Lymphoepithelial lesions (LELs) are a useful diagnostic feature of extranodal marginal zone B-cell lymphoma (EMZL); however, there is scant literature comparing their frequency and morphology at various sites.
To evaluate any diagnostically useful, site-specific, morphologic patterns in EMZLs.
In this retrospective review, we evaluated 136 EMZLs from different sites for LEL pattern and other pathologic differences, including CD43 coexpression and plasma cell component features.
Prominent and destructive LELs were most common in salivary and thyroid gland cases, and LELs were rare to absent in breast, skin, and ocular adnexa cases. An LEL pattern with lymphocytes "stuffing" glandular lumina was seen in lung, thyroid, and salivary gland cases. Monoclonal plasma cells were most common in breast, upper aerodigestive tract, skin, and salivary gland cases. CD43 coexpression was seen in 36% of cases, most commonly in salivary gland, stomach, and upper aerodigestive tract.
The relative importance of LEL pattern, CD43 coexpression, and clonal plasma cell component in EMZLs is site-dependent, and the differences may aid in the diagnosis of EMZLs at different anatomic sites.
"Morphological features helpful in the diagnosis of MALT lymphoma include bona fide epithelial and mucosal injury, typified by the so-called “lymphoepithelial lesion”, a characteristic but nonspecific infiltration of epithelial structures by lymphoma cells (Figure 3) [6, 7, 52]. Care must be taken to avoid overinterpretation of such lesions, however, as they may also appear in benign settings including reactive lymphoid infiltrates and in crypts adjacent to normal Peyer's patches. "
[Show abstract][Hide abstract] ABSTRACT: Helicobacter pylori-related extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue is a paradigm for malignancy arising in an inflammatory background. While the diagnosis of H. pylori gastritis is often straightforward, distinction between severe gastritis and early lymphoma can be difficult and requires careful assessment of clinical findings in addition to histological features and immunohistochemical results. A number of cytogenetic abnormalities have been discovered in H. pylori-related lymphomas and several have clinical importance, related to the responsiveness of lymphoma to H. pylori eradication therapy, but routine molecular studies are not widely utilized. While molecular methods may be used in equivocal cases, a trial of conservative therapy is warranted given the propensity for these lymphomas to regress with eradication of the
organism. Once therapy is initiated, care must be taken to avoid a premature assignment of disease refractoriness because complete response can take several months to more than a year. Cases truly refractory to H. pylori eradication therapy may be treated with adjuvant chemoradiation with a high response rate.
Pathology Research International 01/2011; 2011(15):193149. DOI:10.4061/2011/193149
[Show abstract][Hide abstract] ABSTRACT: Mucosa-associated lymphoid tissue (MALT) lymphoma is listed in the new World Health Organization classification as extranodal marginal zone B-cell lymphoma of MALT. Most cases occur predominantly in adults and are rare in children or adolescents. We report, with a review of earlier literature, a MALT lymphoma of the lower lip in a 7-year-old immunocompetent child. The patient had a sessile, indurated, and firm mass on the lower lip without regional lymphadenopathy. Microscopically, dense lymphoid cell infiltrates composed of small- to medium-sized centrocyte-like cells and plasmacytoid cells infiltrating around scattered reactive germinal centers were observed, with formation of typical lymphoepithelial lesions. Immunohistochemical staining demonstrated positivity of atypical lymphoid cells for CD20, CD43, CD79a, and Bcl-2 and negativity for CD3, CD5, CD10, CD23, Ki-1, Bcl-10, and ALK. Cytoplasmic kappa light chain restriction was demonstrated. We conclude that this case represents the youngest patient with a MALT lymphoma of the lip.
[Show abstract][Hide abstract] ABSTRACT: This chapter provides an overview of lymphomas and related tumors presenting at extranodal locations. Commonalities and differences
in the approach to diagnosis, staging, and their pathogenesis are summarized. Intrinsic tumors of the thymus are also discussed.
KeywordsExtranodal lymphoma, incidence by site–Skin, lymphomas–Brain, lymphoma–Central nervous system, lymphoma–Head and neck, lymphoma–Thyroid, lymphoma–Lung, lymphoma–Small bowel, lymphoma–Liver–Lymphoma–Testes, adrenal, lymphoma–Ovary, lymphoma–Endometrium, lymphoma–Thymus, maturation–Thymus, B cells–Thymoma, classification–Thymic carcinoma–Lymphoblastic lymphoma, mediastinal–Hodgkin lymphoma, thymus–Mediastinal B-cell lymphoma, thymic origin
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