Gastrointestinal sistem lenfoproliferatif lezyonlara pratik yaklaşım
Yıl 2022,
, 213 - 230, 30.09.2022
Tuğba Toyran
Öz
Gastrointestinal sistem, reaktif lenfoid hiperplaziden lenfomaya kadar uzanan lenfoproliferatif lezyonların primer lokalizasyon bölgesidir. Bu hastalıkların teşhisi, özellikle küçük endoskopik biyopsilerde zordur ve doğru tanıya ulaşabilmek için klinik, morfolojik, immünohistokimyasal ve moleküler verilere dayalı entegre bir yaklaşıma ihtiyaç duyulmaktadır. Bu derlemede, gastrointestinal sistemde izlenen Hodgkin dışı lenfomaların temel histolojik özellikleri ile birlikte ayırıcı tanıya giren antiteler tartışılmıştır.
Teşekkür
Derleme yazım süresince, desteğini her zaman hissettiğim, yardım ve katkılarıyla beni yönlendiren, benimle tecrübelerini ve vakalarını paylaşan değerli hocam Prof.Dr.Melek Ergin’e çok teşekkür ederim.
Kaynakça
- Alvarez-Lesmes, J., Chapman, J. R., Cassidy, D., Zhou, Y., Garcia-Buitrago, M., Montgomery, et al. Gastrointestinal Tract LymphomasA Review of the Most Commonly Encountered Lymphomas. Archives of Pathology & Laboratory Medicine. 2021;145(12):585-1596.
- Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma. World J Gastroenterol. 2011;17:697-707.
- Pizzi, M., Sabattini, E., Parente, P., Bellan, A., Doglioni, C., & Lazzi, S. Gastrointestinal lymphoproliferative lesions: a practical diagnostic approach. Pathologica. 2020;112(3):227.
- Montes-Moreno S, King RL, Oschlies I, et al.. Update on lymphoproliferative disorders of the gastrointestinal tract: disease spectrum from indolent lymphoproliferations to aggressive lymphomas. Virchows Arch. 2020;476:667-81.
- Skinnider, BF. Lymphoproliferative disorders of the gastrointestinal tract. Archives of Pathology & Laboratory Medicine. 2018;142(1):44-52.
- Swerdlow S., Campo E., Harris N., et al. WHO classification of tumors of haematopoietic and lymphoid tissues, (Revised 4th ed.): p300-302. Lyon, France, IARC Press, 2017.
- Lo WY., Li JY., Chan YK., et al.. Instability of clonality in gastric lymphoid infiltrates: a study with emphasis on serial biopsies. Am J Surg Pathol. 2005;29:1582-92.
- Hussein M.R. Atypical lymphoid proliferations: the pathologist’s viewpoint. Expert Rev Hematol. 2013;6:139-53.
- Dawson IM., Cornes JS., Morson BC. Primary malignant lymphoid tumours of the intestinal tract: Report of 37 cases with a study of factors influencing prognosis. Br J Surg. 1961;49:80-9.
- Alkan S., Doğan M, Pratik neoplastik lenf nodu patolojisi. 1. Baskı. Ankara, Nobel tıp, 2016.
- Nakamura S, Ponzoni M. Marginal zone B-cell lymphoma: lessons from Western and Eastern diagnostic approaches. Pathology. 2020;52:15-29.
- Wotherspoon AC, Doglioni C, Diss TC, et al.. Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori. Lancet. 1993;342(8871):575-7.
- Copie-Bergman C, Gaulard P, Lavergne-Slove A, et al.. Proposal for a new histological grading system for post-treatment evaluation of gastric MALT lymphoma. Gut. 2003;52:165.
- Attygalle AD, Liu H, Shirali S, et al.. Atypical marginal zone hyperplasia of mucosa-associated lymphoid tissue: a reactive condition of childhood showing immunoglobulin lambda light-chain restriction. Blood. 2004;104:3343-8.
- Al-Saleem T, Al-Mondhiry H. Immunoproliferative small intestinal disease (IPSID): a model for mature B-cell neoplasms. Blood. 2005;105:2274-80.
- Duffles Amarante G, Collins G, Rocha V. What do we know about duodenal-type follicular lymphoma? From pathological definition to treatment options. Br J Haematol. 2020;188:831-7.
