Nodal Marginal Zone B-Cell Lymphoma of a Single Lymph Node in the Adult Neck:Report of One Case

Panpan LI, Yaping LUO, Xiaohua SHI, Yu CHEN, Fengdan WANG, Tong SU, Zhuhua ZHANG, Feng FENG, Zhengyu JIN

Acta Academiae Medicinae Sinicae ›› 2025, Vol. 47 ›› Issue (4) : 651-659.

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Acta Academiae Medicinae Sinicae

Abbreviation (ISO4): Acta Academiae Medicinae Sinicae      Editor in chief: Xuetao CAO

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Acta Academiae Medicinae Sinicae ›› 2025, Vol. 47 ›› Issue (4) : 651-659. DOI: 10.3881/j.issn.1000-503X.16355
Case Reports

Nodal Marginal Zone B-Cell Lymphoma of a Single Lymph Node in the Adult Neck:Report of One Case

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Abstract

Nodal marginal zone B-cell lymphoma(NMZL),the least common subtype of marginal zone lymphoma,represents a low-grade malignancy arising from the marginal zone of lymph node follicles,composed of small B-cells with an inert non-Hodgkin lymphoma nature.It accounts for 1.5% to 1.8% of all non-Hodgkin lymphomas and 10% of all marginal zone lymphomas.The low incidence and lack of typical clinical and pathological features pose a challenge to the diagnosis and clinical management of NMZL.In this article,we reported the diagnosis and treatment of a case of NMZL located in the parapharyngeal space of the left neck and reviewed the relevant literature from both domestic and international sources.We summarized the clinical manifestations,histopathological features,immunohistochemical characteristics,imaging features,diagnosis and treatment modalities,and prognosis of NMZL.

Key words

marginal zone lymphoma / clinical characteristics / treatment / prognosis

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Panpan LI , Yaping LUO , Xiaohua SHI , et al . Nodal Marginal Zone B-Cell Lymphoma of a Single Lymph Node in the Adult Neck:Report of One Case[J]. Acta Academiae Medicinae Sinicae. 2025, 47(4): 651-659 https://doi.org/10.3881/j.issn.1000-503X.16355

