Cite this page: Pernick N. IgH. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainsigh.html. Accessed December 4th, 2024.
Definition / general
- 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)
Interpretation
- Fusion genes involving IgH (common, 10% or more):
- 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
- 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%)
- Fusion genes involving IgH (uncommon, <10%):
- 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)