Hyperplasia of mantle/marginal zone B cells with clear cytoplasm in peripheral lymph nodes. A clinicopathologic study of 35 cases.
We describe 35 peripheral lymph nodes classified as mantle cell/marginal zone B-cell hyperplasia with clear cells using morphologic and immunologic findings. For the purpose of this study, we obtained clinical follow-up information and performed immunoglobulin gene rearrangement studies on paraffin sections by polymerase chain reaction. Architecturally, the nodes were suggestive of a benign process: no pericapsular infiltration, sinuses readily identified, scattered reactive follicles present, and paracortical nodular hyperplasia present. No monocytoid B cells were present. Focally, small lymphoid cells with round nuclei and clear cytoplasm (clear cells) formed monomorphic nodular, inverse follicular, and/or marginal zone patterns. Flow cytometry and immunohistochemical analysis revealed neither light chain restriction nor an aberrant B-cell phenotype. Immunoglobulin gene rearrangement studies showed a clonal band in 1 of 26 cases in which DNA was amplified. To ascertain the clinical relevance of this positive case, follow-up information was obtained 30 months after the initial biopsy; the 83-year-old woman was alive without treatment but had splenomegaly and bone marrow involvement by marginal zone B-cell lymphoma. The morphologic and immunologic criteria used for diagnosis of mantle cell/marginal zone B-cell hyperplasia with clear cytoplasm are valid; however, to rule out the possibility of occult lymphoma, immunoglobulin gene rearrangement studies and clinical follow-up are necessary.
Hunt
J P
JP
Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Chan
J A
JA
Samoszuk
M
M
Brynes
R K
RK
Hernandez
A M
AM
Bass
R
R
Weisenburger
D D
DD
Müller-Hermelink
K
K
Nathwani
B N
BN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001402:B-Lymphocytes / Q000473:pathology*; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology; D002584:Cervix Uteri; D003593:Cytoplasm / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry; D015321:Gene Rearrangement; D006119:Groin; D006801:Humans; D006965:Hyperplasia; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008198:Lymph Nodes / Q000473:pathology*; D016393:Lymphoma, B-Cell / Q000473:pathology; D020522:Lymphoma, Mantle-Cell / Q000473:pathology; D008875:Middle Aged; D013163:Splenomegaly; D014062:Tongue Neoplasms / Q000473:pathology