- Misdraji J, Harris NL, Hasserjian RP, et al.. Primary follicular lymphoma of the gastrointestinal tract. Am J Surg Pathol. 2011;35:1255-63.
- Marks E, Shi Y. Duodenal-type follicular lymphoma: a clinicopathologic review. Arch Pathol Lab Med. 2018;142:542-7
- Miao Y, Lin P, Saksena A, et al.. CD5-negative mantle cell lymphoma: clinicopathologic correlations and outcome in 58 patients. Am J Surg Pathol. 2019;43:1052-60.
- Pizzi M, Agostinelli C, Righi S, et al.. Aberrant expression of CD10 and BCL6 in mantle cell lymphoma. Histopathology. 2017;71:769-77.
- Ye H, Desai A, Zeng D, et al.. Smoldering mantle cell lymphoma. J Exp Clin Cancer Res. 2017;36:185.
- Zhang XM, Aguilera N. New immunohistochemistry for B-cell lymphoma and Hodgkin lymphoma. Arch Pathol Lab Med. 2014;138:1666-72.
- Piccaluga PP, De Falco G, Kustagi M, et al.. Gene expression analysis uncovers similarity and differences among Burkitt lymphoma subtypes. Blood. 2011;117:3596-3608.
- Mundo L, Ambrosio MR, Raimondi F, et al.. Molecular switch from MYC to MYCN expression in MYC protein negative Burkitt lymphoma cases. Blood Cancer J. 2019;9:91.
- Wagener R, Seufert J, Raimondi F, et al.. The mutational landscape of Burkitt-like lymphoma with 11q aberration is distinct from that of Burkitt lymphoma. Blood. 2019;133:962-6
- Xie Y, Pittaluga S, Jaffe ES. The histological classification of diffuse large B-cell lymphomas. Semin Hematol. 2015;52:57-66.
- Alizadeh AA, Eisen MB, Davis RE, et al.. Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling. Nature. 2000;403(6769):503-11.
- Hans, C. P., Weisenburger, D. D., Greiner, T. C., Gascoyne, R. D., Delabie, J., Ott, G., et al.. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood. 2004;103(1):275-282.
- Li L, Li Y, Que X, et al.. Prognostic significances of overexpression MYC and/or BCL2 in R-CHOP-treated diffuse large B-cell lymphoma: a systematic review and meta-analysis. Sci Rep. 2018;8:6267.
- Di Napoli A, Remotti D, Agostinelli C, et al.. A practical algorithmic approach to mature aggressive B cell lymphoma diagnosis in the double/triple hit era: selecting cases, matching clinical benefit: Virchows Arch. 2019;475(4):513-518.
- Li S, Desai P, Lin P, et al.. MYC/BCL6 double-hit lymphoma (DHL): a tumour associated with an aggressive clinical course and poor prognosis. Histopathology. 2016;68:1090-8.
- Salaverria I, Philipp C, Oschlies I, et al.. Translocations activating IRF4 identify a subtype of germinal center-derived B-cell lymphoma affecting predominantly children and young adults. Blood. 2011;118:139-47.
- Choi WW, Weisenburger DD, Greiner TC, et al.. A new immunostain algorithm classifies diffuse large B-cell lymphoma into molecular subtypes with high accuracy. Clin Cancer Res. 2009;15:5494-5502.
- Luria L, Nguyen J, Zhou J, et al.. Manifestations of gastrointestinal plasmablastic lymphoma: a case series with literature review. World J Gastroenterol.
2014;20(33):11894-11903.
- Lorsbach RB, Hsi ED, Dogan A, et al.. Plasma cell myeloma and related neoplasms. Am J Clin Pathol. 2011;136:168-82.
- Delabie J, Holte H, Vose JM, et al.. Enteropathy-associated T-cell lymphoma: clinical and histological findings from the international peripheral T-cell lymphoma project. Blood. 2011;118:148-55.
- Jaffe, ES. T-cell and NK-cell neoplasms of the gastrointestinal tract–recurrent themes, but clinical and biological distinctions exist. Haematologica. 2020;105(7):1760.
