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Tissue Eosinophilia in B-cell Lymphoma: An Underrecognized Phenomenon
Ting Zhou1, Hao Wei Wang1, Siok Bian Ng1
1Laboratory of Pathology, Hematopathology Section.
The American Journal of Surgical Pathology
|November 21, 2023
Summary
Tissue eosinophilia in B-cell lymphomas presents diagnostic challenges. Nodal marginal zone lymphoma is the most common type, often showing plasmacytic differentiation and increased vascularity, mimicking T-cell lymphomas.
Area of Science:
- Hematopathology
- Oncology
- Immunology
Background:
- Tissue eosinophilia is a rare finding in B-cell lymphomas, often causing diagnostic confusion with T-cell lymphomas.
- Limited research exists on this phenomenon, necessitating further investigation to improve diagnostic accuracy.
Purpose of the Study:
- To investigate the clinicopathological features of B-cell lymphomas exhibiting significant tissue eosinophilia.
- To enhance understanding and awareness of eosinophilia in B-cell lymphomas for improved diagnosis.
Main Methods:
- Analysis of 54 B-cell lymphoma cases with tissue eosinophils.
- Review of clinical data, hematoxylin and eosin staining, immunohistochemistry, and PCR-based clonality analysis.
Main Results:
- Nodal marginal zone lymphoma (NMZL) was the most frequent type (26/54 cases).
- Common features included plasmacytic differentiation, increased vascularity, perivascular neoplastic cell distribution, and a T-cell/histiocyte-rich microenvironment.
- Diagnostic clues for B-cell lymphoma included B-cell atypia, lack of follicular dendritic cell meshwork expansion, and specific morphological patterns in diffuse large B-cell lymphoma.
Conclusions:
- Tissue eosinophilia occurs in various B-cell lymphomas, particularly those with post-germinal center differentiation.
- Recognizing these features is crucial to differentiate from T-cell lymphomas and avoid misdiagnosis.
