Lymphoplasmacytic lymphoma differential diagnosis: Difference between revisions

Jump to navigation Jump to search
Line 165: Line 165:
}}</ref><ref name="AC">{{cite journal |vauthors=Chi PJ, Pei SN, Huang TL, Huang SC, Ng HY, Lee CT |title=Renal MALT lymphoma associated with Waldenström macroglobulinemia |journal=J. Formos. Med. Assoc. |volume=113 |issue=4 |pages=255–7 |year=2014 |pmid=24685302 |doi=10.1016/j.jfma.2011.02.007 |url=}}</ref><ref name="AC2">{{cite journal |vauthors=Chi PJ, Pei SN, Huang TL, Huang SC, Ng HY, Lee CT |title=Renal MALT lymphoma associated with Waldenström macroglobulinemia |journal=J. Formos. Med. Assoc. |volume=113 |issue=4 |pages=255–7 |year=2014 |pmid=24685302 |doi=10.1016/j.jfma.2011.02.007 |url=}}</ref><ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }}</ref><ref name="pmid12720138">{{cite journal| author=Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G et al.| title=Prognostic factors in symptomatic Waldenstrom's macroglobulinemia. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 211-5 | pmid=12720138 | doi=10.1053/sonc.2003.50064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720138  }}</ref>
}}</ref><ref name="AC">{{cite journal |vauthors=Chi PJ, Pei SN, Huang TL, Huang SC, Ng HY, Lee CT |title=Renal MALT lymphoma associated with Waldenström macroglobulinemia |journal=J. Formos. Med. Assoc. |volume=113 |issue=4 |pages=255–7 |year=2014 |pmid=24685302 |doi=10.1016/j.jfma.2011.02.007 |url=}}</ref><ref name="AC2">{{cite journal |vauthors=Chi PJ, Pei SN, Huang TL, Huang SC, Ng HY, Lee CT |title=Renal MALT lymphoma associated with Waldenström macroglobulinemia |journal=J. Formos. Med. Assoc. |volume=113 |issue=4 |pages=255–7 |year=2014 |pmid=24685302 |doi=10.1016/j.jfma.2011.02.007 |url=}}</ref><ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }}</ref><ref name="pmid12720138">{{cite journal| author=Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G et al.| title=Prognostic factors in symptomatic Waldenstrom's macroglobulinemia. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 211-5 | pmid=12720138 | doi=10.1053/sonc.2003.50064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720138  }}</ref>
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Mature B-cell Lymphoma
* Mature [[B-cell]] [[Lymphoma]]
* Mutation of the [[MYD88|MYD88 gene]] (L265P)  
* [[Mutation]] of the [[MYD88|MYD88 gene]] (L265P)  
* [[Nonsense mutation|Nonsense]] or [[Frameshift mutation|frameshift mutations]] in the CXR4 gene
* [[Nonsense mutation|Nonsense]] or [[Frameshift mutation|frameshift mutations]] in the CXR4 [[gene]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*[[Weakness]]
*[[Weakness]]
Line 180: Line 180:
* Generalized and local [[lymphadenopathy]]
* Generalized and local [[lymphadenopathy]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Retinal [[hemorrhage]] with [[Blurred vision|blurring of vision]]
*[[Retinal]] [[hemorrhage]] with [[Blurred vision|blurring of vision]]
*[[Vertigo]]
*[[Vertigo]]
*[[Dizziness]]
*[[Dizziness]]
Line 188: Line 188:
*[[Ataxia]]
*[[Ataxia]]
*[[Bleeding]]
*[[Bleeding]]
| align="left" style="background:#F5F5F5;" + |Express pan B-cell antigens
| align="left" style="background:#F5F5F5;" + |Express pan [[B-cell]] [[antigens]]
* [[CD19]]
* [[CD19]]
* [[CD20]]
* [[CD20]]
Line 194: Line 194:
* [[CD79A|CD79a]]
* [[CD79A|CD79a]]
* [[CD5]]
* [[CD5]]
Variable expression of
Variable [[expression]] of
* [[CD11c]]
* [[CD11c]]
* [[CD43]],
* [[CD43]],
* [[CD25]]
* [[CD25]]
Majority express:
Majority [[Expression (genetics)|express]]
* [[IgM]] surface immunoglobulin
* [[IgM]] [[surface immunoglobulin]]
Fewer express
Fewer [[Expression (genetics)|express]]
* [[IgG]] or [[Immunoglobulin A|IgA]]
* [[IgG]] or [[Immunoglobulin A|IgA]]
* Lack [[Immunoglobulin D|IgD]]
* Lack [[Immunoglobulin D|IgD]]
Lack expression of:
Lack [[expression]] of
* CD10
* [[CD10]]
* Cyclin D1
* [[Cyclin D1]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Russell bodies (intracytoplasmic inclusions) and Dutcher bodies (intranuclear inclusions)
* ≥10 percent [[Infiltration (medical)|infiltration]] by small [[lymphocytes]], plasmacytoid [[lymphocytes]], and [[plasma cells|plasma cells.]]
* Prominent epithelioid histiocytes
* Variable numbers of admixed immunoblasts.
 
*[[hyperplasia]] of [[mast cells]] in [[Bone marrow|marrow]] (characteristic but not pathognomonic)
*Diffusely effaced [[Lymph nodes]]
*Absence of [[proliferation]] centers and [[marginal zone]] type [[differentiation]]
 
* [[Russell bodies]] (intracytoplasmic inclusions)
* Dutcher bodies (intranuclear inclusions)
* Prominent [[Epithelioid histiocyte|epithelioid histiocytes]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* [[Diffuse large B-cell lymphoma]]
* [[Diffuse large B-cell lymphoma]]
Line 215: Line 223:
* [[MALT lymphoma|Renal MALT lymphoma]]  
* [[MALT lymphoma|Renal MALT lymphoma]]  
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" + |B cell chronic lymphocytic leukemia/small lymphocytic lymphoma<br><ref name="KleinTu2001">{{cite journal|last1=Klein|first1=Ulf|last2=Tu|first2=Yuhai|last3=Stolovitzky|first3=Gustavo A.|last4=Mattioli|first4=Michela|last5=Cattoretti|first5=Giorgio|last6=Husson|first6=Hervé|last7=Freedman|first7=Arnold|last8=Inghirami|first8=Giorgio|last9=Cro|first9=Lilla|last10=Baldini|first10=Luca|last11=Neri|first11=Antonino|last12=Califano|first12=Andrea|last13=Dalla-Favera|first13=Riccardo|title=Gene Expression Profiling of B Cell Chronic Lymphocytic Leukemia Reveals a Homogeneous Phenotype Related to Memory B Cells|journal=The Journal of Experimental Medicine|volume=194|issue=11|year=2001|pages=1625–1638|issn=0022-1007|doi=10.1084/jem.194.11.1625}}</ref>
! colspan="2" align="center" style="background:#DCDCDC;" + |[[B cell Chronic Lymphocytic Leukemia|B cell chronic lymphocytic leukemia]]/[[small lymphocytic lymphoma]]<br><ref name="KleinTu2001">{{cite journal|last1=Klein|first1=Ulf|last2=Tu|first2=Yuhai|last3=Stolovitzky|first3=Gustavo A.|last4=Mattioli|first4=Michela|last5=Cattoretti|first5=Giorgio|last6=Husson|first6=Hervé|last7=Freedman|first7=Arnold|last8=Inghirami|first8=Giorgio|last9=Cro|first9=Lilla|last10=Baldini|first10=Luca|last11=Neri|first11=Antonino|last12=Califano|first12=Andrea|last13=Dalla-Favera|first13=Riccardo|title=Gene Expression Profiling of B Cell Chronic Lymphocytic Leukemia Reveals a Homogeneous Phenotype Related to Memory B Cells|journal=The Journal of Experimental Medicine|volume=194|issue=11|year=2001|pages=1625–1638|issn=0022-1007|doi=10.1084/jem.194.11.1625}}</ref>


| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Mature B-cell Lymphoma
* Mature [[B-cell]] [[Lymphoma]]
* Ch 13 abnormalties
* [[Chromosome 13]] abnormalties
*  
*  
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
Line 230: Line 238:
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Painless lymphadenopathy
* Painless [[lymphadenopathy]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* May be asymptomatic
* May be [[asymptomatic]]
* Fatigue  
* [[Fatigue]]
* Recurrent infections
* Recurrent [[infections]]
* Hepatosplenomegaly
* [[Hepatosplenomegaly]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* CD5
* [[CD5]]
* CD38
* [[CD38]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Monoclonal small well differentiated B cells.
* Monoclonal small well differentiated [[B cells]]
* Significant  number of smudge cells or basket cells..
* Significant  number of [[smudge cells]] or [[basket cells]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* [[Autoimmune hemolytic anemia]]
* [[Autoimmune hemolytic anemia]]
* [[Red cell aplasia]]
* [[Red cell]] [[aplasia]]
* Autoimmune thrombocytopenia
* [[Autoimmune]] [[thrombocytopenia]]
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Follicular lymphoma]]<br><ref name="pmid25176983">{{cite journal| author=Ganapathi KA, Pittaluga S, Odejide OO, Freedman AS, Jaffe ES| title=Early lymphoid lesions: conceptual, diagnostic and clinical challenges. | journal=Haematologica | year= 2014 | volume= 99 | issue= 9 | pages= 1421-32 | pmid=25176983 | doi=10.3324/haematol.2014.107938 | pmc=4562530 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25176983  }}</ref><ref name="pmid11877266">{{cite journal| author=Lorsbach RB, Shay-Seymore D, Moore J, Banks PM, Hasserjian RP, Sandlund JT et al.| title=Clinicopathologic analysis of follicular lymphoma occurring in children. | journal=Blood | year= 2002 | volume= 99 | issue= 6 | pages= 1959-64 | pmid=11877266 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11877266  }}</ref><ref>[http://pleiad.umdnj.edu/hemepath/follicular/follicular.html Overview] at [[University of Medicine and Dentistry of New Jersey|UMDNJ]]</ref><ref name="pmid16075463">{{cite journal |author=Bosga-Bouwer AG, Haralambieva E, Booman M, ''et al.'' |title=BCL6 alternative translocation breakpoint cluster region associated with follicular lymphoma grade 3B |journal=Genes Chromosomes Cancer |volume=44 |issue=3 |pages=301–4 |date=November 2005 |pmid=16075463 |doi=10.1002/gcc.20246}}</ref><ref name="pmid7028244">{{cite journal| author=Winberg CD, Nathwani BN, Bearman RM, Rappaport H| title=Follicular (nodular) lymphoma during the first two decades of life: a clinicopathologic study of 12 patients. | journal=Cancer | year= 1981 | volume= 48 | issue= 10 | pages= 2223-35 | pmid=7028244 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7028244  }}</ref>
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Follicular lymphoma]]<br><ref name="pmid25176983">{{cite journal| author=Ganapathi KA, Pittaluga S, Odejide OO, Freedman AS, Jaffe ES| title=Early lymphoid lesions: conceptual, diagnostic and clinical challenges. | journal=Haematologica | year= 2014 | volume= 99 | issue= 9 | pages= 1421-32 | pmid=25176983 | doi=10.3324/haematol.2014.107938 | pmc=4562530 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25176983  }}</ref><ref name="pmid11877266">{{cite journal| author=Lorsbach RB, Shay-Seymore D, Moore J, Banks PM, Hasserjian RP, Sandlund JT et al.| title=Clinicopathologic analysis of follicular lymphoma occurring in children. | journal=Blood | year= 2002 | volume= 99 | issue= 6 | pages= 1959-64 | pmid=11877266 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11877266  }}</ref><ref>[http://pleiad.umdnj.edu/hemepath/follicular/follicular.html Overview] at [[University of Medicine and Dentistry of New Jersey|UMDNJ]]</ref><ref name="pmid16075463">{{cite journal |author=Bosga-Bouwer AG, Haralambieva E, Booman M, ''et al.'' |title=BCL6 alternative translocation breakpoint cluster region associated with follicular lymphoma grade 3B |journal=Genes Chromosomes Cancer |volume=44 |issue=3 |pages=301–4 |date=November 2005 |pmid=16075463 |doi=10.1002/gcc.20246}}</ref><ref name="pmid7028244">{{cite journal| author=Winberg CD, Nathwani BN, Bearman RM, Rappaport H| title=Follicular (nodular) lymphoma during the first two decades of life: a clinicopathologic study of 12 patients. | journal=Cancer | year= 1981 | volume= 48 | issue= 10 | pages= 2223-35 | pmid=7028244 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7028244  }}</ref>
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Mature B-cell Lymphoma
* Mature [[B-cell]] [[Lymphoma]]
* Reciprocal translocation t(14;18)
* Reciprocal [[Translocations|translocation]] t(14;18)
* Overexpression of ''BCL2''
* [[Overexpression]] of ''[[BCL2-like 1 (gene)|BCL2]]''
| align="left" style="background:#F5F5F5;" + |20% of patients present with:
| align="left" style="background:#F5F5F5;" + |20% of patients present with:
*[[Fever]]
*[[Fever]]
Line 260: Line 268:
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |±
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Painless peripheral adenopathy in the cervical, axillary, inguinal, and/or femoral regions
* Painless peripheral [[adenopathy]] in the [[cervical]], [[axillary]], [[inguinal]], and/or [[femoral]] regions
* Asymptomatic large abdominal mass
* [[Asymptomatic]] large [[abdominal mass]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* [[Seizures]]
* [[Seizures]]
Line 269: Line 277:
*[[Dyspnea]]
*[[Dyspnea]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* CD21
* [[CD21]]
* CD23
* [[CD23]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Nodular growth pattern
* [[Nodular]] [[growth]] pattern
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Most common clinically indolent NHL
* Most common clinically indolent [[NHL]]
* Peripheral nerve compression
* Peripheral [[nerve]] compression
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Mantle cell lymphoma]]<br><ref>{{Cite journal
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Mantle cell lymphoma]]<br><ref>{{Cite journal
Line 333: Line 341:
}}</ref>
}}</ref>
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Mature B-cell Lymphoma
* Mature [[B-cell]] [[Lymphoma]]
* [[CD5 (protein)|CD5]] positive antigen in pre germinal center of B-cell
* [[CD5 (protein)|CD5]] positive [[antigen]] in pre [[germinal center]] of [[B-cell]]
* [[Chromosomal translocation]] at t(11:14)
* [[Chromosomal translocation]] at t(11:14)
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Fatigue  
* [[Fatigue]]
* Night sweats  
* [[Night sweats]]
* Weight Loss
* [[Weight loss|Weight Loss]]
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |Abdominal distention
| align="center" style="background:#F5F5F5;" + |[[Abdominal distention]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Palpable masses in skin, breast, and salivary glands
* [[Palpable]] masses in [[skin]], [[breast]], and [[salivary glands]]
* Generalized lymphadenopathy
* [[Generalized lymphadenopathy]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Extranodal involvement of GI tract, lungs, and CNS
* Extranodal involvement of [[GI tract]], [[lungs]], and [[CNS]]
* Mental Retardation
* [[Mental retardation|Mental Retardation]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* CD5<sup>+</sup>  
* [[CD5]]<sup>+</sup>  
* B-cell antigen positive
* [[B-cell]] [[antigen]] positive
* Overexpression of Cyclin D1  
* Overexpression of [[Cyclin D1]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Germinal centers filled by small-to-medium atypical lymphocytes
* [[Germinal centers]] filled by small-to-medium [[atypical lymphocytes]]
* Nodular appearance
* [[Nodular]] appearance
| align="center" style="background:#F5F5F5;" + |_
| align="center" style="background:#F5F5F5;" + |_
|-
|-
! rowspan="3" align="center" style="background:#DCDCDC;" + |Marginal zone lymphoma
! rowspan="3" align="center" style="background:#DCDCDC;" + |[[Marginal zone lymphoma]]
! align="center" style="background:#DCDCDC;" + |Extranodal marginal zone B-cell lymphoma of [[MALT lymphoma|mucosa-associated lymphoid tissue]] (MALT) type<br><ref name="sympmalylymmnoingastry">Non-gastric lymphomas – causes, symptoms and treatments. Lymphoma association 2016. https://www.lymphomas.org.uk/sites/default/files/pdfs/Non-Gastric-malt-lymphoma.pdf. Accessed on January 28, 2016</ref><ref name="riskfactorsmaltlymphoma1">Risks of Extranodal marginal zone of mucosa-associated lymphoid tissue (MALT lymphoma). Canadian Cancer Society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/malt-lymphoma/?region=on. Accessed on January 25, 2016</ref><ref name="KinkadeEsan2015">{{cite journal|last1=Kinkade|first1=Zoe|last2=Esan|first2=Olukemi A.|last3=Rosado|first3=Flavia G.|last4=Craig|first4=Michael|last5=Vos|first5=Jeffrey A.|title=Ileal mucosa-associated lymphoid tissue lymphoma presenting with small bowel obstruction: a case report|journal=Diagnostic Pathology|volume=10|issue=1|year=2015|issn=1746-1596|doi=10.1186/s13000-015-0353-6}}</ref><ref name="sympromaltlymphoma2">Symptoms of MALT lymphoma. Cancer research UK 2016. http://www.cancerresearchuk.org/about-cancer/type/non-hodgkins-lymphoma/about/types/mucosaassociated-lymphoid-tissue-lymphoma. Accessed on January 28, 2016</ref><ref name="sympromaltlymphoma22">Symptoms of MALT lymphoma. Cancer research UK 2016. http://www.cancerresearchuk.org/about-cancer/type/non-hodgkins-lymphoma/about/types/mucosaassociated-lymphoid-tissue-lymphoma. Accessed on January 28, 2016</ref><ref name="sympromaltlymphoma1">Signs and symptoms of gastric lymphoma. Wikipedia 2016. https://en.wikipedia.org/wiki/Gastric_lymphoma. Accessed on January 28, 2016</ref><ref name="nongastricorbitlymphomasym1">Clinical presentation of orbital lymphoma. Dr Craig Hacking and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/orbital-lymphoma. Accessed on January 28, 2016</ref><ref name="sympmalylymmnoingastry2">Non-gastric lymphomas – causes, symptoms and treatments. Lymphoma association 2016. https://www.lymphomas.org.uk/sites/default/files/pdfs/Non-Gastric-malt-lymphoma.pdf. Accessed on January 28, 2016</ref><ref>{{cite journal|last1=Taal|first1=B G|last2=Boot|first2=H|last3=van Heerde|first3=P|last4=de Jong|first4=D|last5=Hart|first5=A A|last6=Burgers|first6=J M|title=Primary non-Hodgkin lymphoma of the stomach: endoscopic pattern and prognosis in low versus high grade malignancy in relation to the MALT concept.|journal=Gut|date=1 October 1996|volume=39|issue=4|pages=556–561|doi=10.1136/gut.39.4.556}}</ref><ref name="pmid16950858">{{cite journal| author=Bacon CM, Du MQ, Dogan A| title=Mucosa-associated lymphoid tissue (MALT) lymphoma: a practical guide for pathologists. | journal=J Clin Pathol | year= 2007 | volume= 60 | issue= 4 | pages= 361-72 | pmid=16950858 | doi=10.1136/jcp.2005.031146 | pmc=PMC2001121 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16950858  }}</ref>
! align="center" style="background:#DCDCDC;" + |Extranodal marginal zone [[B-cell]] [[lymphoma]] of [[MALT lymphoma|mucosa-associated lymphoid tissue]] ([[MALT]]) type<br><ref name="sympmalylymmnoingastry">Non-gastric lymphomas – causes, symptoms and treatments. Lymphoma association 2016. https://www.lymphomas.org.uk/sites/default/files/pdfs/Non-Gastric-malt-lymphoma.pdf. Accessed on January 28, 2016</ref><ref name="riskfactorsmaltlymphoma1">Risks of Extranodal marginal zone of mucosa-associated lymphoid tissue (MALT lymphoma). Canadian Cancer Society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/malt-lymphoma/?region=on. Accessed on January 25, 2016</ref><ref name="KinkadeEsan2015">{{cite journal|last1=Kinkade|first1=Zoe|last2=Esan|first2=Olukemi A.|last3=Rosado|first3=Flavia G.|last4=Craig|first4=Michael|last5=Vos|first5=Jeffrey A.|title=Ileal mucosa-associated lymphoid tissue lymphoma presenting with small bowel obstruction: a case report|journal=Diagnostic Pathology|volume=10|issue=1|year=2015|issn=1746-1596|doi=10.1186/s13000-015-0353-6}}</ref><ref name="sympromaltlymphoma2">Symptoms of MALT lymphoma. Cancer research UK 2016. http://www.cancerresearchuk.org/about-cancer/type/non-hodgkins-lymphoma/about/types/mucosaassociated-lymphoid-tissue-lymphoma. Accessed on January 28, 2016</ref><ref name="sympromaltlymphoma22">Symptoms of MALT lymphoma. Cancer research UK 2016. http://www.cancerresearchuk.org/about-cancer/type/non-hodgkins-lymphoma/about/types/mucosaassociated-lymphoid-tissue-lymphoma. Accessed on January 28, 2016</ref><ref name="sympromaltlymphoma1">Signs and symptoms of gastric lymphoma. Wikipedia 2016. https://en.wikipedia.org/wiki/Gastric_lymphoma. Accessed on January 28, 2016</ref><ref name="nongastricorbitlymphomasym1">Clinical presentation of orbital lymphoma. Dr Craig Hacking and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/orbital-lymphoma. Accessed on January 28, 2016</ref><ref name="sympmalylymmnoingastry2">Non-gastric lymphomas – causes, symptoms and treatments. Lymphoma association 2016. https://www.lymphomas.org.uk/sites/default/files/pdfs/Non-Gastric-malt-lymphoma.pdf. Accessed on January 28, 2016</ref><ref>{{cite journal|last1=Taal|first1=B G|last2=Boot|first2=H|last3=van Heerde|first3=P|last4=de Jong|first4=D|last5=Hart|first5=A A|last6=Burgers|first6=J M|title=Primary non-Hodgkin lymphoma of the stomach: endoscopic pattern and prognosis in low versus high grade malignancy in relation to the MALT concept.|journal=Gut|date=1 October 1996|volume=39|issue=4|pages=556–561|doi=10.1136/gut.39.4.556}}</ref><ref name="pmid16950858">{{cite journal| author=Bacon CM, Du MQ, Dogan A| title=Mucosa-associated lymphoid tissue (MALT) lymphoma: a practical guide for pathologists. | journal=J Clin Pathol | year= 2007 | volume= 60 | issue= 4 | pages= 361-72 | pmid=16950858 | doi=10.1136/jcp.2005.031146 | pmc=PMC2001121 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16950858  }}</ref>
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Mature B-cell Lymphoma
* Mature [[B-cell]] [[Lymphoma]]
* Recurrent translocation of s such as:
* Recurrent [[Translocations|translocation]] of s such as:
** t(1;14)(p22;q32)
** t(1;14)(p22;q32)
** t(11;18)(q21;q21)
** t(11;18)(q21;q21)
Line 368: Line 376:
** t(3;14)(p14.1;q32)
** t(3;14)(p14.1;q32)
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*B symptoms may or may not be present
*[[B symptoms]] may or may not be present
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Painless or painfull [[lymphadenopathy]] which can be gastric or non-gastric.
*Painless or painful [[lymphadenopathy]] which can be [[gastric]] or non-[[gastric]]
*[[Orbital mass causes|lump in the superior lateral quadrant of the orbit]], [[breast]], [[neck]], or [[salivary gland]]
*[[Orbital mass causes|Lump in the superior lateral quadrant of the orbit]], [[breast]], [[neck]], or [[salivary gland]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Symptoms depend on the location of the tumor:  
*[[Symptoms]] depend on the location of the [[tumor]]  
*[[fatigue]]
*[[fatigue]]
*[[heartburn]],
*[[heartburn]]  
*[[fever]],
*[[fever]]
*[[cough]] with [[Hemoptysis|blood in sputum]],
*[[cough]] with [[Hemoptysis|blood in sputum]]
*[[Dyspnea|shortness of breath]]
*[[Dyspnea|Shortness of breath]]
| align="left" style="background:#F5F5F5;" + |B-cell associated antigens that co-express
| align="left" style="background:#F5F5F5;" + |[[B-cell]] associated [[antigens]] that co-express
* [[BCL-2]],
* [[BCL-2]]


*[[CD19]]
*[[CD19]]
Line 389: Line 397:
*[[CD22]]
*[[CD22]]
*[[CD79a]]
*[[CD79a]]
Negative for:
Negative for
*[[CD5]]
*[[CD5]]
*[[CD10]]
*[[CD10]]
*[[CD43]]
*[[CD43]]
*[[cyclin D1]].
*[[cyclin D1]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Presence of dense diffuse lymphoid infiltrate of marginal‐zone cells in lamina propria  
*Presence of dense diffuse [[lymphoid]] infiltrate of marginal‐zone [[Cells (biology)|cells]] in [[lamina propria]]
*prominent lymphoepithelial lesions and consisting of small atypical cells with monocytoid features.
*Prominent lymphoepithelial [[lesions]] and consisting of small atypical [[Cells (biology)|cells]] with [[monocytoid]] [[Features (pattern recognition)|features]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*''[[Helicobacter|H. pylori]]'' infection  
*''[[Helicobacter|H. pylori]]'' [[infection]]
*[[Hashimoto's thyroiditis]],
*[[Hashimoto's thyroiditis]]
*[[Sjogren’s syndrome]]
*[[Sjogren’s syndrome]]
*[[Celiac disease]].
*[[Celiac disease]]
|-
|-
! align="center" style="background:#DCDCDC;" + |[[Splenic marginal zone lymphoma]]<br><ref name="pmid11337382">{{cite journal |vauthors=Hernández JM, García JL, Gutiérrez NC, Mollejo M, Martínez-Climent JA, Flores T, González MB, Piris MA, San Miguel JF |title=Novel genomic imbalances in B-cell splenic marginal zone lymphomas revealed by comparative genomic hybridization and cytogenetics |journal=Am. J. Pathol. |volume=158 |issue=5 |pages=1843–50 |date=May 2001 |pmid=11337382 |pmc=1891967 |doi=10.1016/S0002-9440(10)64140-5 |url=}}</ref><ref name="pmid15642391">{{cite journal |vauthors=Andersen CL, Gruszka-Westwood A, Atkinson S, Matutes E, Catovsky D, Pedersen RK, Pedersen BB, Pulczynski S, Hokland P, Jacobsen E, Koch J |title=Recurrent genomic imbalances in B-cell splenic marginal-zone lymphoma revealed by comparative genomic hybridization |journal=Cancer Genet. Cytogenet. |volume=156 |issue=2 |pages=122–8 |date=January 2005 |pmid=15642391 |doi=10.1016/j.cancergencyto.2004.04.026 |url=}}</ref><ref name="pmid20479288">{{cite journal |vauthors=Salido M, Baró C, Oscier D, Stamatopoulos K, Dierlamm J, Matutes E, Traverse-Glehen A, Berger F, Felman P, Thieblemont C, Gesk S, Athanasiadou A, Davis Z, Gardiner A, Milla F, Ferrer A, Mollejo M, Calasanz MJ, Florensa L, Espinet B, Luño E, Wlodarska I, Verhoef G, García-Granero M, Salar A, Papadaki T, Serrano S, Piris MA, Solé F |title=Cytogenetic aberrations and their prognostic value in a series of 330 splenic marginal zone B-cell lymphomas: a multicenter study of the Splenic B-Cell Lymphoma Group |journal=Blood |volume=116 |issue=9 |pages=1479–88 |date=September 2010 |pmid=20479288 |doi=10.1182/blood-2010-02-267476 |url=}}</ref><ref>Splenic marginal zone lymphoma. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf57e3e27c3994bd5327/. Accessed on December 22, 2015</ref><ref name="pmid12916862">{{cite journal |vauthors=Weng WK, Levy S |title=Hepatitis C virus (HCV) and lymphomagenesis |journal=Leuk. Lymphoma |volume=44 |issue=7 |pages=1113–20 |date=July 2003 |pmid=12916862 |doi=10.1080/1042819031000076972 |url=}}</ref><ref name="pmid11739181">{{cite journal |vauthors=Quinn ER, Chan CH, Hadlock KG, Foung SK, Flint M, Levy S |title=The B-cell receptor of a hepatitis C virus (HCV)-associated non-Hodgkin lymphoma binds the viral E2 envelope protein, implicating HCV in lymphomagenesis |journal=Blood |volume=98 |issue=13 |pages=3745–9 |date=December 2001 |pmid=11739181 |doi= |url=}}</ref><ref name="pmid20530156">{{cite journal |vauthors=Chuang SS, Liao YL, Chang ST, Hsieh YC, Kuo SY, Lu CL, Hwang WS, Lin IH, Tsao CJ, Huang WT |title=Hepatitis C virus infection is significantly associated with malignant lymphoma in Taiwan, particularly with nodal and splenic marginal zone lymphomas |journal=J. Clin. Pathol. |volume=63 |issue=7 |pages=595–8 |date=July 2010 |pmid=20530156 |doi=10.1136/jcp.2010.076810 |url=}}</ref>
! align="center" style="background:#DCDCDC;" + |[[Splenic marginal zone lymphoma]]<br><ref name="pmid11337382">{{cite journal |vauthors=Hernández JM, García JL, Gutiérrez NC, Mollejo M, Martínez-Climent JA, Flores T, González MB, Piris MA, San Miguel JF |title=Novel genomic imbalances in B-cell splenic marginal zone lymphomas revealed by comparative genomic hybridization and cytogenetics |journal=Am. J. Pathol. |volume=158 |issue=5 |pages=1843–50 |date=May 2001 |pmid=11337382 |pmc=1891967 |doi=10.1016/S0002-9440(10)64140-5 |url=}}</ref><ref name="pmid15642391">{{cite journal |vauthors=Andersen CL, Gruszka-Westwood A, Atkinson S, Matutes E, Catovsky D, Pedersen RK, Pedersen BB, Pulczynski S, Hokland P, Jacobsen E, Koch J |title=Recurrent genomic imbalances in B-cell splenic marginal-zone lymphoma revealed by comparative genomic hybridization |journal=Cancer Genet. Cytogenet. |volume=156 |issue=2 |pages=122–8 |date=January 2005 |pmid=15642391 |doi=10.1016/j.cancergencyto.2004.04.026 |url=}}</ref><ref name="pmid20479288">{{cite journal |vauthors=Salido M, Baró C, Oscier D, Stamatopoulos K, Dierlamm J, Matutes E, Traverse-Glehen A, Berger F, Felman P, Thieblemont C, Gesk S, Athanasiadou A, Davis Z, Gardiner A, Milla F, Ferrer A, Mollejo M, Calasanz MJ, Florensa L, Espinet B, Luño E, Wlodarska I, Verhoef G, García-Granero M, Salar A, Papadaki T, Serrano S, Piris MA, Solé F |title=Cytogenetic aberrations and their prognostic value in a series of 330 splenic marginal zone B-cell lymphomas: a multicenter study of the Splenic B-Cell Lymphoma Group |journal=Blood |volume=116 |issue=9 |pages=1479–88 |date=September 2010 |pmid=20479288 |doi=10.1182/blood-2010-02-267476 |url=}}</ref><ref>Splenic marginal zone lymphoma. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf57e3e27c3994bd5327/. Accessed on December 22, 2015</ref><ref name="pmid12916862">{{cite journal |vauthors=Weng WK, Levy S |title=Hepatitis C virus (HCV) and lymphomagenesis |journal=Leuk. Lymphoma |volume=44 |issue=7 |pages=1113–20 |date=July 2003 |pmid=12916862 |doi=10.1080/1042819031000076972 |url=}}</ref><ref name="pmid11739181">{{cite journal |vauthors=Quinn ER, Chan CH, Hadlock KG, Foung SK, Flint M, Levy S |title=The B-cell receptor of a hepatitis C virus (HCV)-associated non-Hodgkin lymphoma binds the viral E2 envelope protein, implicating HCV in lymphomagenesis |journal=Blood |volume=98 |issue=13 |pages=3745–9 |date=December 2001 |pmid=11739181 |doi= |url=}}</ref><ref name="pmid20530156">{{cite journal |vauthors=Chuang SS, Liao YL, Chang ST, Hsieh YC, Kuo SY, Lu CL, Hwang WS, Lin IH, Tsao CJ, Huang WT |title=Hepatitis C virus infection is significantly associated with malignant lymphoma in Taiwan, particularly with nodal and splenic marginal zone lymphomas |journal=J. Clin. Pathol. |volume=63 |issue=7 |pages=595–8 |date=July 2010 |pmid=20530156 |doi=10.1136/jcp.2010.076810 |url=}}</ref>
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* Mature B-cell Lymphoma
* Mature [[B-cell]] [[Lymphoma]]
* Clonal rearrangements of the [[immunoglobulin]] genes (heavy and light chains)
* [[Clonal colony|Clonal]] rearrangements of the [[immunoglobulin]] [[genes]] ([[Heavy-chain immunoglobulin|heavy]] and [[light chain]]<nowiki/>s)
** Deletion 7q21-32
** [[Deletion (genetics)|Deletion]] 7q21-32
** Translocations of the CDK6 gene located on 7q21  
** [[Translocations]] of the CDK6 [[gene]] located on 7q21  
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*[[Fever]]
*[[Fever]]
Line 417: Line 425:
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Painless swelling in the neck, [[axilla]], [[groin]], [[thorax]], and [[abdomen]].
*Painless [[swelling]] in the [[neck]], [[axilla]], [[groin]], [[thorax]], and [[abdomen]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Chest pain
*[[Chest pain]]
*[[Bone pain]]
*[[Bone pain]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
Line 427: Line 435:
*Small [[lymphocytes]]  
*Small [[lymphocytes]]  
*Transformed blasts
*Transformed blasts
*Epithelial histocytes
*[[Epithelial]] [[histocytes]]
*Plasmacytic differentiation of neoplastic cells
*Plasmacytic [[differentiation]] of [[neoplastic]] [[Cells (biology)|cells]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*[[Hepatitis C]] infection
*[[Hepatitis C]] [[infection]]
|-
|-
! align="center" style="background:#DCDCDC;" + |[[Nodal marginal zone B-cell lymphoma]]<br><ref name="SpinaKhiabanian2016">{{cite journal|last1=Spina|first1=V.|last2=Khiabanian|first2=H.|last3=Messina|first3=M.|last4=Monti|first4=S.|last5=Cascione|first5=L.|last6=Bruscaggin|first6=A.|last7=Spaccarotella|first7=E.|last8=Holmes|first8=A. B.|last9=Arcaini|first9=L.|last10=Lucioni|first10=M.|last11=Tabbo|first11=F.|last12=Zairis|first12=S.|last13=Diop|first13=F.|last14=Cerri|first14=M.|last15=Chiaretti|first15=S.|last16=Marasca|first16=R.|last17=Ponzoni|first17=M.|last18=Deaglio|first18=S.|last19=Ramponi|first19=A.|last20=Tiacci|first20=E.|last21=Pasqualucci|first21=L.|last22=Paulli|first22=M.|last23=Falini|first23=B.|last24=Inghirami|first24=G.|last25=Bertoni|first25=F.|last26=Foa|first26=R.|last27=Rabadan|first27=R.|last28=Gaidano|first28=G.|last29=Rossi|first29=D.|title=The genetics of nodal marginal zone lymphoma|journal=Blood|volume=128|issue=10|year=2016|pages=1362–1373|issn=0006-4971|doi=10.1182/blood-2016-02-696757}}</ref><ref name="canadiancancer">Nodal marginal zone lymphoma . Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/nodal-marginal-zone-lymphoma/?region=nb Accessed on March 4, 2016</ref>  
! align="center" style="background:#DCDCDC;" + |[[Nodal marginal zone B-cell lymphoma]]<br><ref name="SpinaKhiabanian2016">{{cite journal|last1=Spina|first1=V.|last2=Khiabanian|first2=H.|last3=Messina|first3=M.|last4=Monti|first4=S.|last5=Cascione|first5=L.|last6=Bruscaggin|first6=A.|last7=Spaccarotella|first7=E.|last8=Holmes|first8=A. B.|last9=Arcaini|first9=L.|last10=Lucioni|first10=M.|last11=Tabbo|first11=F.|last12=Zairis|first12=S.|last13=Diop|first13=F.|last14=Cerri|first14=M.|last15=Chiaretti|first15=S.|last16=Marasca|first16=R.|last17=Ponzoni|first17=M.|last18=Deaglio|first18=S.|last19=Ramponi|first19=A.|last20=Tiacci|first20=E.|last21=Pasqualucci|first21=L.|last22=Paulli|first22=M.|last23=Falini|first23=B.|last24=Inghirami|first24=G.|last25=Bertoni|first25=F.|last26=Foa|first26=R.|last27=Rabadan|first27=R.|last28=Gaidano|first28=G.|last29=Rossi|first29=D.|title=The genetics of nodal marginal zone lymphoma|journal=Blood|volume=128|issue=10|year=2016|pages=1362–1373|issn=0006-4971|doi=10.1182/blood-2016-02-696757}}</ref><ref name="canadiancancer">Nodal marginal zone lymphoma . Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/nodal-marginal-zone-lymphoma/?region=nb Accessed on March 4, 2016</ref>  
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Mature B-cell Lymphoma
*Mature [[B-cell]] [[Lymphoma]]
*Stimulation of antigen receptor by autoantigen and co-stimulatory molecule CD40
*Stimulation of [[antigen]] [[receptor]] by [[autoantigen]] and co-stimulatory [[molecule]] [[CD40]]
*[[Mutation|Mutations]] in [[KMT2D]], PTTPRD, [[NOTCH2]], [[KLF2]]
*[[Mutation|Mutations]] in [[KMT2D]], PTTPRD, [[NOTCH2]], [[KLF2]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
Line 445: Line 453:
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Painless [[swelling]] in the neck, [[axilla]], [[groin]], [[thorax]], and [[abdomen]]
*Painless [[swelling]] in the [[neck]], [[axilla]], [[groin]], [[thorax]], and [[abdomen]]
*Generalized and local [[lymphadenopathy]]
*Generalized and local [[lymphadenopathy]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Hemorrhage
*[[Hemorrhage]]
*Dyspepsia
*[[Dyspepsia]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Follicular cells in reactive zone
*[[Follicular cells]] in reactive zone
*Centrocyte like cells in marginal zone lymphoma
*Centrocyte like [[Cells (biology)|cells]] in [[marginal zone lymphoma]]
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
*Centrocytes
*Centrocytes
Line 459: Line 467:
*[[Immunoblast|Immunoblasts]]  
*[[Immunoblast|Immunoblasts]]  
| align="left" style="background:#F5F5F5;" + |
| align="left" style="background:#F5F5F5;" + |
* [[Hepatitis C]] infection  
* [[Hepatitis C]] [[infection]]


