Lacrimal gland lymphoma: A cytomorphologic and immunophenotypic study

Abstract

The cytomorphology of lacrimal gland lymphoma has not been specifically described. Herein we present six cases of histologically proven lacrimal gland lymphoma which we analyzed using fine-needle aspiration cytology, cell suspension immunophenotype analysis, and immunoglobulin gene rearrangement studies. Fine-needle aspiration cytology revealed atypical populations of cells comprised of either monomorphic small round lymphocytes with or without plasmacytoid features (4 cases), a mixed population of small and large irregular lymphocytes (1 case), or a population of large irregular lymphocytes (1 case). The initial cytologic diagnosis was malignant lymphoma in all six cases. Cell suspension immunophenotype analysis demonstrated that the lesions were composed predominantly of B-cells that expressed monotypic surface immunoglobulin. Three cases demonstrated an immunoglobulin heavy chain gene rearrangement. The atypical cytologic features and the abnormal immunophenotype were consistently predictive of malignant lymphoma. Given that these lesions are small and biopsy material is often limited, fine-needle aspiration offers the advantage of providing tissue that is ideal for cytologic and cell suspension immunophenotype evaluation, obviating the need to provide surgical biopsy material for this purpose. We conclude that fine-needle aspiration can identify malignant lymphoid lesions of the lacrimal gland and may serve as a valuable adjunct in the assessment of these lesions. Additional study is warranted to determine whether fine-needle aspiration can reliably distinguish between benign and malignant lymphoid proliferations of the lacrimal gland.

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

“…Recently, there has been a case report detailing the FNA findings of a low grade MALT lymphoma involving salivary gland. 6 Other case reports and case series, some of which we believe represent low grade MALT lymphomas have also been previously described, [8][9][10]19,20 although they have not been specifically identified as MALT lymphoma.…”

“…There are numerous recently published studies that describe the fine-needle aspiration biopsy findings of low grade lymphoma involving various extranodal organs. [8][9][10] Although probable cases of MALT lymphoma are recognizable within these series based on the extranodal location of these lymphomas and the illustrated findings, these reports do not specifically address the concept of MALT or discuss the clinical significance of distinguishing this entity from other low grade B cell lymphomas. A recent article 11 claims to be the first report of a primary splenic lymphoma diagnosed by FNA, but the histology is said to have been follicular mixed cell lymphoma.…”