Moureiden Z, Tashkandi H, Hussaini MO. Sclerotic marginal zone lymphoma: A case report. World J Methodol 2023; 13(4): 366-372 [PMID: 37771876 DOI: 10.5662/wjm.v13.i4.366]
Corresponding Author of This Article
Mohammad Omar Hussaini, MD, Associate Professor, Director, Pathology and Laboratory Medicine, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, United States. mohammad.hussaini@moffitt.org
Research Domain of This Article
Pathology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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World J Methodol. Sep 20, 2023; 13(4): 366-372 Published online Sep 20, 2023. doi: 10.5662/wjm.v13.i4.366
Sclerotic marginal zone lymphoma: A case report
Zade Moureiden, Hammad Tashkandi, Mohammad Omar Hussaini
Zade Moureiden, Hammad Tashkandi, Mohammad Omar Hussaini, Pathology and Laboratory Medicine, Moffitt Cancer Center, Tampa, FL 33612, United States
Author contributions: Moureiden Z, Tashkandi H, and Hussaini MO contributed to the conception and design of the study, acquisition and analysis of data; Moureiden Z and Hussaini MO drafted the manuscript or figures.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammad Omar Hussaini, MD, Associate Professor, Director, Pathology and Laboratory Medicine, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, United States. mohammad.hussaini@moffitt.org
Received: June 14, 2023 Peer-review started: June 14, 2023 First decision: July 7, 2023 Revised: August 4, 2023 Accepted: August 23, 2023 Article in press: August 23, 2023 Published online: September 20, 2023 Processing time: 97 Days and 11.6 Hours
Abstract
BACKGROUND
Marginal zone lymphoma (MZL) is an indolent non-Hodgkin B cell lymphoma with various architectural pattern including perifollicular, follicular colonization, nodular, micronodular, and diffuse patterns. A sclerotic variant has not been previously reported and represents a diagnostic pitfall.
CASE SUMMARY
A 66-year-old male developed left upper extremity swelling. Chest computed tomography (CT) in September 2020 showed 14 cm mass in left axilla. Needle core biopsy of axillary lymph node showed sclerotic tissue with atypical B lymphoid infiltrate but was non-diagnostic. Excisional biopsy was performed for diagnosis and showed extensive fibrosis and minor component of infiltrating B cells. Flow cytometry showed a small population of CD5-, CD10-, kappa restricted B cells. Monoclonal immunoglobulin heavy chain and light chain gene rearrangement were identified. Upon being diagnosed with MZL, patient was treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone and achieved complete remission by positron emission tomography/CT.
CONCLUSION
This is an important case report because by morphology this case could have easily been overlooked as non-specific fibrosis with chronic inflammation representing a significant diagnostic pitfall. Moreover, this constitutes a new architectural pattern. While sclerotic lymphomas have rarely been described (often misdiagnosed as retroperitoneal fibrosis), we do not know of any cases describing this architectural presentation of MZL.
Core Tip: In the clinical context of suspicious lymphadenopathy, the presence of an extensive sclerosis on biopsy should not deter the clinician from a diagnosis of lymphoma, and careful evaluation and work up is needed to exclude covert lymphoma.