- van Vliet C, Spagnolo DV. T- and NK-cell lymphoproliferative disorders of the gastrointestinal tract: review and update. Pathology. 2020;52:128-41.
- van Gils T, Nijeboer P, van Wanrooij RL, et al.. Mechanisms and management of refractory coeliac disease. Nat Rev Gastroenterol Hepatol. 2015;12:572-579.
- Ko, Y. H., Karnan, S., Kim, K. M., Park, C. K., Kang, E. S., Kim, Y. et al.. Enteropathy-associated T-cell lymphoma clinicopathologic and array comparative genomic hybridization study. Human pathology. 2010;41(9):1231-1237.
- Chander U, Leeman-Neill RJ, Bhagat G. Pathogenesis of Enteropathy-Associated T Cell Lymphoma. Curr Hematol Malig Rep. 2018;13:308-17.
- Tan, S. Y., Chuang, S. S., Tang, T., Tan, L., Ko, Y. H., Chuah, K. L. et al.. Type II EATL (epitheliotropic intestinal T-cell lymphoma): a neoplasm of intra-epithelial T-cells with predominant CD8αα phenotype. Leukemia, 2013:27(8);1688-1696.
- Kikuma, K., Yamada, K., Nakamura, S., Ogami, A., Nimura, S., Hirahashi, et al.. Detailed clinicopathological characteristics and possible lymphomagenesis of type II intestinal enteropathy-associated T-cell lymphoma in Japan. Human Pathology, 2014:45(6);1276-1284.
- Inghirami G, Pileri SA, European TCLSG. Anaplastic large-cell lymphoma. Semin Diagn Pathol. 2011;28:190-201.
- Tan SY, Ooi AS, Ang MK, et al. Nuclear expression of MATK is a novel marker of type II enteropathy-associated T-cell lymphoma. Leukemia. 2011;25:555-7.
- Swerdlow, S. H., Jaffe, E. S., Brousset, P., Chan, J. K., Gaulard, P., Harris, N. L., et al.. Cytotoxic T-cell and NK-cell lymphomas: current questions and controversies. The American journal of surgical pathology. 2014;38(10):e60.
- Yu BH, Shui RH, Sheng WQ, et al.. Primary intestinal extranodal natural killer/t-cell lymphoma, nasal type: a comprehensive clinicopathological analysis of 55 cases. PLoS One. 2016;11:e0161831.
- Matnani, R., Ganapathi, K. A., Lewis, S. K., Green, P. H., Alobeid, B., & Bhagat, G. Indolent T‐and NK‐cell lymphoproliferative disorders of the gastrointestinal tract: a review and update. Hematological Oncology. 2017; 35(1): 3-16.
- Perry AM, Warnke RA, Hu Q, et al.. Indolent T-cell lymphoproliferative disease of the gastrointestinal tract. Blood. 2013;122:3599-3606.
- Soderquist, C. R., Patel, N., Murty, V. V., Betman, S., Aggarwal, N., Young, K. H., et al. Genetic and phenotypic characterization of indolent T-cell lymphoproliferative disorders of the gastrointestinal tract. Haematologica. 2020;105(7):1895.
- Takeuchi K, Yokoyama M, Ishizawa S, et al.. Lymphomatoid gastropathy: a distinct clinicopathologic entity of self-limited pseudomalignant NK-cell proliferation. Blood. 2010;116:5631-7.
- Mansoor, A., Pittaluga, S., Beck, P. L., Wilson, W. H., Ferry, J. A., & Jaffe, E. S. NK-cell enteropathy: a benign NK-cell lymphoproliferative disease mimicking intestinal lymphoma: clinicopathologic features and follow-up in a unique case series. Blood. The Journal of the American Society of Hematology. 2011;117(5):1447-1452.
- Xia, D., Morgan, E. A., Berger, D., Pinkus, G. S., Ferry, J. A., & Zukerberg, L. R. NK-cell enteropathy and similar indolent lymphoproliferative disorders: a case series with literature review. American Journal of Clinical Pathology. 2019;151(1):75-85.
- Dojcinov SD, Venkataraman G, Raffeld M, et al.. EBV positive mucocutaneous ulcer--a study of 26 cases associated with various sources of immunosuppression. Am J Surg Pathol. 2010;34:405-17.
