title: Incidental early detection of a splenic marginal zone lymphoma by polymerase chain reaction analysis of paraffin-embedded tissue.
abstract: Splenic marginal zone lymphoma (SMZL) most commonly presents with splenomegaly and stage IV disease. To our knowledge, there have been only two reported cases of SMZL without associated splenomegaly; one was detected incidentally after a bicycle accident. This previously reported case represented an early-stage SMZL with monoclonality confirmed by immunohistochemistry. We report a case of early-stage SMZL detected incidentally following a motor vehicle accident; monoclonality was confirmed by polymerase chain reaction analysis of paraffin-embedded tissue owing to the inability of confirmation by immunohistochemical techniques. We describe our findings and emphasize the importance of recognizing early stages of SMZL in incidental splenectomies by polymerase chain reaction analysis of paraffin-embedded tissue. Frozen tissue is not generally available in such cases.
authors.affiliation: Department of Pathology, St Louis University Health Sciences Center, MO 63104, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Dunphy
authors.forename: C
authors.initials: C
authors.lastname: Bee
authors.forename: J W
authors.initials: JW
authors.lastname: McDonald
authors.forename: L E
authors.initials: LE
authors.lastname: Grosso
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D004273:DNA, Neoplasm / Q000032:analysis* / Q000235:genetics; D005260:Female; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007150:Immunohistochemistry; D016393:Lymphoma, B-Cell / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics*; D008228:Lymphoma, Non-Hodgkin / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics*; D008264:Macrophages / Q000473:pathology; D009367:Neoplasm Staging; D016612:Paraffin Embedding; D016133:Polymerase Chain Reaction / Q000379:methods; D013154:Spleen / Q000473:pathology; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics*
chemical_list: D004273:DNA, Neoplasm; D007143:Immunoglobulin Heavy Chains