Ocular Follicular Lymphoma with Marginal Zone Differentiation: A Diagnostic Pitfall Mimicking MALT Lymphoma
Abstract
Follicular lymphoma with marginal zone differentiation (FL with MZD) is a rare variant that mimics mucosa-associated lymphoid tissue (MALT) lymphoma. A 64-year-old woman presented with a conjunctival mass that was initially diagnosed as MALT lymphoma. Staging revealed additional pelvic and subcutaneous lesions in the patient. Although a needle biopsy of the pelvic mass showed monocytoid B cells lacking germinal center markers, an excisional subcutaneous biopsy demonstrated follicular dendritic cell networks, germinal center marker positivity, and aberrant BCL2 expression. IgH-BCL2 fusion was detected in all lesions, confirming the diagnosis of FL with MZD. This case highlights the need for integrated clinicopathological and cytogenetic evaluations with adequate tissue sampling to make an accurate diagnosis.
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BibTeX
@article{miyachi2026ocular,
title = {{Ocular Follicular Lymphoma with Marginal Zone Differentiation: A Diagnostic Pitfall Mimicking MALT Lymphoma}},
author = {Takashi Miyachi and Akihiro Kitadate and Wataru Kuroki and Takeshi Iwase and Katsuyoshi Takata and Naoto Takahashi},
journal = {Internal Medicine},
year = {2026},
month = jul,
doi = {10.2169/internalmedicine.7401-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7401-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Ocular Follicular Lymphoma with Marginal Zone Differentiation: A Diagnostic Pitfall Mimicking MALT Lymphoma
AU - Takashi Miyachi
AU - Akihiro Kitadate
AU - Wataru Kuroki
AU - Takeshi Iwase
AU - Katsuyoshi Takata
AU - Naoto Takahashi
PY - 2026
DA - 2026/07/18
JO - Internal Medicine
DO - 10.2169/internalmedicine.7401-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7401-26/_article
AB - Follicular lymphoma with marginal zone differentiation (FL with MZD) is a rare variant that mimics mucosa-associated lymphoid tissue (MALT) lymphoma. A 64-year-old woman presented with a conjunctival mass that was initially diagnosed as MALT lymphoma. Staging revealed additional pelvic and subcutaneous lesions in the patient. Although a needle biopsy of the pelvic mass showed monocytoid B cells lacking germinal center markers, an excisional subcutaneous biopsy demonstrated follicular dendritic cell networks, germinal center marker positivity, and aberrant BCL2 expression. IgH-BCL2 fusion was detected in all lesions, confirming the diagnosis of FL with MZD. This case highlights the need for integrated clinicopathological and cytogenetic evaluations with adequate tissue sampling to make an accurate diagnosis.
SN - 1349-7235
SN - 0918-2918
ER -