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An enlarged axillary lymph node from a 63-year-old woman showed proliferating marginal zone B-cells arranged in a vague nodular pattern or in band-forming aggregates throughout the cortex. Marginal zone B-cells, which also infiltrated the adjacent fatty tissue, had round or slightly indented nuclei of medium size and a moderate amount of clear cytoplasm. Immunohistochemically, these cells were CD20+, CD79a+, Bcl-2+, sIgD–, CD5–, CD10–, CD21–, CD23–, CD45RO–, Bcl-6–, and cyclin D–. A portion of the cells were sIgM- and CD43-positive. The polytypic nature of these cells was demonstrated by immunohistochemistry and polymerase chain reaction. Systemic bacterial infection appears to be the cause of marginal zone B-cell hyperplasia. This unusual marginal zone B-cell hyperplasia should be differentiated from low-grade B cell lymphomas, and particularly from nodal marginal zone B-cell lymphomas.
Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan 2:
Department of Pathology and Genetics, Aichi Cancer Center Hospital, Nagoya, Japan 3:
Kurosu Hospital, Ujiie, Japan 4:
Department of Pathology, Dokkyo University School of Medicine, Mibu, Japan