Primary Spinal Marginal Zone Lymphoma - Case Report and Review of the Literature.

Feb 2012

Ahmadi SA, Frank S, Hänggi D, Eicker SO.

Source

1Department of Neurosurgery, Heinrich-Heine-University, Düsseldorf, Germany, Email: ahmadi@med.uni-duesseldorf.de, Phone: +49 176 66 88 9045, Fax: +49 211 81 16509 2Division Neuropathology - Institute of Pathology, University Hospital Basel, Schönbeinstr. 40, CH-4031 Basel 3Department of Neurosurgery, Heinrich-Heine-University, Düsseldorf, Germany. Email: sven.eicker@med.uni-duesseldorf.de.

Abstract

BACKGROUND AND IMPORTANCE:

Marginal zone lymphoma (MZL) describes a heterogeneous group of indolent B-celllymphomas. The World Health Organization recognizes 3 types of MZLs: splenic MZL (SMZL), nodal MZL (NMZL) and extranodal MZL of mucosa-associated lymphoid tissue (MALT). There is no consensus on the optimal adjuvant treatment modalities for intracranial primary MZLs. To date, no case of spinal primary MZL has been reported.

CLINICAL PRESENTATION:

We present the first case of spinal MZL diagnosed in a 65 year-old male suffering from progressive paraparesis. He underwent surgical removal of the main spinal tumor mass, which extended epidurally from vertebral body T3 to T7. Surgery was followed by 10 sessions of local irradiation for a total dose of 31 Gy. On long-term follow-up in 2010, the patient was in good health without any signs of residual or recurrent disease. Twenty-seven publications reporting on 61 cases of intracranial primary MZL were identified and reviewed. In the majority of cases ofmarginal zone B-cell lymphoma (MZBCL), adjuvant radiotherapy was employed, with some combining radiotherapy and chemotherapy after surgical removal of the main tumor bulk. Long-term follow-up in most patients showed no evidence of disease and clinical well-being years after the initial diagnosis.

CONCLUSION:

Chemotherapy and/or radiation have been employed in larger case series. While there is no defined treatment guideline for this rare disease entity, our review of the literature suggests a favorable prognosis when combining both surgical and adjuvant radiotherapy approaches.

Neurogsurgery

CD5-positive marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) of the lung.

Feb 2012

Terada T.

Abstract

CD5-positive marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) of the lung is very rare. An 82-year-old Japanese woman was found to have an abnormal lung shadow on chest X-ray photography, and was admitted to our hospital. Imaging modalities including X-ray photography, computed tomography, and magnetic resonance imaging showed a small (2 x 1 x 1 cm) opacity of the right upper lobe. Transbronchial lung biopsy was performed. It showed severe proliferation of small lymphocytes. The small lymphocytes were centrocytes-like, and minor plasma cell differentiation was recognized. Lymphoepithelial lesions were scattered. Immunohistochemically, the tumor cells were positive for CD5, CD20, CD43, CD45, CD79alpha, bcl-2, and kappa-chain, but negative for CD2, CD3, CD10, CD21, CD23, CD35, CD45RO, CD56, IgA, IgG, IgM, IgD, lambda-chain, TdT, and cyclin D1. The Ki-67 labeling was 10%. CD3-positive and CD45RO-positive inflammatory T-cells were scattered in small amount. The pathological diagnosis was CD5-positive marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) of the lung. The patient was treated with chemotherapy (CHOP: cyclophosphamide, hydroxydaunorbicin, vincristine, and predonisone), and the lung tumor disappeared. The patient is now free of the lymphoma 10 years after the first manifestation. Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1541653085652296.

BioMed

Characterization of chromosomal aberrations in thymic MALT lymphoma.

Feb 2012

Kominato S, Nakayama T, Sato F, Yamada S, Xia H, Fujiyoshi Y, Hattori H, Inagaki H.

Source

Department of Pathology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.

Abstract

Mucosa-associated lymphoid tissue (MALT) lymphoma arising in the thymus is a rare disorder that shows a strong association with autoimmune disease. Several MALT-lymphoma-specific and -associated chromosomal abnormalities, including t(11;18), t(14;18), t(1;14), trisomy 3 and trisomy 18, are known to occur. The former translocation results in apoptosis inhibitor 2 gene (API2)-MALT lymphoma-associated translocation 1 (MALT1) fusion. In this study, we examined 14 cases of thymic MALT lymphomas for API2-MALT1 fusion using multiplex reverse transcription polymerase chain reaction and looked for trisomy 3, trisomy 18 and abnormalities of MALT1 and IGH genes using fluorescence in situ hybridization. Thymic MALT lymphoma cases had a high frequency of trisomy 3 (7/14 cases), a very low incidence of trisomy 18 (1/14) and no detectable MALT1-associated (0/13) or IGH-associated (0/13) gene abnormalities including t(11;18). A review of the literature showed that the pattern of chromosomal aberrations in thymic MALT lymphoma was similar to those of thyroid and salivary gland MALT lymphomas. Although frequently detected, trisomy 3 was not associated with any of the clinicopathological factors analyzed, suggesting that trisomy 3 may play a role in lymphoma development. In conclusion, the present study showed that thymic MALT lymphoma has a characteristic pattern of chromosomal aberrations that may be similar to those of other autoimmune-associated MALT lymphomas.

