Sclerotic marginal zone lymphoma: A case report.

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Marginal zone lymphoma (MZL) is an indolent non-Hodgkin B cell lymphoma.
• MZL presents with various architectural patterns, but a sclerotic variant has not been previously reported.
• This sclerotic variant can be a diagnostic pitfall.

Observation:

• A 66-year-old male presented with left upper extremity swelling due to a large axillary mass.
• Initial needle core biopsy showed sclerotic tissue with atypical B lymphoid infiltrate, proving non-diagnostic.
• Excisional biopsy revealed extensive fibrosis with a minor component of infiltrating B cells, confirmed as MZL by flow cytometry and gene rearrangement studies.

Findings:

• The patient was diagnosed with marginal zone lymphoma (MZL).
• The lymphoma exhibited an unusual sclerotic architectural pattern characterized by extensive fibrosis.
• Immunophenotyping and molecular studies confirmed a clonal B cell population.

Implications:

• This case report describes a novel sclerotic architectural pattern of marginal zone lymphoma.
• The sclerotic presentation can be mistaken for non-specific fibrosis, posing a significant diagnostic challenge.
• Recognition of this pattern is crucial for accurate diagnosis and appropriate management of MZL.