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ICD-O-3 Morphology
9689/3: Splenic marginal zone B-cell lymphoma
Effective
2001 and later
Reportable
for cases diagnosed
2001 and later
Primary Site(s)
C422
Primary site must be spleen (C422)
Coding Manual:
Hematopoietic Coding Manual (PDF)
Abstractor Notes
Splenomegaly is seen in almost all patients, commonly without lymphadenopathy. The bone marrow is frequently positive. Nodal and extranodal involvement are rare.
The lack of CD5 expression is helpful in the discrimination between SMZL and chronic lymphocytic leukemia/small lymphocytic lymphoma, and the lack of CD10 expression argues against follicular lymphoma. Mantle cell lymphoma is excluded due to the lack of CD5 and cyclin-D1 expression.
The lack of CD5 expression is helpful in the discrimination between SMZL and chronic lymphocytic leukemia/small lymphocytic lymphoma, and the lack of CD10 expression argues against follicular lymphoma. Mantle cell lymphoma is excluded due to the lack of CD5 and cyclin-D1 expression.
Diagnostic Confirmation
This histology can be determined by positive histology (including peripheral blood) with or without genetics and/or immunophenotyping. Review the Definitive Diagnostic Methods, Immunophenotyping and Genetics Data sections below, and the instructions in the Hematopoietic Manual for further guidance on assigning Diagnostic confirmation.
Grade
Not Applicable
Module Rule
None
Alternate Names
Splenic lymphoma with circulating villous lymphocytes (SLVL)
Splenic lymphoma with villous lymphocytes
Splenic marginal zone B-cell lymphoma (SMZL)
Definition
Splenic marginal zone lymphoma (SMZL) is a B-cell neoplasm composed of small lymphocytes that surround and replace the splenic white pulp germinal centers, efface the follicle mantle, and merge with a peripheral (marginal) zone of larger cells, including scattered transformed blasts; both small and larger cells infiltrate the red pulp. Splenic hilar lymph nodes and bone marrow are often involved, lymphoma cells are frequently found in the peripheral blood as villous lymphocytes.
Definitive Diagnostic Methods
Genetic testing
Histologic confirmation
Immunophenotyping
Genetics Data
Allelic loss of chromosome 7q31-32
Dysregulation of CDK6 gene at 7q21
Immunoglobulin heavy and light chain rearrangement
Immunophenotyping
Annexin A1 neg
CD5-
CD10-
CD20+
CD23-
CD43-
CD79a+
CD103-
Cyclin D1 absent
Ki-67 staining shows distinctive targetoid pattern
LEF1 absent
Surface IgD
Surface IgM
Treatments
Chemotherapy
Immunotherapy
Surgery
Transformations to
Transformations from
None
Same Primaries
Corresponding ICD-9 Codes
200.3 Marginal zone lymphoma
Corresponding ICD-10 Codes
C83.0 Non-Hodgkin lymphoma small cell (diffuse)
Corresponding ICD-10-CM Codes (U.S. only)
C83.0 Small cell B-cell lymphoma (effective October 01, 2015)
Signs and Symptoms
Anemia
Drenching night sweats
Fatigue
Fever (for no known reason)
Painless swelling in the lymph nodes
Skin rashes or itchy skin
Splenomegaly
Thrombocytopenia (autoimmune)
Weight loss (for no known reason)
Diagnostic Exams
Blood chemistry studies
CT (CAT) scan
Cytogenetic analysis
Flow cytometry
Immunohistochemistry
Immunophenotyping
Laparoscopy (rarely performed)
Laparotomy (rarely performed)
Lymph node biopsy
PET (positron emission tomography) scan
Splenectomy
Progression and Transformation
Transformation to large B-cell lymphoma may occur
Epidemiology and Mortality
Age: mostly 50 years and older
Incidence: 2% of lymphoid neoplasms
Sex: no male or female predominance
Survival: long term survival for patients who have splenectomy
Sources
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds):
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mature B-cell neoplasms
Pages: 223-225
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mature B-cell neoplasms
Pages: 223-225
International Classification of Diseases for Oncology, Third Edition, Second Revision. Geneva: World Health Organization, 2020.
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577
National Cancer Institute
Section: General Information About Adult Non-Hodgkin Lymphoma (NHL)
Pages: https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq
Section: General Information About Adult Non-Hodgkin Lymphoma (NHL)
Pages: https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq
