Journal List > J Korean Assoc Pediatr Surg > v.22(2) > 1071974

Min, Youn, Han, Oh, Kim, and Jung: A Case of Pediatric Nodal Marginal Zone Lymphoma

Abstract

Lymph node enlargement is a common finding in children suggesting normal or benign. Palpable nodes which are large, hard or fixed must be examined carefully to rule out malignant diseases. In this case, a 15-year-old boy presented to our hospital to inspect the palpable mass at his post-auricular area being found 2 months ago. It was diagnosed as nodal marginal zone lymphoma (NMZL) through excisional biopsy and immunohistochemistry. NMZL is very rare, especially in children and young adults, but occurs locally in most cases with a good prognosis compared to adults. We described a rare case of NMZL diagnosed in adolescent.

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Fig. 1.
A palpable, fixed 3×2-cm-sized mass positioning at the left posterior auricular area (arrowheads).
jkaps-2016-22-2-59f1.tif
Fig. 2.
Ultrasonographic image showing a hypoechoic lobulated mass, with 2.2×2.4×0.8 cm size and inner vascularity (arrowheads).
jkaps-2016-22-2-59f2.tif
Fig. 3.
Immunophenotypic features of excised mass. (A) H&E stain (×40) showing a gross lymphoid tissue with effaced normal follicular architectures suggesting neoplastic rather than reactive condition. (B) With a few normal germinal centers left, it was mostly filled with diffusely grown small to medium-sized atypical cells (H&E stain, ×200). These cells were positive in CD20 (B lymphocyte antigen; C) and Bcl-2 (F) but negative in CD10 (D) and Bcl-6 (E) (C-F: ×40).
jkaps-2016-22-2-59f3.tif
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