Expression of estrogen receptor beta (er beta ) in low grade b-cell lymphomas: An immunohistochemical study

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Conference Proceeding

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Am J Clin Pathol


Most lymphoid malignancies are associated with higher incidence and poorer prognosis in men than women. Epidemiological data associate reproductive hormones and oral contraceptives with reduced risk in women, attributed to estrogen. Estrogen’s action is mediated by two nuclear receptors, estrogen receptor alpha (ERα) and estrogen receptor beta (ERβ), with different tissue distribution and actions. ERα promotes cell proliferation whereas ERβ shows anti- proliferative effects. Studies show ERβ to be predominantly expressed in lymphoid tissue. There is a dearth of studies about expression of ERβ in lymphoid malignancies. Hence, we characterized the expression of ERβ in low grade B- cell lymphomas by immunohistochemistry in men and women. Methods and Materials

Low-grade B-cell lymphomas diagnosed between 2006 and 2016 were retrieved from archives. ERβ immunostaining was performed on formalin-fixed paraffin-embedded sections of 45 lymphoma cases with typical histology, flow cytometry, and cytogenetics: 10 chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) (six men, four women), nine mantle cell lymphomas (five men, four women), 10 marginal zone lymphomas (four men, six women), eight follicular lymphomas (four men, four women), four classical (two men, two women), and four nodular lymphocyte predominant (two men, two women) Hodgkin lymphomas. Control tissue from tonsils, lymph nodes, and spleen were also immunostained. Results

Immunohistochemical ERβ staining of tonsils and lymph nodes in men and women show strong nuclear staining of lymphocytes in the germinal and mantle zone of the lymphoid follicles as compared to the paracortical region. The white pulp (periarteriolar lymphatic sheath) and red pulp in spleen show strong ERβ positivity. Strong nuclear staining of lymphocytes was seen in all cases of CLL/SLL, mantle, marginal, follicular, and Hodgkin lymphomas. No difference in staining was seen between men and women in normal lymphoid and lymphoma specimens. Conclusion

All low-grade B- cell lymphomas strongly express ERβ in men and women, highlighting role of estrogens in pathogenesis. Since estrogen concentrations are higher in women, this might explain the sex predilection and poorer prognosis in men. Also, these results raise the possibility of using ERβ agonists as a novel therapeutic agent in these lymphomas.



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