Please use this identifier to cite or link to this item: https://doi.org/10.1111/his.12854
Title: IgG4-positive extranodal marginal zone lymphoma arising in Hashimoto's thyroiditis: clinicopathological and cytogenetic features of a hitherto undescribed condition
Authors: Tan, Char-Loo 
Ong, Yew-Kwang 
Tan, Soo-Yong 
Ng, Siok-Bian 
Keywords: Science & Technology
Life Sciences & Biomedicine
Cell Biology
Pathology
Hashimoto's thyroiditis
IgG4
lymphoma
MALT
translocation
TISSUE LYMPHOMA
IGG4-RELATED DISEASE
IGG4
PATHOLOGY
RISK
Issue Date: 1-May-2016
Publisher: WILEY
Citation: Tan, Char-Loo, Ong, Yew-Kwang, Tan, Soo-Yong, Ng, Siok-Bian (2016-05-01). IgG4-positive extranodal marginal zone lymphoma arising in Hashimoto's thyroiditis: clinicopathological and cytogenetic features of a hitherto undescribed condition. HISTOPATHOLOGY 68 (6) : 931-937. ScholarBank@NUS Repository. https://doi.org/10.1111/his.12854
Abstract: Aims: Hashimoto's thyroiditis was recently divided into IgG4-plasma cell-rich and IgG4-plasma cell-poor subtypes. The former, also known as IgG4 thyroiditis, is associated with clinical, serological, sonographic and morphological features that are distinctive from those of the non-IgG4 subgroup. We describe an interesting case of IgG4-positive mucosa-associated lymphoid tissue (MALT) lymphoma arising in a background of IgG4 thyroiditis. Methods and results: The thyroid gland showed typical features of IgG4 thyroiditis, including characteristic patterns of fibrosis. A dense lymphoplasmacytic infiltrate diffusely involved the entire gland without formation of a destructive tumour mass. Lymphoepithelial lesions were prominent. There were abundant IgG4-positive plasma cells, with the IgG4/IgG ratio exceeding 40%. The IgG4-positive plasma cells were monotypic for kappa light chain, and there was monoclonal IGH rearrangement. Fluorescence in-situ hybridization revealed IGH translocation without translocation of MALT1, bcl-10, or FOXP1. Conclusions: This represents the first case of IgG4-producing MALT lymphoma associated with IgG4 thyroiditis. IGH translocation with an unknown partner gene was identified. We suggest the performance of serum and immunohistochemical investigations for IgG and IgG4 in all cases of Hashimoto's thyroiditis to diagnose IgG4 thyroiditis. In addition, clonality assays and light chain studies are useful to exclude a low-grade lymphoma arising in this context.
Source Title: HISTOPATHOLOGY
URI: https://scholarbank.nus.edu.sg/handle/10635/206836
ISSN: 03090167
1365-2559
DOI: 10.1111/his.12854
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