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Case 157 - Discussion

Hematopathology Case

 

Marginal Zone Hyperplasia of Spleen

  • Marginal zone > 12 cell layers

  • Well circumscribed marginal zone without involvement of the red pulp

  • Preserved periarterial T-cell zone and lymphoid follicles

  • Mixed population of lymphocytes

  • Presence of granulocytes

  • CD43-

  • DDX: marginal zone lymphoma of spleen

    • Spleen usually markedly enlarged grossly with numerous miliary white nodules throughout the spleen;

    • Mainly white pulp pattern, which are prominently expanded with irregular borders;

    • Nearly always involves bone marrow, with nodular infiltration and characteristic sinusoidal infiltration (better seen on CD20 staining);

    • Often circulating tumor cells in the peripheral blood;

    • May be associated with monoclonal gammopathy, IgG or IgM;

    • ~50% cases positive for 7q-.