Biopsy and Histology

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:

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

Reference: 1. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for B-Cell Lymphomas V.4.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 10, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.