Diagnosis Of Malignant Lymphoma Research Articles

A Diagnosis of Malignant Lymphoma by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Using a Puncture Needle with a Core Trap Followed by Chemotherapy After Placement of an Airway Stent: a Case Report

A Diagnosis of Malignant Lymphoma by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Using a Puncture Needle with a Core Trap Followed by Chemotherapy After Placement of an Airway Stent: a Case Report

I. Basic Approach for Symptoms and Diagnosis of Malignant Lymphoma ～When and How～

I. Basic Approach for Symptoms and Diagnosis of Malignant Lymphoma ～When and How～

High Throughput T Cell Receptor Sequencing Augments Diagnosis and Response Assessment in Patients with Angioimmunoblastic T Cell Lymphoma

Diagnosis and response assessment to therapy has been shown to be challenging in patients with angioimmunoblastic T cell lymphoma (AITL). While at disease onset histology of neoplastic T cell infiltrates in affected lymph nodes and/or bone marrow might be hard to distinguish from reactive lymphproliferation, clonality analyses using T cell receptor (TCR) spectratyping has been helpful in the diagnosis of malignant lymphoma. Nevertheless, resolution of this method is confined to a particular base pair fragment length, which could include several different T cell clones, making detection of minimal residual disease (MRD) almost impossible. From a clinical point of view, rapid responses of AITL to chemotherapy is not uncommon. But as a matter of fact, clinical symptoms of the lymphoma might persist, while neither imaging nor histology is able to detect residual disease.In an attempt to augment diagnosis of malignancy and improve MRD detection in AILT we established a high throughput TCR profiling approach using next generation sequencing (NGS). In order to determine lymphomaspecific TCR gamma V-J rearrangements, we analysed the entire expressed human TCR gamma repertoire in several different tissues using LymphoTrack TRG assays (Invivoscribe) together with the MiSeq Illumina platform.In all analysed cases of histologically proven AITL (n=6), TCR profiling resulted in detection of at least one lymphomaspecific clonal V-Jgamma rearranged TCR sequence in all examined relevant tissue probes (lymph nodes, bone marrow, blood) with observed frequencies up to 16% of all reads in lymph nodes and 7% in blood/bone marrow at the time of diagnosis. Lymphomaspecific TCR sequences as revealed by NGS correlated with clonality results as determined from Vgamma fragments analyses by spectratyping. In addition to confirmation of diagnosis, in some cases lymphomaspecific TCR sequences could be detected in lymph node and bone marrow biopsies up to one year before establishment of AITL diagnosis, in which routine pathology examination could only describe an unspecific lymphadenitis. Treatment responses resulted in diminished frequencies of the lymphomaspecific TCR sequences in blood and bone marrow samples with complete disappearance after allogeneic stem cell transplantation. Of particular importance was the observed sustained detection of lymphomaspecific TCR sequences in bone marrow samples in apparently successful treated patients with refractory clinical symptoms, in which lymphoma activity could not firmly be proven by other imaging or pathology methods.In conclusion, NGS based TCR profiling using V-J gamma rearrangments is very helpful for further analyses of AITL biology and might serve as MRD marker for therapy guidance. DisclosuresNo relevant conflicts of interest to declare.

Utility of touch smear cytology of lymph nodes in diagnosis of malignant lymphoma

Utility of touch smear cytology of lymph nodes in diagnosis of malignant lymphoma

Outcomes of Patients of Eastern Mediterranean Region with Lymphoma and COVID-19.Does Recent Chemo Immunotherapy Have a Role on Severity?

