J Pathol Transl Med.  2020 Jul;54(4):340-345. 10.4132/jptm.2020.03.18.

Primary hepatic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue

• Choi S
• Kim JH
• Kim K
• Kim M
• Choi HJ
• Kim YM
• Suh JH
• Seo MJ
• Cha HJ

• KMID: 2504565
• DOI: http://doi.org/10.4132/jptm.2020.03.18

Abstract

Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), is one of the specific type of low-grade B-cell lymphoma not infrequently found worldwide. It typically involves mucosal sites such as stomach and conjunctiva; however, primary hepatic MALT lymphoma has been extremely rarely reported. We describe a case of hepatic MALT lymphoma in a 70-year-old male patient who underwent left hepatectomy due to the incidentally detected liver masses at a medical checkup. The resected specimen revealed multinodular masses consisting of small-to-intermediate-sized lymphoid cells with serpentine pattern and focal lymphoepithelial lesions. The tumor cells were diffusely positive for CD20 and Bcl-2 but negative for CD3, CD10, CD5, CD23, CD43, and cyclinD1. The Ki-67 labeling index was 10% and immunoglobulin heavy chain gene rearrangement study confirmed monoclonal proliferation. In this paper, we discuss several unique clinicopathologic characteristics which will be helpful to the differential diagnosis of hepatic MALT lymphoma.

Keyword

Lymphoma, B-cell, marginal zone; Mucosa-associated lymphoid tissue; Liver

Figure

• 

  Fig. 1. (A) The magnetic resonance imaging shows a hypointense in T1, and T2, and arterial enhancing lesion in left lateral segment (arrows). (B) The positron emission tomography/computed tomography shows two hypermetabolic masses in left lateral segment (maximal standardized uptake value, 4.4). T1-WI, T1 weighted image; T2-WI, T2 weighted image.

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  Fig. 2. (A) Gross image of the liver shows well-demarcated and grayish tan masses. (B) Low power view of the lesion demonstrates serpentine infiltrations of lymphoid cells. (C) High power view of the lesion demonstrates small-to-intermediated-size lymphoid cell infiltration. (D, E) Lymphoepithelial lesion is present, which is revealed by cytokeratin 7 immunohistochemical stain.

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  Fig. 3. The lymphoid cells are positive for CD20 (A), and negative for CD3 (B) and CD10 (C). (D) The non-neoplastic liver shows portal to periportal lymphocytic infiltration.

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