- Natkunam Y, Goodlad JR, Chadburn A, et al.. EBV-Positive B-Cell proliferations of varied malignant potential: 2015 SH/EAHP workshop report-part 1. Am J Clin Pathol. 2017;147:129-52.
Practical approach to gastrointestinal system lymphoproliferative lesions
Yıl 2022,
, 213 - 230, 30.09.2022
Tuğba Toyran
Öz
The gastrointestinal tract is the primary localization site of lymphoproliferative lesions ranging from reactive lymphoid hyperplasia to lymphoma. Diagnosis of these diseases is difficult, especially in small endoscopic biopsies. And integrated approach based on clinical, morphological, immunohistochemical and molecular data is needed for accurate diagnosis. In this review, the basic histological features of non-Hodgkin lymphomas in the gastrointestinal tract and the entities included in the differential diagnosis are discussed.
Kaynakça
- Alvarez-Lesmes, J., Chapman, J. R., Cassidy, D., Zhou, Y., Garcia-Buitrago, M., Montgomery, et al. Gastrointestinal Tract LymphomasA Review of the Most Commonly Encountered Lymphomas. Archives of Pathology & Laboratory Medicine. 2021;145(12):585-1596.
- Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma. World J Gastroenterol. 2011;17:697-707.
- Pizzi, M., Sabattini, E., Parente, P., Bellan, A., Doglioni, C., & Lazzi, S. Gastrointestinal lymphoproliferative lesions: a practical diagnostic approach. Pathologica. 2020;112(3):227.
- Montes-Moreno S, King RL, Oschlies I, et al.. Update on lymphoproliferative disorders of the gastrointestinal tract: disease spectrum from indolent lymphoproliferations to aggressive lymphomas. Virchows Arch. 2020;476:667-81.
- Skinnider, BF. Lymphoproliferative disorders of the gastrointestinal tract. Archives of Pathology & Laboratory Medicine. 2018;142(1):44-52.
- Swerdlow S., Campo E., Harris N., et al. WHO classification of tumors of haematopoietic and lymphoid tissues, (Revised 4th ed.): p300-302. Lyon, France, IARC Press, 2017.
- Lo WY., Li JY., Chan YK., et al.. Instability of clonality in gastric lymphoid infiltrates: a study with emphasis on serial biopsies. Am J Surg Pathol. 2005;29:1582-92.
- Hussein M.R. Atypical lymphoid proliferations: the pathologist’s viewpoint. Expert Rev Hematol. 2013;6:139-53.
- Dawson IM., Cornes JS., Morson BC. Primary malignant lymphoid tumours of the intestinal tract: Report of 37 cases with a study of factors influencing prognosis. Br J Surg. 1961;49:80-9.
- Alkan S., Doğan M, Pratik neoplastik lenf nodu patolojisi. 1. Baskı. Ankara, Nobel tıp, 2016.
- Nakamura S, Ponzoni M. Marginal zone B-cell lymphoma: lessons from Western and Eastern diagnostic approaches. Pathology. 2020;52:15-29.
- Wotherspoon AC, Doglioni C, Diss TC, et al.. Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori. Lancet. 1993;342(8871):575-7.
- Copie-Bergman C, Gaulard P, Lavergne-Slove A, et al.. Proposal for a new histological grading system for post-treatment evaluation of gastric MALT lymphoma. Gut. 2003;52:165.
- Attygalle AD, Liu H, Shirali S, et al.. Atypical marginal zone hyperplasia of mucosa-associated lymphoid tissue: a reactive condition of childhood showing immunoglobulin lambda light-chain restriction. Blood. 2004;104:3343-8.
- Al-Saleem T, Al-Mondhiry H. Immunoproliferative small intestinal disease (IPSID): a model for mature B-cell neoplasms. Blood. 2005;105:2274-80.
- Duffles Amarante G, Collins G, Rocha V. What do we know about duodenal-type follicular lymphoma? From pathological definition to treatment options. Br J Haematol. 2020;188:831-7.
- Misdraji J, Harris NL, Hasserjian RP, et al.. Primary follicular lymphoma of the gastrointestinal tract. Am J Surg Pathol. 2011;35:1255-63.
