Related Subjects:
|Hodgkin Lymphoma
|Non Hodgkin Lymphoma
|Diffuse large B-cell lymphoma
|Intravascular large B-cell lymphoma
|Mantle cell lymphoma
|Marginal Zone Lymphoma
|Gastric (MALT) Lymphoma
|Primary CNS Lymphoma (PCNSL)
|Burkitt's lymphoma
|Follicular Lymphoma
🧬 Marginal Zone Lymphoma (MZL) is a rare B-cell non-Hodgkin lymphoma (NHL), arising from lymphocytes in the "marginal zone" around lymphoid tissues. It is indolent (slow-growing) but clinically important due to its link with infections and autoimmune disease.
ℹ️ About
- Indolent (slow-growing) B-cell lymphoma
- A type of non-Hodgkin Lymphoma (NHL)
- Accounts for ~10% of all NHL cases
🧬 Aetiology
- Often infection-driven (chronic antigen stimulation):
- 🍽️ Helicobacter pylori → gastric MALT lymphoma
- 🥛 Campylobacter jejuni → small bowel lymphoma
- 🦠 Hepatitis C virus (HCV) → splenic MZL
- Autoimmune links: Sjögren’s syndrome, Hashimoto’s thyroiditis
🩺 Clinical Features
- 📍 Nodal disease: painless lymphadenopathy
- ⚠️ B-symptoms: fatigue, weight loss, night sweats
- 🫁 Extranodal (MALT): gastric pain, dyspepsia, organ-specific symptoms
- 🩸 Splenic MZL: abdominal discomfort from splenomegaly, cytopenias
Types of MZL
- Extranodal (MALT) Lymphoma: most common, linked to chronic infection/autoimmunity
- Nodal MZL: rare, mainly lymph node involvement
- Splenic MZL: ~10% cases, linked with HCV, splenomegaly common
🔎 Investigations
- 🔬 Biopsy: gold standard diagnosis
- 🖥️ Imaging: CT/PET, ultrasound (especially for spleen)
- 🧪 Bloods: FBC, LDH, viral serology (esp. HCV)
- 🦴 Bone marrow biopsy: useful in splenic subtype
💊 Management
- 👀 Watchful waiting: asymptomatic/indolent cases
- 💊 Antibiotics: eradicate H. pylori in gastric MALT → can induce remission
- ☢️ Radiotherapy: for localized disease
- 💉 Chemo-immunotherapy: Rituximab ± chemotherapy in advanced disease
- 🪓 Splenectomy: in splenic subtype with massive splenomegaly
Prognosis
- 📈 Generally favourable (indolent course)
- ⏳ Many patients live for years post-diagnosis
- ⚖️ Prognosis depends on subtype, stage, and response to therapy
