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Immunohistochemistry with anti-MAL antibody and RNAscope with MAL probes are complementary techniques for diagnosis of primary mediastinal large B-cell lymphoma
  1. Anthony Jacquier1,
  2. Charlotte Syrykh2,
  3. Isabelle Bedgedjian1,
  4. Franck Monnien1,
  5. Camille Laurent2,
  6. Séverine Valmary-Degano1,
  7. Pierre Brousset2
  1. 1Department of Pathology, University Hospital of Besancon, Besancon, France
  2. 2Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
  1. Correspondence to Professor Pierre Brousset, IUCT Oncopole, Toulouse 31100, France; brousset.p{at}


Aims Primary mediastinal large B-cell lymphoma (PMBL) diagnosis can be challenging on needle biopsies. Robust techniques are needed to ensure diagnosis of this lymphoma which is highly sensitive to recently developed therapy protocols.

Methods In this study, we sought to determine precise PMBL phenotype, compared with diffuse large B-cell lymphoma not otherwise specified, by combining immunohistochemistry with anti-MAL antibody and RNA in situ hybridisation (RNAscope) with specific MAL probes.

Results The overall MAL positivity level reached 93% (14/15) of cases of PMBL. Among the 15 cases enrolled in the study, 11 were undoubtedly positive for MAL immunostaining whereas 13 were positive by RNA in situ hybridisation. Interestingly, one case that was negative by in situ hybridisation turned out to be positive by immunohistochemistry.

Conclusions Taken together, our results demonstrate that in situ detection of both MAL transcripts and protein are complementary and increase the sensitivity and specificity of PMBL diagnosis.

  • lymphoma
  • in situ hybridisation
  • immunohistochemistry
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  • Handling editor Mary Frances McMullin.

  • Contributors PB had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: AJ, CS, SV-D, CL, PB. Analysis and interpretation of data: AJ, CS, IB, FM, CL, PB.

  • Funding Supported by grants from the French National Agency of Research (ANR) through the Labex TOUCAN.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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