Initial Diagnostic Workup of Marginal Zone Lymphoma (MZL)

The diagnosis of MZL follows a similar workup for diagnosing other subtypes of Non-Hodgkin’s Lymphoma (NHL).1

  • Evaluation of symptoms – onset, behavior, presence of B-cell symptoms (recurring fever, drenching night sweats, significant weight loss)2
  • Review of systems, noting any recent changes or infections1
  • Quantifying performance status1
  • Determining risk factors for NHL2
Physical Examination The essential workup for MZL includes a physical exam with assessment of performance status.1
Laboratory Workup Certain laboratory studies are essential in patients suspected of having MZL. Additional studies may be informative in specific clinical situations, depending on findings from the history and physical exam.1


Tumor Biopsy
Bone Marrow Biopsy

Immunophenotyping is required to establish a diagnosis of MZL. Cytogenetic analyses and molecular analysis may be used to detect additional mutations associated with MZL.1
Molecular Profiling
NHL is complex, requiring physicians to differentiate among many different subtypes.3 Biopsies of the lymph node or other disease site can be used to help identify MZL. Bone marrow biopsy + aspirate is required to accurately determine disease stage.1
Imaging Studies Imaging is essential for diagnosing MZL.1

NCCN, National Comprehensive Cancer Network.

References: 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 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. 2. Merck Manual. 20th ed. Lane KAG, ed. Rahway, New Jersey: Merck & Co., Inc. 2018. 3. Lymphoma—Non-Hodgkin: Subtypes. Accessed August 2, 2018.