Human germinal center-associated lymphoma (HGAL) protein is specifically expressed in the cytoplasm of germinal center B-cells, but is absent in mantle and marginal zone B-cells and in the interfollicular and paracortical regions in normal tonsils and lymph nodes. Its high degree of specificity for germinal center B-cells makes anti-HGAL an ideal marker for the detection of germinal center-derived B-cell lymphomas. Anti-HGAL has the highest overall sensitivity of detecting follicular lymphoma (FL) and in detecting the interfollicular and diffuse components of FL compared with antibodies against bcl2, LMO2, CD10, and bcl6. The addition of anti-HGAL to the immunohistologic panel is beneficial in the work-up of nodal and extranodal B-cell lymphomas, and the efficacy of anti-HGAL in detecting the follicular, interfollicular, and diffuse components of FL is of particular value in the setting of variant immunoarchitectural patterns.
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