* Chronic infectious conditions or autoimmune processes, such as:
* [[Chronic (medical)|Chronic]] [[infectious]] conditions or [[autoimmune]] processes, such as:
**''H pylori'' gastritis
**''[[H pylori]]'' [[gastritis]]
**Hashimoto thyroiditis
**[[Hashimoto's thyroiditis|Hashimoto thyroiditis]]
**Sjögren syndrome
**[[Sjögren's syndrome|Sjögren syndrome]]
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" + |B cell chronic lymphocytic leukemia/small lymphocytic lymphoma<br><ref name="KleinTu2001">{{cite journal|last1=Klein|first1=Ulf|last2=Tu|first2=Yuhai|last3=Stolovitzky|first3=Gustavo A.|last4=Mattioli|first4=Michela|last5=Cattoretti|first5=Giorgio|last6=Husson|first6=Hervé|last7=Freedman|first7=Arnold|last8=Inghirami|first8=Giorgio|last9=Cro|first9=Lilla|last10=Baldini|first10=Luca|last11=Neri|first11=Antonino|last12=Califano|first12=Andrea|last13=Dalla-Favera|first13=Riccardo|title=Gene Expression Profiling of B Cell Chronic Lymphocytic Leukemia Reveals a Homogeneous Phenotype Related to Memory B Cells|journal=The Journal of Experimental Medicine|volume=194|issue=11|year=2001|pages=1625–1638|issn=0022-1007|doi=10.1084/jem.194.11.1625}}</ref>
! colspan="2" align="center" style="background:#DCDCDC;" + |B cell chronic lymphocytic leukemia/small lymphocytic lymphoma<br><ref name="KleinTu2001">{{cite journal|last1=Klein|first1=Ulf|last2=Tu|first2=Yuhai|last3=Stolovitzky|first3=Gustavo A.|last4=Mattioli|first4=Michela|last5=Cattoretti|first5=Giorgio|last6=Husson|first6=Hervé|last7=Freedman|first7=Arnold|last8=Inghirami|first8=Giorgio|last9=Cro|first9=Lilla|last10=Baldini|first10=Luca|last11=Neri|first11=Antonino|last12=Califano|first12=Andrea|last13=Dalla-Favera|first13=Riccardo|title=Gene Expression Profiling of B Cell Chronic Lymphocytic Leukemia Reveals a Homogeneous Phenotype Related to Memory B Cells|journal=The Journal of Experimental Medicine|volume=194|issue=11|year=2001|pages=1625–1638|issn=0022-1007|doi=10.1084/jem.194.11.1625}}</ref>

