56 yrs old female presents with lymphadenopathy.
HISTO: The architecture partially obliterated (single FC are still remain). There is prominent marginal zone expansion/pattern with confuent and nodular formations consisting of small cc like cells with admixture of pmn's, macrophages and single activated cells/immunoblasts. There are any granulomas, MASSIVE clustering of macrophages (single accumulations only), necrosis and other signs of well known reactive lymphadenopathies.
IH (marginal zone): CD20 (+) 80% with admixture of CD3+ lympho's, Bcl 2(+) 30%, CD43 (+) 30% (in SINUS the expression is more prominent, maybe due to normal cells admixture?), Ki67 <10%, IgD/IgM(-)(I do not believe in Ig stains:)), single CD68+ macrophages and single clusters with some larger nuclei,
CyclinD1/CD34(-). Ig kappa/lambda- "backgroud noise" only (uninformative as usual).
"WORKING FORMULATION": Marginal zone lymphoma.
DISCUSSION: Differential of reactive and malignant marginal proliferations.
THE QUALITY IS NOT OPTIMAL (external blocks). IMMUNOREACTIVITY IS LOW, ESP. NUCLEAR REACTIONS!
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