IntroductionOutcomes of patients with hematological cancers and Corona Virus Disease-19 (COVID-19) have been dismal with high rates of hospitalization, admission to intensive care unit and high mortality of up to 20% compared to general population, more so pronounced among black and ethnic minorities. There is hardly any data on outcomes of patients with lymphoma and concurrent COVID-19 from eastern mediterranean region. From eastern mediterranean area no similar studies have been reported so far.MethodsHere we describe outcomes of eleven consecutive patients who had history malignant lymphoma (either treated or currently on treatment) and now had developed COVID-19 infection, recently admitted at our tertiary care center between April and July 2020 with minimum of 10 days follow up.ResultsTotal of eleven (n=11) patients were identified with COVID-19 who also had diagnosis of malignant lymphoma. There were 5 males and 6 females and median age was 31 years (Range 19-59). Diagnoses included five cases of diffuse large b cell lymphoma, two cases of primary central nervous system lymphoma, three cases of classical Hodgkin lymphoma, one case of low grade non Hodgkin lymphoma. Two cases were newly diagnosed and had not received any treatment while six patients were on active treatment and three patients had received treatment more than six months prior. Three patients were on Rituximab based therapy at the time of infection and two patients had prior autologous stem cell transplant. Seven patients had mild COVID-19 while four had severe form of disease. All patients were on supportive care and treatment included various options including chloroquine, antibiotics, convalescent plasma, interferon, enoxaparin, Tocilizumab depending on treating physician’s discretion. Four patients had home isolation and recovered fully, while seven patients needed hospitalization of which three made full recovery while three needed admissions to intensive care unit (ICU) due to severe COVID-19. Out of three patients in ICU, two needed noninvasive ventilation, one needed mechanical ventilation. At the time analysis one ICU patient made complete recovery and discharged home while two others are still in hospital. After a median follow up of 37 days (range 10-87), no mortality has been recorded so far. Out of four patients with severe COVID-19, one was newly diagnosed and treatment naïve, and one was in remission for more than a year, the remaining two were on active rituximab based chemotherapy for lymphoma. However, 3 out of 4 patients had cleared COVID-19 by polymerase chain reaction testing.ConclusionsOur results suggest that COVID-19 causes significant morbidity in patients with lymphoma like other studies, however there has been no mortality so far in our cohort with relatively long follow up, although some patients are still admitted at the time of analysis. One of the reason for lower mortality could be younger age group. Our study also suggests that over two thirds of the patients had only mild disease out of which majority of them were on some sort of therapy or had undergone recent transplant, making us wonder if recent immunochemotherapy may have some protective effect against cytokine storm or severe COVID-19 by having dampening role on immune system. Half of the patients who had severe disease were not on any therapy while the other two who were on active therapy, although still inpatients, had cleared the virus interestingly. Further studies needed to examine this further, our results from this ethnic community are encouraging.DisclosuresNo relevant conflicts of interest to declare.

Image-guided core needle biopsy in the diagnosis of malignant lymphoma: comparison with surgical excision biopsy

PurposeThis study aimed to compare the efficacy and safety of image-guided core needle biopsy (CNB) with those of surgical excision biopsy (SEB) for the diagnosis of lymphoma, and to clarify the indication of CNB in clinical practice. MethodThis retrospective study included 263 image-guided CNB cases and 108 SEB cases that were performed at our institution between January 2014 and December 2018. The rate of patients with performance status of grade 1–4 was higher in the CNB group than in the SEB group (43.7% vs. 24.1%, P < 0.01). Waiting time to biopsy and diagnosis was shorter for CNB group than for SEB group (4 days vs. 7 days, 13 days vs. 15 days, P < 0.01). The rate of biopsy at the deep sites was higher in the CNB group than in the SEB group (53.2% vs. 8.3%, P < 0.01). Successful biopsy and complication rates were compared between the 2 groups. ResultsThere were no significant differences between the CNB and SEB groups in successful biopsy rates (89.0% vs. 93.5%, P = 0.25). The grade 3 complication rate was significantly lower for CNB group than for SEB group (0% vs. 4.6%, P < 0.01), although there was no significant difference in overall complication rates (4.9% vs. 6.5%, respectively, P = 0.61). ConclusionsCNB showed high diagnostic yield comparable to SEB for suspected lymphoma. CNB was especially recommended to the cases with low-PS, lesions in the deep sites, and requiring early pathological diagnosis.

RHOA G17V mutation in angioimmunoblastic T-cell lymphoma: A potential biomarker for cytological assessment

BackgroundThe World Health Organization, in a 2016 revision, introduced recurrent genetic abnormalities for classifying mature T- and NK-cell neoplasms. However, the role of genetic analyses from lymph node aspiration cytology is still not elucidated. We hypothesize that the use of genetic analyses may increase the accuracy of diagnosis from cytological preparations. MethodsFifty-seven formalin-fixed paraffin-embedded (FFPE) samples were collected for next-generation sequencing (NGS) targeting potential driver mutations including TET2, DMN3TA, IDH2, RHOA, STAT3, and STAT5B. Competitive allele-specific TaqMan polymerase chain reaction (cast-PCR) was performed to validate the mutation status by using FFPE and preoperative fine needle aspiration cytology (FNAC) samples. ResultsAmong these six candidate genes, only IDH2 and RHOA mutations were significantly more frequent in nodal subtypes, angioimmunoblastic T-cell lymphoma (AITL) and peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) (P = .002 and <0.001, respectively). All genes exhibited different mutation patterns except RHOA with a hotspot mutation involving the Gly17 residue. The RHOA G17V mutation was found in 15 (75%) of 20 AITL and two (22%) of nine PTCL, NOS. Cast-PCR using FFPE samples showed 100% concordance with NGS. Among 12 lymph node aspirates, the preliminary diagnoses were suspicious for lymphoma (3, 25%), atypical lymphoid cells (3, 25%) and benign/negative (6, 50%). Cast-PCR detected the RHOA G17V mutation in six (75%) of eight RHOA-mutated aspirates and revealed negative results in all (100%) of four wild-type aspirates, with an 83.3% (10/12) concordance comparing to FFPE samples. ConclusionsThe RHOA G17V mutation serves as a useful biomarker for cytological assessment in AITL. The use of cast-PCR is valuable in the diagnosis of malignant lymphomas from cytological preparations, and thus avoiding the potential risks of invasive procedures.