Revision as of 20:08, 21 February 2019


For the WikiDoc page for this topic, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]

Overview

Lymphoplasmacytic lymphoma must be differentiated from multiple myeloma, chronic lymphocytic leukemia/small lymphocytic lymphoma, b-cell prolymphocytic leukemia, follicular lymphoma, mantle cell lymphoma, and marginal zone lymphoma.

Differentiating Lymphoplasmacytic lymphoma from other Diseases

Lymphoplasmacytic lymphoma must be differentiated from other B cell lymphoid neoplasms including:

  • Expresses B cell markers CD19, CD20, and CD22.
  • Infiltrates the bone marrow with a characteristic intertrabecular and intrasinusoidal pattern
  • Most common cytogenetic abnormalities are loss of 7q (19%) along with +3q (19%) and +5q (10% )[9][10]
Histopathology, immunophenotype, and genetic features of differential diagnosis of lymphoplasmacytic lymphoma
Disease entity Histopathology Immunophenotype Genetic or other features
Lymphoplasmacytic lymphoma
Chronic lymphocytic leukemia/small lymphocytic lymphoma
  • Always express CD5.
  • Del13q, del 11q, del17p, trisomy 12
B-cell prolymphocytic leukemia
  • t(11;14) must be excluded.
Follicular lymphoma
  • Nodular growth pattern of follicle center cells (centrocytes and centroblasts).
  • t(14;18)
Multiple myeloma
  • Absent Surface Ig.
  • Expresses CD138, CD38, CD79a, and VS38c.
  • Infrequently expresses CD19.
  • Approximately 70 percent of myeloma cells will express CD56.
Mantle cell lymphoma
  • Typically co-express surface IgM and IgD.
  • The vast majority over-express cyclin D1.
  • t(11;14)
Marginal zone lymphoma
Disease Etiology (Genetic or other) Clinical manifestations Paraclinical findings Associated findings
Lab findings
Symptoms Signs Immunochemistry Histopathology
Constitutional symptoms Rash Abdominal pain Diarrhea Mass Other
Lymphoplasmacytic lymphoma (Waldenstrom’s macroglobulinemia)
[11][12][13][14][15]
+ Express pan B-cell antigens

Variable expression of

Majority express

Fewer express

Lack expression of

B cell chronic lymphocytic leukemia/small lymphocytic lymphoma
[16]

33% of patients present with:

Follicular lymphoma
[17][18][19][20][21]
20% of patients present with: + + ±
  • Most common clinically indolent NHL
  • Peripheral nerve compression
Mantle cell lymphoma
[22][23][24][25][26]
Abdominal distention + _
Marginal zone lymphoma Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type
[27][28][29][30][31][32][33][34][35][36]
± + + B-cell associated antigens that co-express

Negative for

Splenic marginal zone lymphoma
[37][38][39][40][41][42][43]
+ +
Nodal marginal zone B-cell lymphoma
[44][45]
+
B cell chronic lymphocytic leukemia/small lymphocytic lymphoma
[16]
  • Mature B-cell Lymphoma
  • Ch 13 abnormalties

33% of patients present with:

  • Painless lymphadenopathy
  • May be asymptomatic
  • Fatigue
  • Recurrent infections
  • Hepatosplenomegaly
  • CD5
  • CD38
  • Monoclonal small well differentiated B cells.
  • Significant number of smudge cells or basket cells..
B cell chronic lymphocytic leukemia/small lymphocytic lymphoma
[16]
  • Mature B-cell Lymphoma
  • Ch 13 abnormalties

33% of patients present with:

  • Painless lymphadenopathy
  • May be asymptomatic
  • Fatigue
  • Recurrent infections
  • Hepatosplenomegaly
  • CD5
  • CD38
  • Monoclonal small well differentiated B cells.
  • Significant number of smudge cells or basket cells..
GC-associated lymphoid clones infiltrating the BM osteoblastic niche exhibit mesenchymal features in common with SLO germinal centers.(A–D) Histological examination of B-cell non-Hodgkin lymphoma (B-NHL) patient specimens. (A) The frequency of para-trabecular/osteoblastic localization of lymphoid malignant clones in 197 cases of B-NHL with bone marrow (BM) infiltration. Lymphoid clones of germinal center (GC)-derivation exhibiting preferential tropism for the BM osteoblastic niche include: follicular lymphoma (FL), T-cell rich histiocyte rich diffuse large B-cell lymphoma (TCRBCL), and diffuse large B-cell lymphoma of GC type (DLBCL-GC). Non-GC-related lymphoid clones include: DLBCL- activated B-cell type (ABC); mantle-cell lymmphoma, (MCL); marginal-zone lymphoma, (MZL); lymphoplasmacytic lymphoma, (LPL). (B) Para-trabecular (left panel) and inter-trabecular (right panel) localization of two representative cases of FL with BM infiltration. The distribution of the lymphomatous infiltrates around bone trabeculae or in the inter-trabecular lacunae is highlighted by CD20 immunostaining (inserts). (C–D) FL lymphoid infiltrates localizing within the osteoblastic niche area (left panels) and inter-trabecular BM (right panels) display a stromal architecture reminiscent of that of secondary lymphoid organ (SLO) GCs and are characterized by the expression of BM-MSC markers SPARC (C) and CD146 (right D).Source: Sangaletti S. et al, Molecular Immunology Unit; Department of Experimental Oncology and Molecular Medicine; Fondazione IRCCS Istituto Nazionale Tumori; Milan, Italy.
Expression of CD19 and CD20 in B-cell lineage.Notes: Illustrative representation of B-cell differentiation, maturation, antigen expression and B-cell neoplasm associated with different stages of B-cell development. Cell lines used in the research study.47–51Abbreviations: GC, germinal center; ALL, acute lymphoblastic leukemia; MCL, Mantle cell lymphoma; FL, follicular lymphoma; BL, Burkitt lymphoma; DLBCL, Diffuse Large B-Cell Lymphoma; MZL, Marginal Zone Lymphoma; CLL/SLL, Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma; MALT, Mucosa-Associated lymphoid tissue; WM, Waldenstrom macroglobulinemia; MM, plasma cell myeloma; WSU-BL, Wayne State University-Burkitt lymphoma cell line; WSU-FSCCL, Wayne State University-follicular small cleaved cell lymphoma Cell line; WSU-NHL, Wayne State University-FL grade 3 Cell line; WSU-DLCL and WSU-DLCL2, Wayne State University-Diffuse large B-Cell lymphoma cell line; WSU-WM, Wayne State University-Waldenstrom macroglobulinemia Cell line.Source: Raufi A. et al, Lymphoma Research Laboratory, Wayne State University School of Medicine (WSU-SOM), Gordon Scott Hall for Basic Medical Sciences, Detroit, MI, USA.

