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[Clinicopathologic features and differential diagnosis of splenic B-cell marginal zone lymphoma involving bone marrow].
[waldenström macroglobulinemia]
To
study
the
clinicopathologic
features
and
differential
diagnosis
of
splenic
B-
cell
marginal
zone
lymphoma
(
SMZL
)
involving
bone
marrow
.
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
.
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
CD
19
(
+
)
CD
2
0
(
+
)
FMC
7
(
+
)
CD
22
(
+
)
CD
10
(
-
)
CD
2
(
-
)
CD
3
(
-
)
CD
7
(
-
)
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
(
CD
2
3
(
+
)
bcl-
2
(
-
)
)
was
found
in
2
cases
(
91
.
0
%
)
.
Immunohistochemical
study
showed
the
following
results
:
CD
2
0
(
+
)
PAX
5
(
+
)
CD
3
(
-
)
CD
5
(
-
)
CD
10
(
-
)
cyclin
D
1
(
-
)
CD
2
3
(
-
)
CD
4
3
(
-
)
Annexin
A
1
(
-
)
CD
11
C
(
-
)
CD
2
5
(
-
)
in
all
the
22
cases
,
CD
38
(
+
)
in
2
cases
(
9
.
1
%
)
and
CD
138
(
+
)
in
2
cases
(
9
.
1
%
)
.
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
.
Diseases
Validation
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"bone marrow involvement"
symptom
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waldenström macroglobulinemia
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