Volume 5, Issue 6, Pages 381-383 (June 2004) Nodal marginal-zone lymphoma associated with monoclonal light-chain and heavy-chain deposition disease  Philip Went, Stefano Ascani, Erik Strøm, Sverre-Henning Brorson, Maurizio Musso, Pier-Luigi Zinzani, Brunangelo Falini, Stephan Dirnhofer, Prof Stefano Pileri  The Lancet Oncology  Volume 5, Issue 6, Pages 381-383 (June 2004) DOI: 10.1016/S1470-2045(04)01495-0 Copyright © 2004 Elsevier Ltd Terms and Conditions

Figure 1 Histological analysis of a lymph-node biopsy sample from a patient with nodal marginal-zone lymphoma. (A) Most of the lymph node is occupied by hyaline material (stained with periodic acid Schiff; ×200). (B) This material consists of homogenous perivascular and interstitial deposits (stained with toluidine blue; ×600). (C) Within the hyaline material there is a lymphomatous population of small cells with round or oval nuclei and a rim of clear cytoplasm mixed with blast cells and plasma cells (stained with Giemsa; ×500). The neoplastic cells strongly express CD27 (D) and IRTA1 protein (E), but not BCL6 (F) or CD5 (G) (APAAP technique counterstained with Gill's haematoxylin; ×500). Panels F and G also show the presence of internal controls represented by a remnant of a BCL6+ germinal centre (red) and CD5+ T-lymphocytes (red halos), respectively (APAAP technique counterstained with Gill's haematoxylin; ×400 and ×500, respectively). The Lancet Oncology 2004 5, 381-383DOI: (10.1016/S1470-2045(04)01495-0) Copyright © 2004 Elsevier Ltd Terms and Conditions

Figure 2 Analysis of the immunoglobulin components of a lymph-node biopsy sample from a patient with nodal marginal-zone lymphoma. The hyaline material and plasma cells expressed both μ (A) and κ. (B) Heavy-chain and light-chain immunoglobulin (APAAP technique counterstained with Gill's haematoxylin; ×300). (C) Cells negative for λlight-chain immunoglobulin. (D) Cells positive for IgM heavy-chain immunoglobulin (immunoelectron microscopy, ×80 000). (E) Amorphous (nonfibrillar) material found in the extracellular matrix (electron micrograph, ×47 000). (F) Cells were positive for κ light-chain immunoglobulin (immunoelectron microscopy, ×80 000). The high specificity of the staining reaction is clearly seen by the absence of immunogold-labelled antibody in the regions highlighted by asterisks in panels D and F. The Lancet Oncology 2004 5, 381-383DOI: (10.1016/S1470-2045(04)01495-0) Copyright © 2004 Elsevier Ltd Terms and Conditions