Fine-needle aspiration biopsy findings in marginal zone B cell lymphoma

Abstract

Marginal zone B cell lymphomas (MZBCLs) represent a category of non‐Hodgkin's lymphoma which may arise in a wide variety of extranodal organs where they are termed low grade B cell lymphomas of mucosa‐associated lymphoid tissue (MALT). MZBCLs may involve primarily lymph nodes and or spleen where they are designated monocytoid B cell lymphoma or splenic marginal zone lymphoma, respectively. Recognition of this category of lymphoma, in particular, extranodal MALT lymphoma, is clinically significant in determining optimal therapy. Although there have been recent case reports describing the cytologic findings in low grade MALT lymphoma in various extranodal organs, this category of lymphoma has not been widely recognized or discussed in the cytology literature. The cytologic findings in seven fine‐needle aspirations and two bronchial washings of histologically confirmed marginal zone lymphoma (five extranodal MALT lymphomas and four nodal marginal zone lymphomas) are described. In all of the cases, the cytologic specimens showed a polymorphous proliferation comprising a predominant population of intermediate sized lymphoid cells with centrocyte‐like or monocytoid features, transformed cells, and variable numbers of plasma cells. These findings, while highly suggestive of MALT lymphoma in extranodal proliferations, may be more difficult to distinguish from reactive conditions in lymph nodes. Diagn. Cytopathol. 1999;20:190–198. © 1999 Wiley‐Liss, Inc.

The role of fine-needle aspiration in the diagnosis of thyroid lymphoma: a retrospective study of nine cases and review of published series

“…The distinguishing cytomorphological features consist of a heterogeneous proliferation composed of a predominant population of intermediate-sized lymphoid cells with centrocyte-like or monocytoid features, transformed cells, and variable numbers of cells with plasmacytoid features, as described for MZL in thyroid and other sites. 13 24 25 Although lymphoepithelial lesions (LELs) are highly associated with extranodal MZL, they are not specific. LELs were not present in our single case of MALT lymphoma and were not described in the reviewed series.…”

Cytology and immunophenotyping of low- and intermediate-grade B-cell non-Hodgkin's lymphomas with a predominant small-cell component: A study of 56 cases

“…In addition, there is considerable overlap in the cytomorphology between reactive/inflammatory lymphoid processes and low-grade B-cell non-Hodgkin's lymphomas, thus further adding to the difficulty in recognizing these lymphomas cytologically. 7,18,[22][23][24][25] The aspiration smears from a minimally reactive lymph node may contain an unusually high percentage of small lymphocytes with only a few other cell types, resulting in a relatively monotonous pattern that could be confused with SLL . 26,27 On the other hand, the findings of small lymphocytes admixed with a conspicuous population of medium-sized prolymphocytes and large paraimmunoblasts in SLLs may be interpreted as a reactive or inflammatory process as in one of our falsenegative cases.…”

“…MALT lymphoma is often characterized by a heterogeneous cellular population, because reactive germinal centers are often admixed with the lymphoma. 18 In addition, the characteristic lymphoepithelial lesions observed in histology are generally not appreciated in the aspiration smears of MALT lymphoma. 27 In body cavity fluid specimens, the distinction be- tween marked chronic inflammation and low-grade lymphomas, particularly SLL, can be quite difficult based on cytology alone, as illustrated in 2 of our false-negative cases.…”

“…These low-grade lymphomas account for a significant percentage of false-negative or indeterminate cases. 7,[13][14][15][16][17][18] In a series of FNA of lymph nodes in 1,103 patients, the false-negative cases of diagnosing lymphomas accounted for 12% and were often due to the misinterpretation of low-grade lymphomas as benign. 14 In another series of biopsy-proven malignant lymphomas, 5 out of 7 (71%) false-negative FNAs were SLL.…”

Castleman’s disease of the mesorectum: Report of a case

“…[12][13][14][15][16] Above and beyond these causes, a hamartomatous process has been described; however, no genetic or toxic factor has been identifi ed. [17][18][19] Interestingly, our patient had no infl ammatory or autoimmunity disorder.…”