Comparison of patients with and without pre-existing lymphoma at diagnosis of primary Sjögren’s syndrome

Objective: In the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjögren’s syndrome (pSS), pre-existing lymphoma is not an exclusion criterion for pSS diagnosis, as in earlier criteria. We aimed to explore whether there are differences between pSS patients with and without pre-existing lymphoma at pSS diagnosis.Method: Patients with ICD-7–10 codes for Sjögren’s syndrome (SS) and a diagnosis of malignant lymphoma before or after SS diagnosis were identified by linking the Swedish Patient Register 1964–2007 with the Cancer Register 1990–2007 (n = 224). Clinical data were collected from medical records. Lymphoma diagnoses were evaluated by tissue review. Characteristics of pSS patients with and without pre-existing lymphoma were compared.Results: We identified 107 patients with pSS as the reason for an SS diagnosis code and a verified lymphoma. Of these, 18 (17%) had a pre-existing lymphoma at pSS diagnosis, defined as lymphoma diagnosed before or within 6 months of pSS diagnosis. Male gender (39% vs 10%, p = 0.006), enlarged lymph nodes during the pSS disease (61% vs 27%, p = 0.01), mucosa-associated lymphoid tissue (MALT) lymphoma (50% vs 22%, p = 0.02), and salivary gland lymphoma (61% vs 26%, p = 0.006) were more common in patients with a pre-existing lymphoma at pSS diagnosis. Other pSS characteristics were similar.Conclusion: In a substantial proportion of patients, particularly in men, pSS remains undiagnosed until after lymphoma diagnosis. The study highlights the importance of pSS investigation in patients with lymphoma, especially MALT lymphoma, in the salivary glands.

Signal intensity dynamics of malignant lymphoma in diffusion-weighted magnetic resonance imaging compared to positron emission tomography

This article discusses a study performed with an aim to determine the usefulness of diffusion-weighted MRI in pre-treatment assessment and evaluation of chemotherapy response of mediastinal lesions of malignant lymphoma by analysing signal intensity, accumulation of contrast agent and changes in values of ADC. Comparing the results of PET/CT and DW-MRI was another goal of this study. We reviewed data of 21 patients that underwent treatment during years 2013-2014 at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics and had DW-MRI and PET/CT scans carried out. For all patients the diagnosis of malignant lymphoma in mediastinal lymph nodes was confirmed histological. Whether the lymphoma was in active state was determined by PET/CT or histological data. In MRI scans, signal intensity and ADC values were evaluated, while in PET/CT maximum and average standardized uptake values were assessed. Patients underwent chemotherapy and follow up scans were performed to evaluate response. In total, 25 PET/CT and 50 DW-MRI scans were analysed. We found statistically significant difference of values of ADC in active and inactive states of malignant lymphoma of mediastinal lymph nodes. In follow up tests, performed during 2 years after treatment, a tendency of decreasing ADC values over time was seen when chemotherapy was successful and no relapse was observed. Among the reviewed cases, DW-MRI had slightly worse specificity than PET/CT in differentiation of malignant and benign changes in lymph nodes.

Epiglottic diffuse B-cell malignant lymphoma: A case report.

A 55-year-old male patient was admitted to our department with complaints of dysphagia and throat soreness for 2 months. A tumor of the left epiglottis, with an irregular surface, was identified by video laryngoscopy. The diagnosis of malignant lymphoma was confirmed by biopsy during laryngomicrosurgery. The atypical diffuse lymphocytic lymphoma was positive for CD20 and Bcl-2, and negative for CD3, CD10 and Bcl-1. The diagnosis was diffuse large B-cell malignant lymphoma. The patient was treated with eight cycles of rituximab with cyclophosphamide + doxorubicin + vincristine + prednisolone (R-CHOP regimen). This is a rare case of extranodal non-Hodgkin lymphoma occurring in the epiglottis.

