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Immature Terminal Deoxynucleotidyl Transferase Positive B Cells are Detected in a Subset of Adult and Pediatric Liver Biopsies
- Source :
- Applied immunohistochemistrymolecular morphology : AIMM. 27(4)
- Publication Year :
- 2017
-
Abstract
- Terminal deoxynucleotidyl transferase (TdT) is a nuclear enzyme restricted to precursor lymphoid cells and their malignant counterparts; immunohistochemical TdT labeling is helpful in recognition of lymphoblasts, which can resemble mature lymphocytes. The diagnosis of B-lymphoblastic leukemia/lymphoma (B-ALL) is occasionally first encountered on liver core biopsy, but TdT immunostain specificity for B-ALL is not clearly established in this setting, which can be problematic when only a few TdT-positive cells are identified. In this study, we evaluated the incidence and distribution of immature B lymphocytes coexpressing TdT and PAX-5, in pediatric and adult liver biopsies, to determine whether a normal complement of hepatic immature B cells can be detected, which must be recognized in a workup to exclude B-ALL. We selected 41 pediatric and adult liver biopsies with a significant portal and/or sinusoidal hematolymphoid infiltrate and performed immunohistochemical stains for TdT and PAX-5 to identify and categorize distribution of immature B cells. TdT-positive cells were detected in 40% of pediatric liver biopsies with a significant hematolymphoid infiltrate (4/10), which included all biopsies from neonates (and infants under 9 wk of age). In adults, immature B-cell infiltrates were less common (6%, 2/31). Dual immunostaining was performed on 2 cases of neonatal hepatitis, which documented B-cell lineage in at least a subset of TdT-positive cells and there was no colabeling with CD3. Immature B cells can be detected in liver biopsies in a variety of clinical settings, most commonly in children, and presence of a few TdT-positive cells cannot be considered entirely specific for involvement by B-ALL. Further workup for B-ALL can be warranted if there is more extensive multifocal portal and/or sinusoidal involvement by blasts with TdT labeling.
- Subjects :
- Adult
Male
endocrine system
Pathology
medicine.medical_specialty
Histology
Adolescent
CD3
Biopsy
Pathology and Forensic Medicine
03 medical and health sciences
0302 clinical medicine
DNA Nucleotidylexotransferase
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma
Immature B-Lymphocyte
medicine
Humans
Child
Aged
B-Lymphocytes
medicine.diagnostic_test
biology
business.industry
Lymphoblast
Liver Neoplasms
Infant
Middle Aged
medicine.disease
Lymphoma
Neoplasm Proteins
Neonatal hepatitis
stomatognathic diseases
Medical Laboratory Technology
Leukemia
Terminal deoxynucleotidyl transferase
Liver
030220 oncology & carcinogenesis
Immunology
biology.protein
Female
business
030215 immunology
Subjects
Details
- ISSN :
- 15334058
- Volume :
- 27
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Applied immunohistochemistrymolecular morphology : AIMM
- Accession number :
- edsair.doi.dedup.....114401489856b737e2f8f6952866cb90