References

[1]
Zucca E, Rossi D, Bertoni F. Marginal zone lymphomas[J]. Hematol Oncol, 2023, 41(1):88-91.DOI:10.1002/hon.3152.
[2]
蔡伟欣, 周美玲, 舒凌, 等. 伴单克隆IgM增高的淋巴结边缘区淋巴瘤1例并文献复习[J]. 白血病·淋巴瘤, 2022, 31(12):725-729.DOI:10.3760/cma.j.cn115356-20210825-00195.
[3]
Lee CL, Lee IS, Jung SG. A case of nodal marginal zone B-cell lymphoma of the lower eyelid[J]. Arch Craniofac Surg, 2020, 21(4):249-252.DOI:10.7181/acfs.2020.00241.
[4]
Nakamura S, Ponzoni M. Marginal zone B-cell lymphoma:lessons from Western and Eastern diagnostic approaches[J]. Pathology, 2020, 52(1):15-29.DOI:10.1016/j.pathol.2019.08.012.
[5]
Traverse-Glehen A, Bertoni F, Thieblemont C, et al. Nodal marginal zone B-cell lymphoma:a diagnostic and therapeutic dilemma[J]. Oncology(Williston Park), 2012, 26(1):92-104.
[6]
Dierlamm J, Wlodarska I, Michaux L, et al. Genetic abnormalities in marginal zone B-cell lymphoma[J]. Hematol Oncol, 2000, 18(1):1-13.DOI:10.1002/(sici)1099-1069(200003)18:1<1::aid-hon647>3.0.co;2-g.
[7]
Ikeda J, Kohara M, Tsuruta Y, et al. Immunohistochemical analysis of the novel marginal zone B-cell marker IRTA1 in malignant lymphoma[J]. Human Pathology, 2017, 59:70-79.DOI:10.1016/j.humpath.2016.09.011.
[8]
Khalil MO, Morton LM, Devesa SS, et al. Incidence of marginal zone lymphoma in the United States,2001-2009 with a focus on primary anatomic site[J]. Br J Haematol, 2014, 165(1):67-77.DOI:10.1111/bjh.12730.
[9]
Ferreri AJ, Sassone M, Kiesewetter B, et al. High-dose clarithromycin is an active monotherapy for patients with relapsed/refractory extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue(MALT):the HD-K phase Ⅱ trial[J]. Ann Oncol, 2015, 26(8):1760-1765.DOI:10.1093/annonc/mdv214.
[10]
Hanse A, Reiter K, Pruss A, et al. Dissemination of a Sjögren’s syndrome-associated extranodal marginal-zone B cell lymphoma:circulating lymphoma cells and invariant mutation pattern of nodal Ig heavy- and light-chain variable-region gene rearrangements[J]. Arthritis Rheum, 2006, 54(4):127-137.DOI:10.1002/art.21558.
[11]
Bai SJ, Geng Y, Gao YN, et al. Marginal zone lymphoma with severe rashes:a case report[J]. World J Clin Cases, 2024, 12(3):565-574.DOI:10.12998/wjcc.v12.i3.565.
[12]
刘玉珠. 头颈部原发结外非霍奇金淋巴瘤临床特征分析[D]. 乌鲁木齐: 新疆医科大学, 2021.DOI:10.27433/d.cnki.gxyku.2021.000370.
[13]
曹辉. 头颈部淋巴瘤影像特点及其与病理类型相关性研究[D]. 南京: 南京医科大学, 2020.DOI:10.27249/d.cnki.gnjyu.2020.000336.
[14]
Wang M, Guo Y, Dong L, et al. Coexistence of nodal marginal zone B-cell lymphoma and multiple myeloma:a case report and literature review[J]. Medicine, 2022, 101(17):29219.DOI:10.1097/MD.0000000000029219.
[15]
Laurent C, Cook JR, Yoshino T, et al. Follicular lymphoma and marginal zone lymphoma:how many diseases[J]. Virchows Archiv, 2023, 482(1):149-162.DOI:10.1007/s00428-022-03432-2.
[16]
张洪, 郭晶晶, 潘华雄, 等. 儿童型结内边缘区淋巴瘤一例[J]. 临床内科杂志, 2024, 41(1):60-61.DOI:10.3969/j.issn.1001-9057.2024.01.016.
[17]
Piris MA, Rivas C, Morente M, et al. Monocytoid B-cell lymphoma,a tumour related to the marginal zone[J]. Histopathology, 1988, 12(4):383-392.DOI:10.1111/j.1365-2559.1988.tb01953.x.
[18]
Sheibani K, Sohn CC, Burke JS, et al. Monocytoid B-cell lymphoma.A novel B-cell neoplasm[J]. Am J Pathol, 1986, 124(2):310-318.
[19]
Nathwani BN, Drachenberg MR, Hernandez AM, et al. Nodal monocytoid B-cell lymphoma(nodal marginal-zone B-cell lymphoma)[J]. Semin Hematol, 1999, 36(2):128-138.
[20]
Cousar JB, McGinn DL, Glick AD, et al. Report of an unusual lymphoma arisingfrom parafollicular B-lymphocytes(PBLs) or so-called monocytoid lymphocytes[J]. Am J Clin Pathol, 1987, 87(1):121-128.DOI:10.1093/ajcp/87.1.121.