- Marks E, Shi Y. Duodenal-type follicular lymphoma: a clinicopathologic review. Arch Pathol Lab Med. 2018;142:542-7
- Miao Y, Lin P, Saksena A, et al.. CD5-negative mantle cell lymphoma: clinicopathologic correlations and outcome in 58 patients. Am J Surg Pathol. 2019;43:1052-60.
- Pizzi M, Agostinelli C, Righi S, et al.. Aberrant expression of CD10 and BCL6 in mantle cell lymphoma. Histopathology. 2017;71:769-77.
- Ye H, Desai A, Zeng D, et al.. Smoldering mantle cell lymphoma. J Exp Clin Cancer Res. 2017;36:185.
- Zhang XM, Aguilera N. New immunohistochemistry for B-cell lymphoma and Hodgkin lymphoma. Arch Pathol Lab Med. 2014;138:1666-72.
- Piccaluga PP, De Falco G, Kustagi M, et al.. Gene expression analysis uncovers similarity and differences among Burkitt lymphoma subtypes. Blood. 2011;117:3596-3608.
- Mundo L, Ambrosio MR, Raimondi F, et al.. Molecular switch from MYC to MYCN expression in MYC protein negative Burkitt lymphoma cases. Blood Cancer J. 2019;9:91.
- Wagener R, Seufert J, Raimondi F, et al.. The mutational landscape of Burkitt-like lymphoma with 11q aberration is distinct from that of Burkitt lymphoma. Blood. 2019;133:962-6
- Xie Y, Pittaluga S, Jaffe ES. The histological classification of diffuse large B-cell lymphomas. Semin Hematol. 2015;52:57-66.
- Alizadeh AA, Eisen MB, Davis RE, et al.. Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling. Nature. 2000;403(6769):503-11.
- Hans, C. P., Weisenburger, D. D., Greiner, T. C., Gascoyne, R. D., Delabie, J., Ott, G., et al.. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood. 2004;103(1):275-282.
- Li L, Li Y, Que X, et al.. Prognostic significances of overexpression MYC and/or BCL2 in R-CHOP-treated diffuse large B-cell lymphoma: a systematic review and meta-analysis. Sci Rep. 2018;8:6267.
- Di Napoli A, Remotti D, Agostinelli C, et al.. A practical algorithmic approach to mature aggressive B cell lymphoma diagnosis in the double/triple hit era: selecting cases, matching clinical benefit: Virchows Arch. 2019;475(4):513-518.
- Li S, Desai P, Lin P, et al.. MYC/BCL6 double-hit lymphoma (DHL): a tumour associated with an aggressive clinical course and poor prognosis. Histopathology. 2016;68:1090-8.
- Salaverria I, Philipp C, Oschlies I, et al.. Translocations activating IRF4 identify a subtype of germinal center-derived B-cell lymphoma affecting predominantly children and young adults. Blood. 2011;118:139-47.
- Choi WW, Weisenburger DD, Greiner TC, et al.. A new immunostain algorithm classifies diffuse large B-cell lymphoma into molecular subtypes with high accuracy. Clin Cancer Res. 2009;15:5494-5502.
- Luria L, Nguyen J, Zhou J, et al.. Manifestations of gastrointestinal plasmablastic lymphoma: a case series with literature review. World J Gastroenterol.
2014;20(33):11894-11903.
- Lorsbach RB, Hsi ED, Dogan A, et al.. Plasma cell myeloma and related neoplasms. Am J Clin Pathol. 2011;136:168-82.
- Delabie J, Holte H, Vose JM, et al.. Enteropathy-associated T-cell lymphoma: clinical and histological findings from the international peripheral T-cell lymphoma project. Blood. 2011;118:148-55.
- Jaffe, ES. T-cell and NK-cell neoplasms of the gastrointestinal tract–recurrent themes, but clinical and biological distinctions exist. Haematologica. 2020;105(7):1760.
- van Vliet C, Spagnolo DV. T- and NK-cell lymphoproliferative disorders of the gastrointestinal tract: review and update. Pathology. 2020;52:128-41.
- van Gils T, Nijeboer P, van Wanrooij RL, et al.. Mechanisms and management of refractory coeliac disease. Nat Rev Gastroenterol Hepatol. 2015;12:572-579.