Wiley Online Library

Primary extranodal marginal zone lymphoma - Epididymis.

Oct 2011

Rajaian S, Manipadam MT, Nair S, Kekre NS.

Source

Department of Urology, Christian Medical College Hospital, Ida Scudder Road, Vellore, Tamilnadu, India.

For correspondence: Prof. Nitin S. Kekre, Department of Urology, Christian Medical College Hospital, Ida Scudder Road, Vellore, Tamilnadu-632 004, India. E-mail: uro2@cmcvellore.ac.in

Abstract

An elderly male presented with painful swelling in the right side of scrotum. He was treated with antibiotics for epididymoorchitis without any response. Ultrasound examination revealed a hypoechoic vascular mass in the tail of the epididymis. Fine needle aspirate cytology was inconclusive. Excision of the mass was done and biopsy revealed primary extranodal marginal zone lymphoma arising from mucosa associated lymphoid tissue (MALT) of epididymis. Marginal zonelymphoma arising from the MALT of epididymis is very rare. Lymphoma should be considered as a differential diagnosis of any epididymal swelling unresponsive to conservative treatment. We report a rare case of primary extranodal marginallymphoma of MALT arising from epididymis.

Indian Journal of Urology

Clinical manifestations of primary pulmonary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue in Japanese population.

Jan 2012

Ogusa E, Tomita N, Ishii Y, Takasaki H, Hattori Y, Matsumoto C, Ishigatsubo Y.

Source

Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan.

Abstract

We retrospectively analysed 16 cases of newly diagnosed pulmonary mucosa-associated lymphoid tissue (MALT)lymphoma in the Japanese population. The disease was found on the basis of examination findings in 14 cases, and clinical manifestations in 2. According to the extensive staging procedure, four patients had concomitant gastric involvement. Primary treatment involved surgery alone in two patients; surgery followed by rituximab (R)-containing chemotherapy in two; R-containing chemotherapy alone in 11; and chemoradiotherapy without R in one. Over the median observation period of 28 months, disease progression was recorded in three patients, but all 16 patients were alive at the end of the observation period. One patient was treated with R alone and achieved partial remission; subsequent tentative surgery showed no evidence of residual lymphoma. It has been 72 months of progression-free survival after the diagnosis. Primary pulmonaryMALT lymphoma exhibited an indolent clinical course. R has potential as a therapeutic agent in patients with pulmonaryMALT lymphoma.

Keywords:

• MALT lymphoma;
• lung;
• rituximab

Wiley Online

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Lack of association of conjunctival MALT lymphoma with Chlamydiae or Helicobacter pylori in a cohort of Chinese patients.

Feb 2012

Cai JP, Cheng JW, Ma XY, Li YZ, Li Y, Huang X, Wei RL.

Source

Department of Ophthalmology, Shanghai Changzheng Hospital, 2nd Military Medical University, Shanghai, China.

Abstract

Background:

This study was conducted to detect microbial pathogens in conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma specimens in an attempt to determine possible associations between conjunctival MALT lymphoma and microbial infections.

Material/Methods:

Using PCR technique, freshly obtained tumor specimens from 16 cases of conjunctival MALT lymphoma, as confirmed by postoperative pathology, were analyzed for DNA of Chlamydia psittaci (C. psittaci), Chlamydia trachomatis (C. trachomatis), Chlamydia pneumoniae (C. pneumoniae) and Helicobacter pylori (H. pylori). Synthetic C. psittaci, C. trachomatis, C. pneumoniae and H. pylori DNA were used as positive control, and blank plasmid DNA as negative control.

Results:

Electrophoresis showed that no bands corresponding to the positive control were observed in the specimens, indicating that no DNA of the 4 microorganisms was detected in the specimens of the 16 cases of conjunctival MALT lymphoma.

Conclusions:

The PCR technique was able to detect the positive control quickly and accurately, but the results of PCR in analyzing the 16 specimens were negative, indicating that there is no association between conjunctival MALT lymphoma and the 4 microorganisms in Chinese patients.

PubMed