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Case 35 - Discussion

Hematopathology Case

 

Small B-cell lymphoma, most consistent with nodal marginal zone B-cell lymphoma

  • Positive: CD79a, focal CD20 and BCL2
  • Negative: CD5, BCL1, BCL6 and CD10
  • ISH: Kappa restriction.
  • The lymph node architecture is effaced by nodular proliferation of small lymphocytes. The tumor cells have slightly irregular nuclei with occasional small nucleolus. The major differential diagnosis includes follicular lymphoma, mantle cell lymphoma, and nodal marginal zone lymphoma. The cytologic features and lack of BCL6 and CD10 expression are against  follicular lymphoma. The negative BCL1 staining is also against mantle cell lymphoma. Overall, a nodal marginal zone lymphoma is favored.