Tissue Biopsy

Excisional Lymph Node Biopsy

Excisional biopsy (entire lymph node removed) is recommended to establish the diagnosis of MZL.¹

• Adequate tissue volume is essential
• Note: Core needle biopsy (large bore needle removes a core of lymph node tissue) is not recommended unless there is no other way to obtain the necessary diagnostic tissue¹
• The role of fine needle biopsy in the diagnosis of lymphoma is controversial; when used alone, there is often inadequate tissue for diagnostic tests¹

Rationale for Tissue Biopsy

Complete and accurate differential diagnosis of MZL and other NHL subtypes require¹:

• Morphologic evaluation by a pathologist
• Molecular characterization of FL tissue
• Immunophenotyping
• Cytogenetics

Molecular analysis may provide useful diagnostic or prognostic information in certain cases.

Tissue biopsy may be performed during¹:

• Initial diagnosis
• Recurrence/relapse
• Restaging and follow-up to rule out large cell lymphoma

Bone Marrow Biopsy

Bone marrow aspiration and biopsy may be used to determine if there is bone marrow involvement of the MZL.¹

• Bone marrow biopsy with aspiration should be performed at diagnosis and is essential to document clinical stage I-II disease in nodal MZL and for diagnosis of splenic MZL¹
• Bone marrow biopsy with aspiration is not essential for diagnosis of gastric and nongastric MALT lymphoma but may be useful in selected cases¹
• Bone marrow biopsy may be deferred in some cases where observation is the recommended initial therapy¹