Dutcher bodies have been described in lymphoid neoplasms with plasmacytic differentiation, including plasma cell myeloma, lymphoplasmacytic lymphoma, and marginal zone lymphoma. We report a pathologic study of 3 cases of follicular lymphoma with extensive Dutcher body formation in comparison with lymphoplasmacytic lymphoma and marginal zone lymphoma. Of 3 cases, 1 showed a follicular growth pattern, whereas the other 2 cases demonstrated only a vague nodular appearance highlighted by immunohistochemical analysis. Cells containing Dutcher bodies were counted at 25, 90, or 110 per high-power field in each case, respectively. In 2 cases, cells with Dutcher bodies were clustered in an intrafollicular distribution, a possible histopathologic clue for follicular lymphoma. Immunoglobulin M κ was identified as the component of Dutcher bodies in all 3 cases, implying a possible molecular basis for the formation of Dutcher bodies in B-cell lymphomas. All 3 cases had cytogenetic changes supporting the diagnosis of follicular lymphoma, including dual rearrangement of BCL2 and BCL6, rearrangement of BCL2 with trisomy 3 (BCL6), and isolated BCL6 rearrangement. We emphasize immunohistochemical analyses with anti-κ/λ and anti-immunoglobulin heavy-chain isotypes to characterize Dutcher bodies and document clonality in addition to the routine lymphoma workup and indicated cytogenetic studies in B-cell lymphomas with prominent Dutcher bodies.
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