- Ko, Y. H., Karnan, S., Kim, K. M., Park, C. K., Kang, E. S., Kim, Y. et al.. Enteropathy-associated T-cell lymphoma clinicopathologic and array comparative genomic hybridization study. Human pathology. 2010;41(9):1231-1237.
- Chander U, Leeman-Neill RJ, Bhagat G. Pathogenesis of Enteropathy-Associated T Cell Lymphoma. Curr Hematol Malig Rep. 2018;13:308-17.
- Tan, S. Y., Chuang, S. S., Tang, T., Tan, L., Ko, Y. H., Chuah, K. L. et al.. Type II EATL (epitheliotropic intestinal T-cell lymphoma): a neoplasm of intra-epithelial T-cells with predominant CD8αα phenotype. Leukemia, 2013:27(8);1688-1696.
- Kikuma, K., Yamada, K., Nakamura, S., Ogami, A., Nimura, S., Hirahashi, et al.. Detailed clinicopathological characteristics and possible lymphomagenesis of type II intestinal enteropathy-associated T-cell lymphoma in Japan. Human Pathology, 2014:45(6);1276-1284.
- Inghirami G, Pileri SA, European TCLSG. Anaplastic large-cell lymphoma. Semin Diagn Pathol. 2011;28:190-201.
- Tan SY, Ooi AS, Ang MK, et al. Nuclear expression of MATK is a novel marker of type II enteropathy-associated T-cell lymphoma. Leukemia. 2011;25:555-7.
- Swerdlow, S. H., Jaffe, E. S., Brousset, P., Chan, J. K., Gaulard, P., Harris, N. L., et al.. Cytotoxic T-cell and NK-cell lymphomas: current questions and controversies. The American journal of surgical pathology. 2014;38(10):e60.
- Yu BH, Shui RH, Sheng WQ, et al.. Primary intestinal extranodal natural killer/t-cell lymphoma, nasal type: a comprehensive clinicopathological analysis of 55 cases. PLoS One. 2016;11:e0161831.
- Matnani, R., Ganapathi, K. A., Lewis, S. K., Green, P. H., Alobeid, B., & Bhagat, G. Indolent T‐and NK‐cell lymphoproliferative disorders of the gastrointestinal tract: a review and update. Hematological Oncology. 2017; 35(1): 3-16.
- Perry AM, Warnke RA, Hu Q, et al.. Indolent T-cell lymphoproliferative disease of the gastrointestinal tract. Blood. 2013;122:3599-3606.
- Soderquist, C. R., Patel, N., Murty, V. V., Betman, S., Aggarwal, N., Young, K. H., et al. Genetic and phenotypic characterization of indolent T-cell lymphoproliferative disorders of the gastrointestinal tract. Haematologica. 2020;105(7):1895.
- Takeuchi K, Yokoyama M, Ishizawa S, et al.. Lymphomatoid gastropathy: a distinct clinicopathologic entity of self-limited pseudomalignant NK-cell proliferation. Blood. 2010;116:5631-7.
- Mansoor, A., Pittaluga, S., Beck, P. L., Wilson, W. H., Ferry, J. A., & Jaffe, E. S. NK-cell enteropathy: a benign NK-cell lymphoproliferative disease mimicking intestinal lymphoma: clinicopathologic features and follow-up in a unique case series. Blood. The Journal of the American Society of Hematology. 2011;117(5):1447-1452.
- Xia, D., Morgan, E. A., Berger, D., Pinkus, G. S., Ferry, J. A., & Zukerberg, L. R. NK-cell enteropathy and similar indolent lymphoproliferative disorders: a case series with literature review. American Journal of Clinical Pathology. 2019;151(1):75-85.
- Dojcinov SD, Venkataraman G, Raffeld M, et al.. EBV positive mucocutaneous ulcer--a study of 26 cases associated with various sources of immunosuppression. Am J Surg Pathol. 2010;34:405-17.
- Natkunam Y, Goodlad JR, Chadburn A, et al.. EBV-Positive B-Cell proliferations of varied malignant potential: 2015 SH/EAHP workshop report-part 1. Am J Clin Pathol. 2017;147:129-52.