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Cytomorphological and clinicopathological spectrum of pulmonary marginal zone lymphoma: the utility of immunophenotyping, PCR and FISH studies
Author(s) -
Ko H. M.,
Geddie W. R.,
Boerner S. L.,
Rogalla P.,
Cunha Santos G.
Publication year - 2014
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12119
Subject(s) - immunophenotyping , medicine , fish <actinopterygii> , pathology , immunology , biology , antigen , fishery
Objective To review cytomorphological criteria and clinicopathological findings in combination with ancillary tests for the specific diagnosis of pulmonary marginal zone lymphoma ( MZL ) in fine needle aspiration ( FNA ) specimens. Methods Cases of pulmonary MZL diagnosed using cytological specimens from 2005 to 2012 were retrieved and reviewed by three cytopathologists. Results of immunophenotypic analysis, interphase fluorescence in situ hybridization ( FISH ) and molecular assays were collated, together with clinical information and imaging data. Concurrent surgical biopsies were also retrieved. Results Fifteen lung FNA specimens were identified. The smears consisted predominantly of small centrocyte‐like cells. Marked plasma cell differentiation was evident in 11 cases. All cases with slides available showed tissue fragments with lymphoid tangles ( TFLT s). Multinucleated giant cells were present in nine cases, two of which showed granulomas. Immunophenotyping confirmed B ‐cell clonality in all cases. B‐cell clonality was detected by polymerase chain reaction ( PCR ) in two samples. FISH identified MALT 1 translocation in four of 10 cases tested and trisomy 3 in three of four cases. Concurrent surgical biopsies were diagnosed independently as MZL in seven cases. Conclusions Cytology smears from lung FNA samples consisting of small lymphoid cells with a relative abundance of plasma cells or plasmacytoid cells and large TFLT s should prompt immunophenotyping and other ancillary studies, even if multinucleated giant cells and poorly formed granulomas are also identified. Specific diagnosis of pulmonary MZL in FNA samples can be rendered on the basis of morphological features coupled with the demonstration of B‐cell clonality by immunophenotyping or PCR and cytogenetic abnormalities by FISH .