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Sugita Y, Hashimoto G, Fukuda K, Takahashi K, Shioga T, Furuta T, Arakawa F, Ohshima K, Nakamura H, Miyata H, Watanabe M, Kakita A. Primary Nondural Central Nervous System Marginal ZoneB-Cell Lymphoma of the Mucosa-Associated Lymphoid Tissue Type Mimicking CNS Inflammatory Diseases. J Neuropathol Exp Neurol 2021; 80:789-799. [PMID: 34383910 DOI: 10.1093/jnen/nlab058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Marginal zone B-cell lymphomas (MZBCLs) are non-Hodgkin lymphomas arising from postgerminal center marginal zone B cells. MZBCLs are subclassified into extranodal, nodal, and splenic MZBCLs. Primary nondural central nervous system (CNS) MZBCLs of the mucosa-associated lymphoid tissue (MALT) type are among the extranodal examples. Their clinicopathological features are not well characterized. Therefore, the clinicopathological features of 8 primary nondural CNS MZBCLs of the MALT type were assessed to establish their pathological diagnostic criteria. Histologically, all cases of primary nondural CNS MZBCLs of the MALT type showed perivascular expansive monotonous proliferation of small atypical B lymphoid cells with plasma cell differentiation, low Ki-67 labeling index, and minimal invasion from the perivascular space. In addition, no vascular changes such as glomeruloid changes, obliterative fibrointimal proliferation, and intramural lymphocytic infiltration were seen. These key histological characteristics should be considered when diagnosing cases that are suspected to be primary nondural CNS MZBCLs of the MALT type. Additionally, regarding PCR for the detection of immunoglobulin heavy variable gene and T-cell receptor γ gene rearrangements, the former is detected, but the latter is not detected in all cases. Therefore, PCR detection including sequence analysis should be added when diagnosing difficult cases based on the key histological characteristics.
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Affiliation(s)
- Yasuo Sugita
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Go Hashimoto
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Kenji Fukuda
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Kenji Takahashi
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Taro Shioga
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Takuya Furuta
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Fumiko Arakawa
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Koichi Ohshima
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Hideo Nakamura
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Hajime Miyata
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Masashi Watanabe
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Akiyoshi Kakita
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
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