[21]
Piris MA, Arribas A, Mollejo M. Marginal zone lymphoma[J]. Semin Diagn Pathol, 2011, 21(4):135-145.DOI:10.1053/j.semdp.2011.03.001.
[22]
Jiang S, Manandhar U, Zheng KP, et al. A case of nodal marginal zone lymphoma with hypersensitivity to mosquito bites as initial symptom[J]. J Cutan Pathol, 2019, 46(10):769-774.DOI:10.1111/cup.13497.
[23]
Sesboue C, Galtier J, Jeanneau M, et al. Combined reverse-transcriptase multiplex ligation-dependent probe amplification and next-generation sequencing analyses to assign unclassified BCL2/BCL6 nonrearranged small B-cell lymphoid neoplasms as follicular or nodal marginal zone lymphoma[J]. Mod Pathol, 2023, 36(2):100043.DOI:10.1016/j.modpat.2022.100043.
[24]
Pileri S, Ponzoni M. Pathology of nodal marginal zone lymphomas[J]. Best Pract Res Clin Haematol, 2017, 30(1-2):50-55.DOI:10.1016/j.beha.2016.11.001.
[25]
Van Den Brand M, Van Krieken JH. Recognizing nodal marginal zone lymphoma:recent advances and pitfalls.A systematic review[J]. Haematologica, 2013, 98(7):1003-1013.DOI:10.3324/haematol.2012.083386.
[26]
Dierlamm J, Wlodarska I, Michaux L, et al. Genetic abnormalities in marginal zone B-cell lymphoma[J]. Hematol Onco, 2000, 18(1):1-13.DOI:10.1002/(SICI)1099-1069(200003)18:1<1::AID-HON647>3.0.CO;2-G.
[27]
Diehl V, Borchmann P. Hematology/oncology clinics of North America.Hodgkin lymphoma.Preface[J]. Hematol Oncol Clin North Am, 2014, 28(1): ix-x.DOI:10.1016/j.hoc.2013.10.011.
[28]
Alderuccio JP, Lossos IS. Enhancing prognostication and personalizing treatment of extranodal marginal zone lymphoma[J]. Expert Rev Hematol, 2023, 16(5):333-348.DOI:10.1080/17474086.2023.2206557.
[29]
Cheah CY, Seymour JF. Marginal zone lymphoma:2023 update on diagnosis and management[J]. Am J Hematol, 2023, 98(10):1645-1657.DOI:10.1002/ajh.27058.
[30]
Lasica M, Anderson MA, Boussioutas A, et al. Marginal zone lymphomas:a consensus practice statement from the Australasian Lymphoma Alliance[J]. Intern Med J, 2024, 54(6):1017-1030.DOI:10.1111/imj.16390.
[31]
Zucca E, Arcaini L, Buske C, et al. Marginal zone lymphomas:ESMO clinical practice guidelines for diagnosis,treatment and follow-up[J]. Ann Oncol, 2020, 31(1):17-29.DOI:10.1016/j.annonc.2019.10.010.
[32]
Traverse-Glehen A, Baseggio L, Salles G, et al. Splenic marginal zone B-cell lymphoma:a distinct clinicopathological and molecular entity.Recent advances in ontogeny and classification[J]. Curr Opin Oncol, 2011, 23(5):441-448.DOI:10.1097/CCO.0b013e328349ab8d.
[33]
Zhou X, Wuchter P, Egerer G, et al. Serological hepatitis B virus(HBV)activity in patients with HBV infection and B-cell non-Hodgkin’s lymphoma[J]. Eur J Haematol, 2020, 104(5):469-475.DOI:10.1111/ejh.13388.
[34]
Thieblemont C. Clinical presentation and management of marginal zone lymphomas[J]. Hematology Am Soc Hematol Educ Program,2005:307-313.DOI:10.1182/asheducation-2005.1.307.
[35]
Noy A, de Vos S, Coleman M, et al. Durable ibrutinib responses in relapsed/refractory marginal zone lymphoma:long-term follow-up and biomarker analysis[J]. Blood Adv, 2020, 4(22):5773-5784.DOI:10.1182/bloodadvances.2020003121.
[36]
Berger F, Felman P, Thieblemont C, et al. Non-MALT marginal zone B-cell lymphomas:a description of clinical presentation and outcome in 124 patients[J]. Blood, 2000, 95(6):1950-1956.
[37]
Park JH, Kim S, Ryu JS, et al. Complete metabolic response(CMR)in positron emission tomography-computed tomography(PET-CT)scans may have prognostic significance in patients with marginal zone lymphomas(MZL)[J]. Hematol Oncol, 2018, 36(1):56-61.DOI:10.1002/hon.2414.
