American Society of Hematology

Figure 1.

$Figure 1. The histology and immunophenotype of MZ and IEBCs of the cases. Panels A, B, and D-M show the tonsil biopsy of case 2. Panel C shows the appendectal biopsy of case 5. Panels N and O show the tonsil biopsy of case 4. (A) Hematoxylin and eosin-stained sections of tonsil in case 2. There is widening of the MZs around hyperplastic follicles. (B) Higher magnification of MZ, adjacent crypt epithelium (Ep), mantle zone, and follicle center (FC). Inset shows cytologic detail of the MZ cells with transformed blasts. (C) Hematoxylin and eosin-stained sections of the appendix in case 5 showing broadening of the MZs around hyperplastic B-cell follicles. The inset shows a crypt infiltrated by MZ lymphocytes. (D-F) The MZ and intraepithelial lymphocytes express IRTA-1 (D) and CD 43 (E) but fail to express CD27 (F). (G) The proliferation fraction shown by Ki 67 immunostaining is high. (H-I) The MZ cells show weak expression of IgD (H) and strong expression of IgM (I). (J-L) In contrast to the germinal center and follicular mantle, the MZ cells do not express Igκ light chain (J) but do show strong expression of Igλ light chain (K). (L) High magnification of MZ cells immunostained for κ light chain (left) and λ light chain (right). There is striking λ light-chain restriction. Scattered small lymphocytes (probably residual mantle zone cells) express κ light chain. (M-O) The follicle center cells in the tonsil biopsy of case 2 express CD10 (M), but in case 4 where the follicles are colonized by MZ cells, the CD10+ follicle centers are fragmented (N). (O) The colonized areas of the follicles do not express κ light chain (left) but show uniform expression of λ light chain (right). Original magnifications, × 40 (A,C); × 200 (B,O); × 1000 (B inset); × 400 (C inset, L); and × 100 (D-K, M-N). Microscope, Olympus BX51; numerical aperture of objective lenses used: × 4, 0.16 mm (A-C); × 10, 0.40 mm (D-K, M-N); × 20, 0.70 mm (B,O); × 40, 0.85 mm (C inset, L); and × 100, 0.95 mm (B inset). Stains used: hematoxylin and eosin (A) and immunoperoxide (B-D). Camera, Olympus DP11 (Olympus, Tokyo, Japan); acquisition software, Adobe Reader 6.0 (Adobe, San Jose, CA); and software used for image processing, Adobe Photoshop 5.0.$

The histology and immunophenotype of MZ and IEBCs of the cases. Panels A, B, and D-M show the tonsil biopsy of case 2. Panel C shows the appendectal biopsy of case 5. Panels N and O show the tonsil biopsy of case 4. (A) Hematoxylin and eosin-stained sections of tonsil in case 2. There is widening of the MZs around hyperplastic follicles. (B) Higher magnification of MZ, adjacent crypt epithelium (Ep), mantle zone, and follicle center (FC). Inset shows cytologic detail of the MZ cells with transformed blasts. (C) Hematoxylin and eosin-stained sections of the appendix in case 5 showing broadening of the MZs around hyperplastic B-cell follicles. The inset shows a crypt infiltrated by MZ lymphocytes. (D-F) The MZ and intraepithelial lymphocytes express IRTA-1 (D) and CD 43 (E) but fail to express CD27 (F). (G) The proliferation fraction shown by Ki 67 immunostaining is high. (H-I) The MZ cells show weak expression of IgD (H) and strong expression of IgM (I). (J-L) In contrast to the germinal center and follicular mantle, the MZ cells do not express Igκ light chain (J) but do show strong expression of Igλ light chain (K). (L) High magnification of MZ cells immunostained for κ light chain (left) and λ light chain (right). There is striking λ light-chain restriction. Scattered small lymphocytes (probably residual mantle zone cells) express κ light chain. (M-O) The follicle center cells in the tonsil biopsy of case 2 express CD10 (M), but in case 4 where the follicles are colonized by MZ cells, the CD10⁺ follicle centers are fragmented (N). (O) The colonized areas of the follicles do not express κ light chain (left) but show uniform expression of λ light chain (right). Original magnifications, × 40 (A,C); × 200 (B,O); × 1000 (B inset); × 400 (C inset, L); and × 100 (D-K, M-N). Microscope, Olympus BX51; numerical aperture of objective lenses used: × 4, 0.16 mm (A-C); × 10, 0.40 mm (D-K, M-N); × 20, 0.70 mm (B,O); × 40, 0.85 mm (C inset, L); and × 100, 0.95 mm (B inset). Stains used: hematoxylin and eosin (A) and immunoperoxide (B-D). Camera, Olympus DP11 (Olympus, Tokyo, Japan); acquisition software, Adobe Reader 6.0 (Adobe, San Jose, CA); and software used for image processing, Adobe Photoshop 5.0.

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