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Annals of Hematology

, Volume 89, Issue 10, pp 1003–1009 | Cite as

Central nervous system manifestations of marginal zone B-cell lymphoma

  • Soley Bayraktar
  • Alexandra Stefanovic
  • Naomi Montague
  • Janet Davis
  • Timothy Murray
  • Izidore S. Lossos
Original Article

Abstract

Primary or secondary central nervous system (CNS) involvement by marginal zone B-cell lymphoma (MZBCL) is rare. A retrospective analysis of patients was done with MZBCL involving the CNS, diagnosed and treated at our institution between 2004 and 2010. We identified 10 MZBCL patients with primary (six) or secondary (four) CNS involvement. Five patients presented with primary dural lymphoma and were treated with surgical resection, whole-brain radiation, or systemic chemotherapy. Only one patient had CNS relapse 5 years later. A single patient with primary intraocular lymphoma achieved clinical remission with ocular radiotherapy and systemic chemotherapy. Four patients had ocular MZBCL within 5 years of the initial diagnosis of primary ocular adnexal MZBCL and primary splenic MZBCL. There was no evidence of local recurrence in all but one who developed systemic relapse after 3 years of follow-up. Primary or secondary CNS involvement by MZBCL display indolent clinical behavior and have a generally favorable prognosis, underlining the importance of their differentiation from aggressive lymphomas that more commonly involve the CNS.

Keywords

Marginal zone B-cell lymphoma Primary CNS lymphoma Primary intraocular lymphoma Primary dural lymphoma 

Notes

Acknowledgements

The authors thank Dr. Gerald Byrne from the Department of Hematopathology for his pathology review of the cases.

Funding

This work was supported by the United States Public Health Service, National Institutes of Health [grant numbers R01-CA109335, R01-CA122105], and the Dwoskin Family Foundation.

