A "floral" variant of nodal marginal zone lymphoma.
We describe 6 cases of a specific variant of nodal marginal zone lymphoma with "floral" lymph follicles in patients ranging in age from 18 to 66 years. All 6 patients had lymphadenopathy, either local (n = 5) or systemic (n = 1), and good performance status (0), and none had fever, weight loss, or night sweating. They all underwent excisional biopsy. Histologically, all lesions had a distinctive morphology, with proliferation of medium-sized atypical lymphoid cells in the marginal zone, hyperplastic lymph follicles with enlarged germinal centers, and a thickened mantle zone. In places, folliculolysis was observed. On immunohistochemical staining, the atypical lymphoid cells showed a B-cell phenotype (CD20 +), IgM positivity in 2 of 5 cases, and negativity for CD5, CD10, CD23, CD43, bcl-6, and IgD. Polymerase chain reaction examination for immunoglobulin heavy chain in 5 cases showed monoclonality in all. Five patients did not receive adjuvant chemotherapy and had no recurrences. The patient with systemic lymphadenopathy received chemotherapy and had a complete response without relapse. This variant should be differentiated from the usual nodal marginal zone lymphoma because of its specific clinical and pathological features.
Karube
Kennosuke
K
Department of Pathology, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan. xs255@cis.fukuoka-u.ac.jp
Ohshima
Koichi
K
Tsuchiya
Takeshi
T
Yamaguchi
Takahiro
T
Kawano
Riko
R
Suzumiya
Junji
J
Harada
Mine
M
Kikuchi
Masahiro
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D018858:Germinal Center / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007075:Immunoglobulin M / Q000032:analysis; D007135:Immunoglobulin Variable Region / Q000187:drug effects; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases; D016393:Lymphoma, B-Cell / Q000737:chemistry / Q000235:genetics / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D007143:Immunoglobulin Heavy Chains; D007075:Immunoglobulin M; D007135:Immunoglobulin Variable Region