• DOI:10.3760/cma.j.issn.0529-5807.2013.04.005
• Corpus ID: 44777011

[Clinicopathologic features and differential diagnosis of splenic B-cell marginal zone lymphoma involving bone marrow].

@article{Sun2013ClinicopathologicFA,
  title={[Clinicopathologic features and differential diagnosis of splenic B-cell marginal zone lymphoma involving bone marrow].},
  author={Qi Sun and Pei-hong Zhang and En-bin Liu and Wei Liu and Zhanqi Li and Qing-ying Yang and Li-huan Fang and Fu-jun Sun and Hui-shu Chen and Lugui Qiu},
  journal={Zhonghua bing li xue za zhi = Chinese journal of pathology},
  year={2013},
  volume={42 4},
  pages={
          234-8
        }
}

• Qi Sun, Pei-hong Zhang, +7 authors L. Qiu
• Published 1 April 2013
• Medicine
• Zhonghua bing li xue za zhi = Chinese journal of pathology

OBJECTIVE
To study the clinicopathologic features and differential diagnosis of splenic B-cell marginal zone lymphoma (SMZL) involving bone marrow.

METHODS
The clinical and pathologic features of 22 patients with SMZL were retrospectively studied. Immunophenotypic analysis was carried out by flow cytometry and immunohistochemistry. Immunoglobulin heavy chain rearrangement study was performed using polymerase chain reaction-based method.

RESULTS
Villous lymphocytes were found in peripheral blood smears of 11/18 of the patients. In bone marrow aspirates, lymphocytosis (> 20%) was demonstrated in 15 cases (15/18) and villous lymphocytes in 6 cases (6/18). Flow cytometry showed CD19(+) CD20(+) FMC7(+) CD22(+) CD10(-) CD2(-) CD3(-) CD7(-) in 18 cases. Bone marrow biopsies of all the 22 patients revealed various degrees and patterns of neoplastic infiltration, as follows: mild (4 cases, 18.2%), moderate (11 cases, 50.0%) or severe (7 cases, 31.8%); intrasinusoidal (16 cases, 72.7%), interstitial (14 cases, 63.6%), nodular (11 cases, 50.0%) or diffuse (1 case, 4.5%). Reactive germinal center formation (CD23(+) bcl-2(-)) was found in 2 cases (91.0%). Immunohistochemical study showed the following results: CD20(+) PAX5(+) CD3(-) CD5(-) CD10(-) cyclin D1(-) CD23(-) CD43(-) Annexin A1(-) CD11C(-) CD25(-) in all the 22 cases, CD38(+) in 2 cases (9.1%) and CD138(+) in 2 cases (9.1%).

CONCLUSIONS
Different and overlapping patterns of bone marrow involvement are observed in SMZL. As the histologic and immunophenotypic features are not specific to SMZL, distinction from other types of mature B-cell lymphomas is necessary.