Relapsed Splenic Marginal Zone Lymphoma
Lessons From the Friday Unknowns
The patient has a history of splenic marginal zone lymphoma.
Histologic sections show small needle-shaped fragments of tissue diffusely replaced by sheets of small to medium-sized relatively monotonous lymphoid cells with slightly irregular nuclei.
Immunostains for CD3, CD5, CD20, Pax5, CD21, cyclin D1, SOX11, and Ki-67 are performed. Stains for CD3 and CD5 highlight scattered T-cells. Stains for CD20 and Pax5 highlight sheets of B-cells with vague nodularity. CD21 highlights expanded FDC meshwork. The Ki-67 proliferation rate is ~10%. Stains for cyclin D1 and SOX11 are pending.
Flow cytometric analysis on a concurrent FNA specimen shows a population of kappa monotypic B-cells (~12.2%) positive for CD19, CD20, CD22, CD38, CD44, and CD200(partial), and negative for CD5, CD10, CD11c, CD23, CD30, CD43, and ROR1.
These findings are consistent with replase of patient’s known splenic marginal zone lymphoma.
Link to digital slides: https://bit.ly/3pOrprh | Case 3
