FOLLICULAR LYMPHOMA WITH INVOLVEMENT OF THE SPLENIC MARGINAL ZONE - APITFALL IN THE DIFFERENTIAL-DIAGNOSIS OF SPLENIC MARGINAL ZONE CELL LYMPHOMA

Follicular lymphomas (FL) involving the spleen arise in and expand the germinal centers of the white pulp, whereas mantle cell lymphomas ari se in the mantle zone and surround the benign germinal center. The rec ently described marginal zone cell lymphoma (MZCL) is a B-cell neoplas m characterized by concentric expansion of cells around the follicle, with or without infiltration of the mantle zone or germinal center. In addition, the immunoglobulin heavy chain gene is rearranged although none of the MZCL reported have been shown to be positive for the bcl-2 gene translocation by molecular studies. We report a patient with FL showing preferential involvement of the marginal zone of spleen morpho logically mimicking a primary splenic MZCL. The patient reported here had a well-documented previous lymph node diagnosis of FL The immunogl obulin heavy chain gene and bcl-2 gene rearrangement analysis confirme d the clonal origin of both the original FL, as well as the lymphoma, with a marginal zone pattern in the spleen. (C) 1996 by W.B. Saunders Company