References

  1. Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating MJ, Montserrat E, Rai KR, Kipps TJ (2008). "Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines". Blood. 111 (12): 5446–56. doi:10.1182/blood-2007-06-093906. PMC 2972576. PMID 18216293.
  2. Del Giudice I, Davis Z, Matutes E, Osuji N, Parry-Jones N, Morilla A, Brito-Babapulle V, Oscier D, Catovsky D (2006). "IgVH genes mutation and usage, ZAP-70 and CD38 expression provide new insights on B-cell prolymphocytic leukemia (B-PLL)". Leukemia. 20 (7): 1231–7. doi:10.1038/sj.leu.2404238. PMID 16642047.
  3. Ravandi F, O'Brien S (2005). "Chronic lymphoid leukemias other than chronic lymphocytic leukemia: diagnosis and treatment". Mayo Clin. Proc. 80 (12): 1660–74. doi:10.4065/80.12.1660. PMID 16342661.
  4. Karube K, Guo Y, Suzumiya J, Sugita Y, Nomura Y, Yamamoto K, Shimizu K, Yoshida S, Komatani H, Takeshita M, Kikuchi M, Nakamura N, Takasu O, Arakawa F, Tagawa H, Seto M, Ohshima K (2007). "CD10-MUM1+ follicular lymphoma lacks BCL2 gene translocation and shows characteristic biologic and clinical features". Blood. 109 (7): 3076–9. doi:10.1182/blood-2006-09-045989. PMID 17138820.
  5. Anderson KC, Bates MP, Slaughenhoupt BL, Pinkus GS, Schlossman SF, Nadler LM (1984). "Expression of human B cell-associated antigens on leukemias and lymphomas: a model of human B cell differentiation". Blood. 63 (6): 1424–33. PMID 6609729.
    • Bone marrow infiltration of small, cleaved cells that are usually paratrabecular
  6. Pangalis GA, Kyrtsonis MC, Kontopidou FN, Vassilakopoulos TP, Siakantaris MP, Dimopoulou MN, Kittas C, Angelopoulou MK (2003). "Differential diagnosis of Waldenstrom's macroglobulinemia from other low-grade B-cell lymphoproliferative disorders". Semin. Oncol. 30 (2): 201–5. doi:10.1053/sonc.2003.50046. PMID 12720136.
  7. Dorfman DM, Pinkus GS (1994). "Distinction between small lymphocytic and mantle cell lymphoma by immunoreactivity for CD23". Mod. Pathol. 7 (3): 326–31. PMID 8058704.
  8. DiRaimondo F, Albitar M, Huh Y, O'Brien S, Montillo M, Tedeschi A, Kantarjian H, Lerner S, Giustolisi R, Keating M (2002). "The clinical and diagnostic relevance of CD23 expression in the chronic lymphoproliferative disease". Cancer. 94 (6): 1721–30. PMID 11920534.
  9. Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J, Lister TA, Bloomfield CD (1999). "World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997". J. Clin. Oncol. 17 (12): 3835–49. PMID 10577857.
  10. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, Delsol G, De Wolf-Peeters C, Falini B, Gatter KC (1994). "A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group". Blood. 84 (5): 1361–92. PMID 8068936.
  11. Steven P. Treon, Lian Xu, Guang Yang, Yangsheng Zhou, Xia Liu, Yang Cao, Patricia Sheehy, Robert J. Manning, Christopher J. Patterson, Christina Tripsas, Luca Arcaini, Geraldine S. Pinkus, Scott J. Rodig, Aliyah R. Sohani, Nancy Lee Harris, Jason M. Laramie, Donald A. Skifter, Stephen E. Lincoln & Zachary R. Hunter (2012). "MYD88 L265P somatic mutation in Waldenstrom's macroglobulinemia". The New England journal of medicine. 367 (9): 826–833. doi:10.1056/NEJMoa1200710. PMID 22931316. Unknown parameter |month= ignored (help)
  12. Chi PJ, Pei SN, Huang TL, Huang SC, Ng HY, Lee CT (2014). "Renal MALT lymphoma associated with Waldenström macroglobulinemia". J. Formos. Med. Assoc. 113 (4): 255–7. doi:10.1016/j.jfma.2011.02.007. PMID 24685302.
  13. Chi PJ, Pei SN, Huang TL, Huang SC, Ng HY, Lee CT (2014). "Renal MALT lymphoma associated with Waldenström macroglobulinemia". J. Formos. Med. Assoc. 113 (4): 255–7. doi:10.1016/j.jfma.2011.02.007. PMID 24685302.
  14. García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A; et al. (2001). "Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases". Br J Haematol. 115 (3): 575–82. PMID 11736938.
  15. Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G; et al. (2003). "Prognostic factors in symptomatic Waldenstrom's macroglobulinemia". Semin Oncol. 30 (2): 211–5. doi:10.1053/sonc.2003.50064. PMID 12720138.
  16. 16.0 16.1 16.2 Klein, Ulf; Tu, Yuhai; Stolovitzky, Gustavo A.; Mattioli, Michela; Cattoretti, Giorgio; Husson, Hervé; Freedman, Arnold; Inghirami, Giorgio; Cro, Lilla; Baldini, Luca; Neri, Antonino; Califano, Andrea; Dalla-Favera, Riccardo (2001). "Gene Expression Profiling of B Cell Chronic Lymphocytic Leukemia Reveals a Homogeneous Phenotype Related to Memory B Cells". The Journal of Experimental Medicine. 194 (11): 1625–1638. doi:10.1084/jem.194.11.1625. ISSN 0022-1007.
  17. Ganapathi KA, Pittaluga S, Odejide OO, Freedman AS, Jaffe ES (2014). "Early lymphoid lesions: conceptual, diagnostic and clinical challenges". Haematologica. 99 (9): 1421–32. doi:10.3324/haematol.2014.107938. PMC 4562530. PMID 25176983.
  18. Lorsbach RB, Shay-Seymore D, Moore J, Banks PM, Hasserjian RP, Sandlund JT; et al. (2002). "Clinicopathologic analysis of follicular lymphoma occurring in children". Blood. 99 (6): 1959–64. PMID 11877266.
  19. Overview at UMDNJ
  20. Bosga-Bouwer AG, Haralambieva E, Booman M; et al. (November 2005). "BCL6 alternative translocation breakpoint cluster region associated with follicular lymphoma grade 3B". Genes Chromosomes Cancer. 44 (3): 301–4. doi:10.1002/gcc.20246. PMID 16075463.
  21. Winberg CD, Nathwani BN, Bearman RM, Rappaport H (1981). "Follicular (nodular) lymphoma during the first two decades of life: a clinicopathologic study of 12 patients". Cancer. 48 (10): 2223–35. PMID 7028244.
  22. Itziar Salaverria, Cristina Royo, Alejandra Carvajal-Cuenca, Guillem Clot, Alba Navarro, Alejandra Valera, Joo Y. Song, Renata Woroniecka, Grzegorz Rymkiewicz, Wolfram Klapper, Elena M. Hartmann, Pierre Sujobert, Iwona Wlodarska, Judith A. Ferry, Philippe Gaulard, German Ott, Andreas Rosenwald, Armando Lopez-Guillermo, Leticia Quintanilla-Martinez, Nancy L. Harris, Elaine S. Jaffe, Reiner Siebert, Elias Campo & Silvia Bea (2013). "CCND2 rearrangements are the most frequent genetic events in cyclin D1(-) mantle cell lymphoma". Blood. 121 (8): 1394–1402. doi:10.1182/blood-2012-08-452284. PMID 23255553. Unknown parameter |month= ignored (help)
  23. Markus Tiemann, Carsten Schrader, Wolfram Klapper, Martin H. Dreyling, Elias Campo, Andrew Norton, Francoise Berger, Philip Kluin, German Ott, Stephano Pileri, Ennio Pedrinis, Alfred C. Feller, Hartmut Merz, Dirk Janssen, Martin L. Hansmann, Han Krieken, Peter Moller, Harald Stein, Michael Unterhalt, Wolfgang Hiddemann & Reza Parwaresch (2005). "Histopathology, cell proliferation indices and clinical outcome in 304 patients with mantle cell lymphoma (MCL): a clinicopathological study from the European MCL Network". British journal of haematology. 131 (1): 29–38. doi:10.1111/j.1365-2141.2005.05716.x. PMID 16173960. Unknown parameter |month= ignored (help)
