Study of the Utility of Myeloid Cell Nuclear Differentiation Antigen (MNDA) in the Diagnosis of Marginal Zone Lymphoma

Appl Immunohistochem Mol Morphol. 2023 Apr 1;31(4):217-223. doi: 10.1097/PAI.0000000000001115. Epub 2023 Mar 6.

Abstract

Myeloid cell nuclear differentiation antigen (MNDA) is normally expressed on myelomonocytic cells and a subset of B lymphocytes. It was found to be differentially expressed between nodal marginal zone lymphoma (MZL) and follicular lymphoma (FL). However, MNDA has not been widely used as a diagnostic marker in clinical practice. To validate its utility, we studied the expression of MNDA by immunohistochemistry in 313 cases of small B-cell lymphomas. Our results showed that MNDA was positive in 77.9% of MZL, 21.9% of mantle cell lymphoma, 28.9% of small lymphocytic lymphoma/chronic lymphocytic leukemia, 2.6% of FL, and 25% of lymphoplasmacytic lymphoma. MNDA positivity varied from 68.0% to 84.0% among the 3 MZL subtypes, with extranodal MZL having the highest percentage. There was a statistically significant difference in MNDA expression between MZL and FL, mantle cell lymphoma, small lymphocytic lymphoma/chronic lymphocytic leukemia, or lymphoplasmacytic lymphoma. CD43 expression was slightly more frequent in MNDA-negative MZL than in MNDA-positive MZL. Combined use of CD43 and MNDA improved the diagnostic sensitivity for MZL from 77.9% to 87.8%. There was a trend of positive correlation between MNDA and p53 in MZL. In conclusion, MNDA is preferentially expressed in MZL among small B-cell lymphomas and it is a useful marker for the differentiation of MZL and FL.

MeSH terms

  • Adult
  • Antigens, Differentiation, Myelomonocytic / metabolism
  • B-Lymphocytes / pathology
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell* / metabolism
  • Leukemia, Lymphocytic, Chronic, B-Cell* / pathology
  • Lymphoma, B-Cell, Marginal Zone* / diagnosis
  • Lymphoma, Follicular* / diagnosis
  • Lymphoma, Mantle-Cell* / pathology
  • Myeloid Cells / metabolism
  • Transcription Factors / metabolism
  • Waldenstrom Macroglobulinemia* / metabolism

Substances

  • Antigens, Differentiation, Myelomonocytic
  • MNDA protein, human
  • Transcription Factors