[38]
Vaxman I, Bernstine H, Kleinstern G, et al. FDG PET/CT as a diagnostic and prognostic tool for the evaluation of marginal zone lymphoma[J]. Hematol Oncol, 2019, 37(2):168-175.DOI:10.1002/hon.2578.
[39]
Noy A, de Vos S, Thieblemont C, et al. Targeting Bruton tyrosine kinase with ibrutinib in relapsed/refractory marginal zone lymphoma[J]. Blood, 2017, 129(16):2224-2232.DOI:10.1182/blood-2016-10-747345.
[40]
Al-Ibraheem A, Mottaghy FM, Juweid ME. PET/CT in Hodgkin lymphoma: an update[J]. Semin Nucl Med, 2023, 53(3):303-319.DOI:10.1053/j.semnuclmed.2022.10.006.
[41]
Salmeron-Villalobos J, Egan C, Borgmann V, et al. A unifying hypothesis for PNMZL and PTFL:morphological variants with a common molecularprofile[J]. Blood Adv, 2022, 6(16):4661-4674.DOI:10.1182/bloodadvances.2022007322.
[42]
Soriano PK, Stone T, Baqai J, et al. A case of synchronous bone marrow chronic myelomonocytic leukemia(CMML)and nodal marginal zone lymphoma(NMZL)[J]. Am J Case Rep, 2018, 19:1135-1139.DOI:10.12659/AJCR.910583.
[43]
Laurent C, Cook JR, Yoshino T, et al. Follicular lymphoma and marginal zone lymphoma:how many diseases[J]. Virchows Arch, 2023, 482(1):149-162.DOI:10.1007/s00428-022-03432-2.
[44]
Tadmor T, Polliack A. Nodal marginal zone lymphoma: clinical features, diagnosis, management and treatment[J]. Best Pract Res Clin Haematol, 2017, 30(1-2):92-98.DOI:10.1016/j.beha.2016.08.026.
[45]
Opat S, Tedeschi A, Linton K, et al. The magnolia trial:zanubrutinib,a next-generation bruton tyrosine kinase inhibitor,demonstrates safety and efficacy in relapsed/refractory marginal zone lymphoma[J]. Clin Cancer Res, 2021, 27(23):6323-6332.DOI:10.1158/1078-0432.CCR-21-1704.
[46]
Zanoni L, Bezzi D, Nanni C, et al. PET/CT in non-hodgkin lymphoma:an update[J]. Semin Nucl Med, 2023, 53(3):320-351.DOI:10.1053/j.semnuclmed.2022.11.001.
[47]
Kagan KBT, Guz D, Buchrits S, et a. Clinical and pathological predictors for FDG-PET/CT avidity in patients with marginal zone lymphoma-a retrospective cohort study[J]. Eur J Nucl Med Mol Imaging, 2022,49:2290-2299.DOI:10.1007/s00259-022-05683-2.
[48]
Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation,staging,and response assessment of Hodgkin and non-Hodgkin lymphoma:the Lugano classification[J]. J Clin Oncol, 2014, 32(27):3059-3068.DOI:10.1200/JCO.2013.54.8800.
[49]
Qian L, Soderquist C, Schrank Hacker A, et al. Deletion 20q12 is associated with histological transformation of nodal marginal zone lymphoma to diffuse large B - cell lymphoma[J]. Am J Hematol, 2020, 95(3):238-244.DOI:10.1002/ajh.25694.
[50]
Leonard JP, Trneny M, Izutsu K, et al. AUGMENT: a phase III study of lenalidomide plus rituximab versus placebo plus rituximab in relapsed or refractory indolent lymphoma[J]. J Clin Oncol, 2019, 37(14):1188-1199.DOI:10.1200/JCO.19.00010.
[51]
Thieblemont C, Davi F, Noguera ME, et al. Non-MALT marginal zone lymphoma[J]. Curr Opin Hematol, 2011, 18(4):273-279.DOI:10.1097/MOH.0b013e3283477815.
[52]
Wang H, Wan X, Zhang Y, et al. Advances in the treatment of relapsed/refractory marginal zone lymphoma[J]. Front Oncol, 2024,14:1327309.DOI:10.3389/fonc.2024.1327309.
[53]
Vanazzi A, Grana C, Crosta C, et al. Efficacy of 90Yttrium-ibritumomab tiuxetan in relapsed/refractory extranodal marginal-zone lymphoma[J]. Hematol Oncol, 2014, 32(1):10-15.DOI:10.1002/hon.2078.
[54]
Stuver R, Drill E, Qualls D, et al. Retrospective characterization of nodal marginal zone lymphoma[J]. Blood Adv, 2023, 7(17):4838-4847.DOI:10.1182/bloodadvances.2022009587.
[55]
