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Histopathologic Features of Splenic Small B-Cell Lymphomas
A Study of 42 Cases With a Definitive Diagnosis by the World Health Organization Classification

Rina Kansal MD, Charles W. Ross MD, Timothy P. Singleton MD, William G. Finn MD, Bertram Schnitzer MD
DOI: http://dx.doi.org/10.1309/HWG084N3F3LRJ8XB 335-347 First published online: 1 September 2003

Abstract

We studied 42 cases of splenic small B-cell lymphoma (SBL) (21 women, 21 men; aged 32–82 years; median, 65 years) with a definitive diagnosis by the World Health Organization classification: chronic lymphocytic leukemia (CLL), 8; mantle cell lymphoma (MCL), 9; follicular lymphoma (FL), 12; marginal zone lymphoma, 13 (splenic [SMZL], 12; extranodal [EMZL], 1). Splenectomy was performed for diagnosis or therapy; splenic weights were 0.2 to 3.8 kg (median, 1.4 kg). In general, splenic SBLs showed white pulp (WP) expansion; morphologic features of the nodules recapitulated the corresponding lymph node histopathologic features. “Marginal zones” were observed commonly in SMZL and FL, may be present in MCL involving the spleen, and may be seen in hilar lymph nodes (HLNs) in SBLs other than SMZL. FL may simulate SMZL and can be distinguished by the presence of neoplastic follicles and HLN morphologic features. Extracellular hyaline deposits (EH) are common in FL and SMZL. MCL typically shows WP expansion by a monotonous small lymphocytic infiltrate, without diffuse red pulp (RP) infiltration or EH; leukemic MCL may show RP infiltration. Splenic morphologic features in CLL vary in WP or RP dominance; marginal zones usually are not observed in CLL.

Key Words:
  • Splenic lymphoma
  • Marginal zone
  • Small B-cell
  • Mantle cell lymphoma
  • Follicular lymphoma
  • Chronic lymphocytic leukemia
  • Small lymphocytic lymphoma
  • WHO classification