Which histologic findings are characteristic of marginal-zone lymphoma of the prostate?

Updated: Dec 22, 2019
  • Author: Joshua I Warrick, MD; Chief Editor: Liang Cheng, MD  more...
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Answer

Answer

Marginal-zone lymphoma typically appears as an expansive, infiltrative proliferation of small- to medium-sized lymphocytes with variably smooth to irregular nuclear contours. Enlarged, higher-grade tumor cells resembling centroblasts are frequently seen, with increasing number associated with more aggressive tumor behavior. A subset of tumor cells may have the appearance of plasma cells. Associated benign chronic inflammation, including reactive non-neoplastic germinal cells, is common.

As with other lymphomas, marginal-zone lymphomas grow in a destructive manner and may extend beyond the prostate. Lymphoepithelial lesions are a classic (but nonspecific) finding in marginal-zone lymphomas and consist of tumor cells infiltrating altered benign prostate glands. The typical immunophenotype is CD20+/CD10-/CD5-/cyclin D1-. CD43 may be expressed. Light-chain restriction may be seen, particularly when there is a plasmacytic component.

See the images below.

Pathology of prostate leukemia and lymphoma. Margi Pathology of prostate leukemia and lymphoma. Marginal-zone lymphoma of the prostate.
Pathology of prostate leukemia and lymphoma. CD20 Pathology of prostate leukemia and lymphoma. CD20 immunostain of a marginal-zone lymphoma of the prostate.
Pathology of prostate leukemia and lymphoma. Margi Pathology of prostate leukemia and lymphoma. Marginal-zone lymphoma of the prostate, infiltrating the fibromuscular stroma (right) and extending into the extraprostatic soft tissue (left). Prostatic adenocarcinoma is also present (right) and is involved by the lymphoma.
Pathology of prostate leukemia and lymphoma. Margi Pathology of prostate leukemia and lymphoma. Marginal-zone lymphoma of the prostate, infiltrating fibromuscular stroma in a nonperiglandular manner.
Pathology of prostate leukemia and lymphoma. Margi Pathology of prostate leukemia and lymphoma. Marginal-zone lymphoma of the prostate involves a focus of prostatic adenocarcinoma.
Pathology of prostate leukemia and lymphoma. Margi Pathology of prostate leukemia and lymphoma. Marginal-zone lymphoma of the prostate, high power. The nuclei are monomorphic, small, and low grade.

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