Mintz MA, Cyster JG. T follicular helper cells in germinal center B cell selection and lymphomagenesis[J]. Immunol Rev, 2020, 296(1):48-61.DOI:10.1111/imr.12860.
[56]
Kalashnikov I, Tanskanen T, Viisanen L, et al. Transformation and survival in marginal zone lymphoma:a finnish nationwide population-based study[J]. Blood Cancer J, 2023, 13(1):62.DOI:10.1038/s41408-023-00831-9.
[57]
Olszewski A, Jakobsen LH, Collins GP, et al. Burkitt lymphoma international prognostic index[J]. J Clin Oncol, 2021, 39(10):1129-1138.DOI:10.1200/JCO.20.03288.
[58]
Bonnet C, Lejeune M, Van Kemseke C, et al. Prise en charge actueLe du lymphome de la zone marginale[Current management of marginal zone lymphomas][J]. Rev Med Suisse, 2015, 11(483):1549-1556.
[59]
Hoffmann M, Kletter K, Becherer A, et al. 18F-fluorodeoxyglucose positron emission tomography(18F-FDG-PET)for staging and follow-up of marginal zone B-cell lymphoma[J]. Oncology, 2003, 64(4):336-340.DOI:10.1159/000070290.
[60]
de Vos S, Goy A, Dakhil SR, et al. Multicenter randomized phase Ⅱ study of weekly or twice-weekly bortezomib plus rituximab in patients with relapsed or refractory follicular or marginal-zone B-cell lymphoma[J]. J Clin Oncol, 2009, 27(30):5023-5030.DOI:10.1200/JCO.2008.17.7980.
[61]
Kiesewetter B, Troch M, Dolak W, et al. A phase Ⅱ study of lenalidomide in patients with extranodal marginal zone B-cell lymphoma of the mucosa associated lymphoid tissue(MALT lymphoma)[J]. Haematologica, 2013, 98(3):353-356.DOI:10.3324/haematol.2012.065995.
[62]
Flinn IW, van der Jagt R, Kahl B, et al. First-line treatment of patients with indolent non-hodgkin lymphoma or mantle-cell lymphoma with bendamustine plus rituximab versus R-CHOP or R-CVP:results of the bright 5-year follow-up study[J]. J Clin Oncol, 2019, 37(12):984-991.DOI:10.1200/JCO.18.00605.
[63]
Ackler S, Oleksijew A, Chen J, et al. Clearance of systemic hematologic tumors by venetoclax(Abt-199)and navitoclax[J]. Pharmacol Res Perspect, 2015, 3(5):e00178.DOI:10.1002/prp2.178.
[64]
Xue JY, Zhao Y, Aronowitz J, et al. Rapid non-uniform adaptation to conformation-specific KRAS(G12C) inhibition[J]. Nature, 2020, 577(7790):421-425.DOI:10.1038/s41586-019-1884-x.
[65]
Gopal AK, Kahl BS, de Vos S, et al. PI3Kδ inhibition by idelalisib in patients with relapsed indolent lymphoma[J]. N Engl J Med, 2014, 370(11):1008-1018.DOI:10.1056/NEJMoa1314583.
[66]
Joshi M, Sheikh H, Abbi K, et al. Marginal zone lymphoma:old,new,targeted,and epigenetic therapies[J]. Ther Adv Hematol, 2012, 3(5):275-290.DOI:10.1177/2040620712453595.
[67]
Arribas AJ, Campos-Martín Y, Gómez-Abad C, et al. Nodal marginal zone lymphoma:gene expression and miRNA profiling identify diagnostic markers and potential therapeutic targets[J]. Blood, 2012, 119(3):9-21.DOI:10.1182/blood-2011-02-339556.
[68]
Thieblemont C, Molina T, Davi F. Optimizing therapy for nodal marginal zone lymphoma[J]. Blood, 2016, 127(17):2064-2071.DOI:10.1182/blood-2015-12-624296.
[69]
Zamò A, van den Brand M, Climent F, et al. The many faces of nodal and splenic marginal zone lymphomas. A report of the 2022 EA4HP/SH lymphoma workshop[J]. Virchows Arch, 2023, 483(3):317-331.DOI:10.1007/s00428-023-03633-3.
[70]
Bommier C, Donzel M, Rossi C, et al. Real-world data for marginal zone lymphoma patients in the French REALYSA cohort: the REALMA study[J]. Hematol Oncol, 2024, 42(6):e3314.DOI:10.1002/hon.3314.
[71]
王培, 王帅亮, 朱华, 等. 放射性核素探针在嵌合抗原受体T细胞治疗显像中的应用[J]. 国际放射医学核医学杂志, 2023, 47(5):302-307.DOI:10.3760/cma.j.cn121381-202206010-00290.
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