Nodal Marginal Zone Lymphoma with Aberrant CD10 Expression: A Case Report and Literature Review

Buer Song, Nan Zhang, Yan Zheng, Christopher A. D’Angelis, Donghong Cai


CD10+ nodal marginal zone lymphoma is very rare, with only one case report in the English literature currently. Here we report a case of nodal marginal zone lymphoma with strong CD10 expression occurring in a 76 year-old female with extensive lymphadenopathy. The lymph node biopsy showed a population of small lymphocytes diffusely infiltrating into the interfollicular areas and colonizing disrupted follicles. Immunohistochemical staining revealed that these small lymphocytes were positive for CD20, PAX-5, Bcl-2 and bright CD10.  Bcl-6, Cyclin D1 and CD43 were negative in this population of cells. In contrast, the residual germinal center B-cells demonstrated expression of CD10 and Bcl-6 and negative staining for Bcl-2. Flow cytometry study demonstrated a CD10+CD20+ kappa-restricted B-cell lymphoma. FISH studies for translocation of IgH, Bcl-2 and Bcl-6 were negative. Therefore, a diagnosis of CD10+ nodal marginal zone lymphoma was established. This rare disease entity illustrates a possible diagnostic pitfall within the group of mature small B-cell lymphomas, especially for follicular lymphomas with a diffuse pattern. The clinical significance of CD10 positivity in nodal marginal zone lymphomas is unknown. More cases and additional clinical follow up are required to address this question.


CD10, nodal marginal zone lymphoma, follicular lymphoma with a diffuse pattern

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