Marginal zone lymphoma of the lacrimal gland spreading to the lung and the bone marrow 11 years after first symptoms.
We report on the case of a 52-year-old male presenting with an extranodal marginal zone lymphoma of the mucosa-associated tissue (MALT lymphoma) in the lung 11 years after radiotherapy for a MALT lymphoma of the lacrimal gland, which was primarily diagnosed as dacryoadenitis. Both tumors were investigated by immunohistochemistry and molecular techniques demonstrating their clonal genetic relationship. Both harbored the t(14;18)(q32;q21) and a trisomy 3 and showed identical immunoglobulin heavy-chain gene rearrangements. At the time of pulmonary relapse, clonal CD20- and CD43-positive bone marrow B lymphocytes were detected as well. The elaboration of this case emphasizes the importance of the combined use of modern diagnostic methods for establishment of correct diagnosis of MALT lymphomas at late relapses, which is essential for proper patient management.
Zimpfer
Annette
A
Institute of Pathology, University of Basel, Basel, Switzerland.
Freund
Martin C
MC
Dirnhofer
Stephan
S
Gunsilius
Eberhard
E
Streubel
Berthold
B
Chott
Andreas
A
Tzankov
Alexandar
A
D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D019046:Bone Marrow Neoplasms / Q000235:genetics / Q000378:metabolism / Q000556:secondary* / Q000628:therapy; D002883:Chromosomes, Human, Pair 14; D002887:Chromosomes, Human, Pair 18; D002893:Chromosomes, Human, Pair 3; D003131:Combined Modality Therapy; D004273:DNA, Neoplasm / Q000032:analysis; D003607:Dacryocystitis / Q000175:diagnosis; D003937:Diagnosis, Differential; D005134:Eye Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007765:Lacrimal Apparatus / Q000378:metabolism / Q000473:pathology*; D008175:Lung Neoplasms / Q000235:genetics / Q000378:metabolism / Q000556:secondary* / Q000628:therapy; D018442:Lymphoma, B-Cell, Marginal Zone / Q000235:genetics / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D008297:Male; D009364:Neoplasm Recurrence, Local; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D013902:Radiography, Thoracic; D014178:Translocation, Genetic; D014314:Trisomy
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm