Performance of a Commercially Available MAL Antibody in the Diagnosis of Primary Mediastinal Large B-Cell Lymphoma

Am J Surg Pathol. 2017 Feb;41(2):189-194. doi: 10.1097/PAS.0000000000000771.

Abstract

Myelin and lymphocyte (MAL) protein has been previously reported as a highly specific marker for distinguishing primary mediastinal large B-cell lymphoma (PMBL) from diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS). However, there has not been a commercially available MAL antibody for immunohistochemistry. We identified a commercially available MAL monoclonal antibody and evaluated it by immunohistochemistry on 43 cases of PMBL and 63 cases of DLBCL, NOS. We also compared this with a CD200 antibody that was previously reported useful in distinguishing PMBL and DLBCL, NOS. A threshold of 10% positive tumor cells was used to determine positive protein expression. MAL was expressed in 72% cases of PMBL and 0% of cases of DLBCL, NOS (sensitivity=72%, specificity=100%). CD200 was expressed in 81% of PMBL cases and 13% of DLBCL, NOS cases (sensitivity=81%, specificity=87%). To our knowledge, this is the first report on the utility of a commercially available MAL monoclonal antibody in the diagnosis of PMBL. There is a high specificity with good sensitivity in distinguishing PMBL from DLBCL, NOS, similar to previous studies with a noncommercial source. This antibody will likely prove useful in identifying cases of PMBL in routine practice.

MeSH terms

  • Adult
  • Antibodies, Monoclonal
  • Antibody Specificity
  • Biomarkers, Tumor / analysis*
  • Blotting, Western
  • Female
  • Humans
  • Immunohistochemistry
  • Lymphoma, B-Cell / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / diagnosis
  • Male
  • Mediastinal Neoplasms / diagnosis*
  • Middle Aged
  • Myelin and Lymphocyte-Associated Proteolipid Proteins / analysis*
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Antibodies, Monoclonal
  • Biomarkers, Tumor
  • Myelin and Lymphocyte-Associated Proteolipid Proteins