References

  1. 1.
    Isaacson P, Wright DH (1983) Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer 52:1410–1416CrossRefPubMedGoogle Scholar
  2. 2.
    Jaffe ES, Harris NL, Stein H, Isaacson PG (2008) Classification of lymphoid neoplasms: the microscope as a tool for disease discovery. Blood 112:4384–4399CrossRefPubMedGoogle Scholar
  3. 3.
    Tu PH, Giannini C, Judkins AR et al (2005) Clinicopathologic and genetic profile of intracranial marginal zone lymphoma: a primary low-grade CNS lymphoma that mimics meningioma. J Clin Oncol 23:5718–5727CrossRefPubMedGoogle Scholar
  4. 4.
    Maes B, De Wolf-Peeters C (2002) Marginal zone cell lymphoma–an update on recent advances. Histopathology 40:117–126CrossRefPubMedGoogle Scholar
  5. 5.
    Iwamoto FM, DeAngelis LM, Abrey LE (2006) Primary dural lymphomas: a clinicopathologic study of treatment and outcome in eight patients. Neurology 66:1763–1765CrossRefPubMedGoogle Scholar
  6. 6.
    Zinzani PL, Magagnoli M, Galieni P et al (1999) Nongastrointestinal low-grade mucosa associated lymphoid tissue lymphoma: analysis of 75 patients. J Clin Oncol 17(4):1254–1258PubMedGoogle Scholar
  7. 7.
    Thieblemont C, Berger F, Dumontet C et al (2000) Mucosa-associated lymphoid tissue lymphoma is a disseminated disease in one third of 158 patients analyzed. Blood 95:802–806PubMedGoogle Scholar
  8. 8.
    Zucca E, Conconi A, Pedrinis E et al (2003) Nongastric marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. Blood 101:2489–2495CrossRefPubMedGoogle Scholar
  9. 9.
    Arai A, Taomoto K, Yokoyama M et al (2009) A case of CNS metastasis from gastric MALT lymphoma. No Shinkei Geka 37:1235–1240PubMedGoogle Scholar
  10. 10.
    Bekkenk MW, Postma TJ, Meijer CJ, Willemze R (2000) Frequency of central nervous system involvement in primary cutaneous B-cell lymphoma. Cancer 89:913–919CrossRefPubMedGoogle Scholar
  11. 11.
    Restrepo A, Byrne GE (1998) Is central nervous system prophylaxis necessary in ocular adnexal lymphoma? Crit Rev Oncog 9:269–273PubMedGoogle Scholar
  12. 12.
    DeAngelis LM, Seiferheld W, Schold SC (2002) Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: radiation therapy oncology group study 93-10. J Clin Oncol 20:4643–4648CrossRefPubMedGoogle Scholar
  13. 13.
    Schlegel U, Schmidt-Wolf IG, Deckert M (2000) Primary CNS lymphoma: clinical presentation, pathological classification, molecular pathogenesis and treatment. J Neurol Sci 181:1–12CrossRefPubMedGoogle Scholar
  14. 14.
    O'Neill BP, Illig JJ (1989) Primary central nervous system lymphoma. Mayo Clin Proc 64:1005–1020PubMedGoogle Scholar
  15. 15.
    Iwamoto FM, Abrey LE (2006) Primary dural lymphomas: a review. Neurosurg Focus 21:E5CrossRefPubMedGoogle Scholar
  16. 16.
    Razaq W, Goel A, Amin A, Grossbard ML (2009) Primary central nervous system mucosa-associated lymphoid tissue lymphoma: case report and literature review. Clin Lymphoma Myeloma 9:E5–E9CrossRefPubMedGoogle Scholar
  17. 17.
    Puri DR, Tereffe W, Yahalom J (2008) Low-dose and limited-volume radiotherapy alone for primary dural marginal zone lymphoma: treatment approach and review of published data. Int J Radiat Oncol Biol Phys 71:1425–1435PubMedGoogle Scholar
  18. 18.
    Gocmen S, Gamsizkan M, Onguru O (2010) Primary dural lymphoma mimicking a subdural hematoma. J Clin Neurosci 17:380–382CrossRefPubMedGoogle Scholar
  19. 19.
    Bhagavathi S, Greiner T, Kazmi SA (2008) Extranodal marginal zone lymphoma of the dura mater with IgH/MALT1 translocation and review of literature. J Hematop 1:131–137CrossRefPubMedGoogle Scholar
  20. 20.
    Ancheta RG, Lewin H, Said J, Hurwitz SA (2008) Primary dural marginal zone lymphoma in a woman with inflammatory breast cancer. J Clin Oncol 26:326–328CrossRefPubMedGoogle Scholar
  21. 21.
    Goetz P, Lafuente J, Revesz T et al (2002) Primary low-grade B-cell lymphoma of mucosa-associated lymphoid tissue of the dura mimicking the presentation of an acute subdural hematoma Case report and review of the literature. J Neurosurg 96:611–614CrossRefPubMedGoogle Scholar
  22. 22.
    Estevez M, Chu C, Pless M (2002) Small B-cell lymphoma presenting as diffuse dural thickening with cranial neuropathies. J Neurooncol 59:243–247CrossRefPubMedGoogle Scholar
  23. 23.
    Baraboutis IG, Marinos L, Lekakis LJ et al (2009) Long-term complete regression of nodal marginal zone lymphoma transformed into diffuse large B-cell lymphoma with highly active antiretroviral therapy alone in human immunodeficiency virus infection. Am J Med Sci 338:517–521CrossRefPubMedGoogle Scholar
  24. 24.
    Coupland SE, Joussen A, Anastassiou G, Stein H (2005) Diagnosis of a primary uveal extranodal marginal zone B-cell lymphoma by chorioretinal biopsy: case report. Graefes Arch Clin Exp Ophthalmol 243:482–486CrossRefPubMedGoogle Scholar
  25. 25.
    Raparia K, Chang CC, Chevez-Barrios P (2009) Intraocular lymphoma: diagnostic approach and immunophenotypic findings in vitrectomy specimens. Arch Pathol Lab Med 133:1233–1237PubMedGoogle Scholar
  26. 26.
    Colovic MD, Jankovic GM, Cemerikic-Martinovic V et al (1998) Primary intraocular marginal zone B-cell (MALT) lymphoma. Eur J Haematol 60:61–62CrossRefPubMedGoogle Scholar
  27. 27.
    Coupland SE, Foss HD, Hidayat AA et al (2002) Extranodal marginal zone B cell lymphomas of the uvea: an analysis of 13 cases. J Pathol 197:333–340CrossRefPubMedGoogle Scholar
  28. 28.
    Ramulu P, Iliff NT, Green WR, Kuo IC (2007) Asymptomatic conjunctival mucosa-associated lymphoid tissue-type lymphoma with presumed intraocular involvement. Cornea 26:484–486CrossRefPubMedGoogle Scholar
  29. 29.
    Hoang-Xuan T, Bodaghi B, Toublanc M et al (1996) Scleritis and mucosal-associated lymphoid tissue lymphoma: a new masquerade syndrome. Ophthalmology 103:631–635PubMedGoogle Scholar
  30. 30.
    Sarraf D, Jain A, Dubovy S et al (2005) Mucosa-associated lymphoid tissue lymphoma with intraocular involvement. Retina 25:94–98CrossRefPubMedGoogle Scholar
  31. 31.
    Fung CY, Tarbell NJ, Lucarelli MJ et al (2003) Ocular adnexal lymphoma: clinical behavior of distinct World Health Organization classification subtypes. Int J Radiat Oncol Biol Phys 57:1382–1391PubMedGoogle Scholar
  32. 32.
    Sullivan TJ, Valenzuela AA (2006) Imaging features of ocular adnexal lymphoproliferative disease. Eye (Lond) 20:1189–1195Google Scholar
  33. 33.
    Polito E, Galieni P, Leccisotti A (1996) Clinical and radiological presentation of 95 orbital lymphoid tumors. Graefes Arch Clin Exp Ophthalmol 234:504–509CrossRefPubMedGoogle Scholar
  34. 34.
    Nam H, Ahn YC, Kim YD et al (2009) Prognostic significance of anatomic subsites: results of radiation therapy for 66 patients with localized orbital marginal zone B cell lymphoma. Radiother Oncol 90:236–241CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Soley Bayraktar
    • 1
  • Alexandra Stefanovic
    • 1
  • Naomi Montague
    • 2
  • Janet Davis
    • 3
  • Timothy Murray
    • 3
  • Izidore S. Lossos
    • 1
    • 4
  1. 1.Department of Medicine, Division of Hematology/OncologyUniversity of Miami, Sylvester Comprehensive Cancer CenterMiamiUSA
  2. 2.Department of PathologyUniversity of Miami, Jackson Memorial HospitalMiamiUSA
  3. 3.Department of OphthalmologyUniversity of Miami, Bascom Palmer Eye InstituteMiamiUSA
  4. 4.Department of Molecular and Cellular PharmacologyUniversity of Miami, Miller School of MedicineMiamiUSA

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