  24. L. H. Argatoff, J. M. Connors, R. J. Klasa, D. E. Horsman & R. D. Gascoyne (1997). "Mantle cell lymphoma: a clinicopathologic study of 80 cases". Blood. 89 (6): 2067–2078. PMID 9058729. Unknown parameter |month= ignored (help)
  25. Markus Tiemann, Carsten Schrader, Wolfram Klapper, Martin H. Dreyling, Elias Campo, Andrew Norton, Francoise Berger, Philip Kluin, German Ott, Stephano Pileri, Ennio Pedrinis, Alfred C. Feller, Hartmut Merz, Dirk Janssen, Martin L. Hansmann, Han Krieken, Peter Moller, Harald Stein, Michael Unterhalt, Wolfgang Hiddemann & Reza Parwaresch (2005). "Histopathology, cell proliferation indices and clinical outcome in 304 patients with mantle cell lymphoma (MCL): a clinicopathological study from the European MCL Network". British journal of haematology. 131 (1): 29–38. doi:10.1111/j.1365-2141.2005.05716.x. PMID 16173960. Unknown parameter |month= ignored (help)
  26. Julie M. Vose (2017). "Mantle cell lymphoma: 2017 update on diagnosis, risk-stratification, and clinical management". American journal of hematology. 92 (8): 806–813. doi:10.1002/ajh.24797. PMID 28699667. Unknown parameter |month= ignored (help)
  27. Non-gastric lymphomas – causes, symptoms and treatments. Lymphoma association 2016. https://www.lymphomas.org.uk/sites/default/files/pdfs/Non-Gastric-malt-lymphoma.pdf. Accessed on January 28, 2016
  28. Risks of Extranodal marginal zone of mucosa-associated lymphoid tissue (MALT lymphoma). Canadian Cancer Society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/malt-lymphoma/?region=on. Accessed on January 25, 2016
  29. Kinkade, Zoe; Esan, Olukemi A.; Rosado, Flavia G.; Craig, Michael; Vos, Jeffrey A. (2015). "Ileal mucosa-associated lymphoid tissue lymphoma presenting with small bowel obstruction: a case report". Diagnostic Pathology. 10 (1). doi:10.1186/s13000-015-0353-6. ISSN 1746-1596.
  30. Symptoms of MALT lymphoma. Cancer research UK 2016. http://www.cancerresearchuk.org/about-cancer/type/non-hodgkins-lymphoma/about/types/mucosaassociated-lymphoid-tissue-lymphoma. Accessed on January 28, 2016
  31. Symptoms of MALT lymphoma. Cancer research UK 2016. http://www.cancerresearchuk.org/about-cancer/type/non-hodgkins-lymphoma/about/types/mucosaassociated-lymphoid-tissue-lymphoma. Accessed on January 28, 2016
  32. Signs and symptoms of gastric lymphoma. Wikipedia 2016. https://en.wikipedia.org/wiki/Gastric_lymphoma. Accessed on January 28, 2016
  33. Clinical presentation of orbital lymphoma. Dr Craig Hacking and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/orbital-lymphoma. Accessed on January 28, 2016
  34. Non-gastric lymphomas – causes, symptoms and treatments. Lymphoma association 2016. https://www.lymphomas.org.uk/sites/default/files/pdfs/Non-Gastric-malt-lymphoma.pdf. Accessed on January 28, 2016
  35. Taal, B G; Boot, H; van Heerde, P; de Jong, D; Hart, A A; Burgers, J M (1 October 1996). "Primary non-Hodgkin lymphoma of the stomach: endoscopic pattern and prognosis in low versus high grade malignancy in relation to the MALT concept". Gut. 39 (4): 556–561. doi:10.1136/gut.39.4.556.
  36. Bacon CM, Du MQ, Dogan A (2007). "Mucosa-associated lymphoid tissue (MALT) lymphoma: a practical guide for pathologists". J Clin Pathol. 60 (4): 361–72. doi:10.1136/jcp.2005.031146. PMC 2001121. PMID 16950858.
  37. Hernández JM, García JL, Gutiérrez NC, Mollejo M, Martínez-Climent JA, Flores T, González MB, Piris MA, San Miguel JF (May 2001). "Novel genomic imbalances in B-cell splenic marginal zone lymphomas revealed by comparative genomic hybridization and cytogenetics". Am. J. Pathol. 158 (5): 1843–50. doi:10.1016/S0002-9440(10)64140-5. PMC 1891967. PMID 11337382.
  38. Andersen CL, Gruszka-Westwood A, Atkinson S, Matutes E, Catovsky D, Pedersen RK, Pedersen BB, Pulczynski S, Hokland P, Jacobsen E, Koch J (January 2005). "Recurrent genomic imbalances in B-cell splenic marginal-zone lymphoma revealed by comparative genomic hybridization". Cancer Genet. Cytogenet. 156 (2): 122–8. doi:10.1016/j.cancergencyto.2004.04.026. PMID 15642391.
  39. Salido M, Baró C, Oscier D, Stamatopoulos K, Dierlamm J, Matutes E, Traverse-Glehen A, Berger F, Felman P, Thieblemont C, Gesk S, Athanasiadou A, Davis Z, Gardiner A, Milla F, Ferrer A, Mollejo M, Calasanz MJ, Florensa L, Espinet B, Luño E, Wlodarska I, Verhoef G, García-Granero M, Salar A, Papadaki T, Serrano S, Piris MA, Solé F (September 2010). "Cytogenetic aberrations and their prognostic value in a series of 330 splenic marginal zone B-cell lymphomas: a multicenter study of the Splenic B-Cell Lymphoma Group". Blood. 116 (9): 1479–88. doi:10.1182/blood-2010-02-267476. PMID 20479288.
  40. Splenic marginal zone lymphoma. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf57e3e27c3994bd5327/. Accessed on December 22, 2015
  41. Weng WK, Levy S (July 2003). "Hepatitis C virus (HCV) and lymphomagenesis". Leuk. Lymphoma. 44 (7): 1113–20. doi:10.1080/1042819031000076972. PMID 12916862.
  42. Quinn ER, Chan CH, Hadlock KG, Foung SK, Flint M, Levy S (December 2001). "The B-cell receptor of a hepatitis C virus (HCV)-associated non-Hodgkin lymphoma binds the viral E2 envelope protein, implicating HCV in lymphomagenesis". Blood. 98 (13): 3745–9. PMID 11739181.
  43. Chuang SS, Liao YL, Chang ST, Hsieh YC, Kuo SY, Lu CL, Hwang WS, Lin IH, Tsao CJ, Huang WT (July 2010). "Hepatitis C virus infection is significantly associated with malignant lymphoma in Taiwan, particularly with nodal and splenic marginal zone lymphomas". J. Clin. Pathol. 63 (7): 595–8. doi:10.1136/jcp.2010.076810. PMID 20530156.
  44. Spina, V.; Khiabanian, H.; Messina, M.; Monti, S.; Cascione, L.; Bruscaggin, A.; Spaccarotella, E.; Holmes, A. B.; Arcaini, L.; Lucioni, M.; Tabbo, F.; Zairis, S.; Diop, F.; Cerri, M.; Chiaretti, S.; Marasca, R.; Ponzoni, M.; Deaglio, S.; Ramponi, A.; Tiacci, E.; Pasqualucci, L.; Paulli, M.; Falini, B.; Inghirami, G.; Bertoni, F.; Foa, R.; Rabadan, R.; Gaidano, G.; Rossi, D. (2016). "The genetics of nodal marginal zone lymphoma". Blood. 128 (10): 1362–1373. doi:10.1182/blood-2016-02-696757. ISSN 0006-4971.
  45. Nodal marginal zone lymphoma . Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/nodal-marginal-zone-lymphoma/?region=nb Accessed on March 4, 2016

Template:WH Template:WS