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Stains

IgH


Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 17 May 2012, last major update May 2012 - IN PROGRESS
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.

Definition
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● Gene rearrangement studies prove clonality for B cell lymphomas if IgH is monotypic (cutaneous marginal zone lymphoma, Am J Clin Pathol 2010;133:59; histiocytic sarcoma, Mod Pathol 2005;18:693)
● Note that T cell lymphomas can rarely have coexisting clonal IgH rearrangements (Am J Clin Pathol 2006;126:14)
● FISH and PCR useful for detecting fusion genes, including those with IGH (FISH may be superior to PCR, Am J Clin Pathol 2005;124:421)

Fusion genes involving IgH (common-10% or more)
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● BCL1-IgH (due to t(11;14)(q13;q32)): mantle cell lymphoma (90%), B cell prolymphocytic leukemia (20%), splenic lymphoma with villous lymphocytes (10%), CLL (2-5%), myeloma (2-5%); BCL1 is also known as cyclin D1
● BCL2-IgH (due to t(14;18)): follicular lymphoma (80%+), diffuse large cell lymphoma (30%), CLL (occasional)
● BCL2-IgH and MYC-IGH: "double-hit" lymphoma (Am J Surg Pathol 2010;34:327)
● BCL3-IgH (due to t(14;19)(q32;q13)): CLL/SLL (4-20%, Am J Clin Pathol 2011;135:686)
● BCL6-IgH (due to t(3;14)(q27;q32)): diffuse large B cell lymphoma (30%), follicular lymphoma (10%), nodular lymphocyte predominant Hodgkin lymphoma (some, J Mol Diagn 2005;7:352)
● FGFR3-IgH (due to t(4;14)(p16;q32)): myeloma (20-30%)
● MALT1-IgH (due to t(14;18)(q32;q21)): MALT lymphoma (11%, but varies by site, Leukemia 2004;18:1722)
● MUM/IRF4-IgH (due to t(6;14)(p25;q32)): myeloma (20%)
● MYC-IgH (due to t(8;14)(q24;q32.3)): Burkitt lymphoma (75%), plasmablastic lymphoma (~35%, Am J Surg Pathol 2010;34:1686, Am J Clin Pathol 2009;132:597), ALL-L3 (6%)
● PAX5-IgH (due to t(9;14)(p13;q32)): lymphoplasmacytic lymphoma (0-50%), diffuse large B cell lymphoma and other B cell lymphoproliferative disorders

Fusion genes involving IgH (uncommon, <10%)
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● BCL11A-IgH: CLL (rare, Am J Clin Pathol 2009;131:663)
● MAF-IgH: myeloma due to t(14;16)(q32;q23) (4%, Am J Clin Pathol 2009;132:361)

FISH images
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IGH-BCL1 in mantle cell lymphoma


IGH-BCL2 in "double-hit" lymphoma


IGH-BCL2 in follicular lymphoma (spleen)


IGH-BCL2 and IGH-BCL6 in diffuse large B cell lymphoma


IGH-BCL3 in CLL


IGH-BCL6 juxtaposition in nodular lymphocyte predominant Hodgkin lymphoma


IGH-BCL11A in CLL (rare)



IGH-MALT1 in MALT lymphoma due to t(14;18)(q32;q21)


IGH-MYC in plasmablastic lymphoma

End of Stains > IgH

Ref Updated: 4/25/12


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