A "floral" variant of nodal marginal zone lymphoma

Hum Pathol. 2005 Feb;36(2):202-6. doi: 10.1016/j.humpath.2004.12.010.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers, Tumor / analysis
  • DNA, Neoplasm / analysis
  • Female
  • Germinal Center / pathology*
  • Humans
  • Hyperplasia
  • Immunoglobulin Heavy Chains / genetics
  • Immunoglobulin M / analysis
  • Immunoglobulin Variable Region / drug effects
  • Immunohistochemistry
  • Lymph Nodes / pathology*
  • Lymphatic Diseases
  • Lymphoma, B-Cell / chemistry
  • Lymphoma, B-Cell / genetics
  • Lymphoma, B-Cell / pathology*
  • Male
  • Middle Aged
  • Polymerase Chain Reaction

Substances

  • Biomarkers, Tumor
  • DNA, Neoplasm
  • Immunoglobulin Heavy Chains
  • Immunoglobulin M
  • Immunoglobulin Variable Region