Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma

TLDR

Mediterranean lymphoma and Western primary gastrointestinal follicle‑center cell lymphoma exhibit striking morphologic and immunohistochemical similarities, including dense monotypic lamina propria plasma cell infiltrates, invasive follicle‑center cells, and gland‑invasive lesions that reflect shared gut‑associated lymphoid tissue maturation. Clonal analysis demonstrates that the lamina propria plasma cells and invasive follicle‑center cells are related, confirming a long‑suspected clonal link in these lymphomas. These data support a common histogenesis of Mediterranean lymphoma and Western primary gastrointestinal follicle‑center cell lymphoma from mucosa‑associated lymphoid tissue.

Abstract

As illustrated in the two cases described in this paper close morphologic and immunohistochemical similarities exist between Mediterranean lymphoma (MTL) and primary gastrointestinal lymphoma of follicle center cell (FCC) origin as it occurs in Western countries. Similarities between the two conditions include a dense noninvasive monotypic lamina propria plasma cell infiltrate, present in all cases of MTL and in some cases of Western gastrointestinal FCC lymphoma, and an invasive infiltrate of FCCs morphologically distinct from the plasma cells. A distinctive lesion produced by individual gland invasion characterizes both types of lymphoma. A clonal relationship between the lamina propria plasma cells and the invasive FCCs, long suspected but never proved in MTL, can be demonstrated in Western cases. Many of the histologic and clinical features common to these lymphomas can be explained in the context of the normal maturation sequences of gut associated lymphoid tissue. It is suggested that MTL and Western cases of primary FCC gastrointestinal lymphoma share a common histogenesis from mucosa associated lymphoid tissue.