:
Follicular lymphoma
MNDA
BCL2- gene rearrangement
TP53 mutation
Extranodal
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