Evidence map›Paper›PMID 42384102›Full record

ArticleJournal of hematopathology2026

Utility of MEF2B immunohistochemistry in distinguishing follicular lymphoma and marginal zone lymphoma in diagnostically challenging cases.

Joanna C Dalland, Oluwayomi S Oyedeji, David S Viswanatha, Cody J Artymiuk, Matthew T Howard, Rebecca L King

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Article in Journal of hematopathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Joanna C DallandDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Dalland.joanna@mayo.edu.
Oluwayomi S OyedejiGreat Lake Pathologists SC (GLP), West Allis, WI, USA.
David S ViswanathaDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Cody J ArtymiukDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Matthew T HowardDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Rebecca L KingDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDistinguishing follicular lymphoma (FL) from marginal zone lymphoma (MZL) can be challenging, as the morphology and immunophenotype can overlap particularly in cases with marginal zone differentiation (MZD). MEF2B (Myocyte enhancer binding factor B) is a transcription factor that controls BCL6 expression in germinal center (GC) B-cells. Previous studies reported this stain to have a high sensitivity and specificity for FL compared to other GC markers. PURPOSE: We investigated the expression of MEF2B in small B cell lymphomas (SBCL) to evaluate its utility in classification of diagnostically challenging cases.

methodsOur archives were searched from 2005-2025 to identify cases of SBCL, including FL, splenic MZL (SMZL), MZL of mucosa-associated lymphoid tissue (MALT), nodal MZL (NMZL) and SBCLs that were difficult to classify upon initial diagnosis (DTC). MEF2B immunohistochemistry was performed. Next generation sequencing (NGS) was performed on a subset.

results62 cases were evaluated: 23 FL (including 14 with MZD), 11 SMZL, 13 MALT, 4 NMZL, and 11 DTC. 21/23 FL (91%) were positive for MEF2B, including 13/14 (93%) with MZD. MEF2B expression was restricted to follicles and negative in MZD areas in 9/13 (69%), while 4 cases showed partial weak expression in MZD areas. 0/11 SMZL (0%) and 0/13 MALT (0%) were positive for MEF2B. 1/4 NMZL showed equivocal MEF2B staining, while the remaining 3 NMZL cases were negative for MEF2B. 8/11 DTC (73%) were positive for MEF2B, and the result aided further classification in 9 DTC cases. NGS further supported or refined the classification in 4/9 cases.

conclusionMEF2B immunohistochemistry can aid in distinguishing FL from MZL in diagnostically challenging cases.

Indexed as

Biomarkers, TumorLymphoma, B-Cell, Marginal ZoneLymphoma, FollicularMEF2 Transcription FactorsDiagnosis, DifferentialFemaleHumansImmunohistochemistryMaleBiomarkers, TumorMEF2B protein, humanMEF2 Transcription FactorsFollicular lymphomaGerminal centerMarginal zone differentiationMarginal zone lymphomaMEF2BMyocyte enhancer binding factor B

Identifiers

PMID42384102
PMCPMC13323876

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