P-251 Diagnosis of malignant lymphoma during at the colorectal cancer surgery

P-251 Diagnosis of malignant lymphoma during at the colorectal cancer surgery

Image-guided core needle biopsy in the diagnosis of malignant lymphoma

ObjectiveCurrent European Society for Medical Oncology (ESMO) guidelines recommend that when feasible, surgical excision biopsy (SEB) is the ideal for diagnosis, sub-typing and grading of malignant lymphoma. We undertook this retrospective study to assess the diagnostic accuracy of image-guided core needle biopsy (CNB) in the diagnosis of malignant lymphoma, to identify the proportion of cases from which oncological treatment was subsequently instigated from the CNB diagnosis, and to evaluate the potential role for minimally invasive CNB techniques in the diagnostic pathway of malignant lymphoma. MethodsAll cases of lymphoma amenable to CNB between 2008 and 2013 were included. Patient records were reviewed to identify the biopsy diagnostic pathway undertaken (fine needle aspiration cytology, CNB, surgical excision biopsy). CNB specimens were graded as fully diagnostic (tumour sub-typing/grading and treatment initiated), partially diagnostic (diagnosis of lymphoma but more tissue required for sub-typing/grading), equivocal or inadequate. The effects of anatomical location, needle gauge, number of core specimens and sub-type of disease on the diagnostic yield of the sample were analysed. Results262 patients and 323 biopsy specimens were included in the study. 237 patients underwent CNB as the initial diagnostic intervention. In 230/237 CNB was fully diagnostic (97%), allowing initiation of treatment. In 7 patients, SEB was necessary in addition to CNB to provide additional diagnostic information to allow initiation of treatment. In 72 patients, SEB was the only diagnostic test performed. ConclusionOur study showed that in 97% of suitable cases, CNB provided sufficient diagnostic information to allow treatment of malignant lymphoma to be instigated. This minimally-invasive technique is well tolerated and has advantages over surgical techniques, including reduced costs, post-procedural complications and delays on the diagnostic pathway. CNB may obviate the use of surgical techniques in the majority of suitable cases, however its success is dependent on close collaboration and acceptance by clinicians and pathologists.

経子宮頸管的針生検による捺印細胞診および組織検査が診断に有用であった子宮原発悪性リンパ腫の 1 例

経子宮頸管的針生検による捺印細胞診および組織検査が診断に有用であった子宮原発悪性リンパ腫の 1 例

Inappetenz, Nachtschweiß, chronisches Ekzem und inguinale sowie axilläre Lymphknotenpakete bei einem 28-jährigen Patienten

A 28-year-old man presented with loss of appetite, night sweats, eczema, and axillary and inguinal lymph node swelling. The tentative diagnosis of malignant lymphoma was made. To confirm the diagnosis, extirpation of a lymph node and a skin biopsy were performed. Systemic treatment with methylprednisolone resulted in an improvement of eczema and lymph node swelling. Because of the histological findings and clinical course, we diagnosed dermatopathic lymphadenopathy, also known as Pautrier-Woringer syndrome.

Diagnosis of malignant lymphomas in 2014

The field of hematopathology is ever-changing with important new discoveries of biologic and clinical importance. We continue to learn more about the clinical, morphologic, immunophenotypic and molecular/genetic features of the seemingly innumerable types of malignant lymphomas and their benign mimics. These discoveries have very pragmatic implications affecting our daily practice in terms of what we are expected to know about the entities we are attempting to diagnose, as well as providing new tools for our diagnostic armamentarium. To help deal with these challenges as they relate to the diagnosis of lymphoma, six international hematopathology experts will cover the following topics in this long course: an approach to diagnostic lymph node pathology (JR Cook), small B-cell lymphomas (L Quintanilla-Fend), aggressive B-cell lymphomas (S Pileri), T-cell lymphomas (L de Leval), Hodgkin lymphomas (NL Harris) and lymphoid hyperplasias and their differential diagnosis with lymphomas (JKC Chan). The goal is to provide guidance related to practicing state-of-the-art lymphoma pathology in 2014.

An atypical case of lymphoproliferative pulmonary involvement in a patient with Sjögren’s syndrome: a case report

BackgroundSjögren’s syndrome is characterized by lymphocytic infiltration of the exocrine glands, together with polyclonal B-cell activation, and lung diseases are well-known complications of the disease. Therefore, in most cases associated with Sjögren’s syndrome, infiltrating lymphocytes in the lung specimen exhibit the features of B-cells. We herein report an atypical case of lymphoproliferative pulmonary involvement in a patient with Sjögren’s syndrome.Case presentationA 46-year-old female was admitted to our hospital because of an abnormal chest roentgenogram finding on a medical checkup. Chest computed tomography showed randomly-distributed micronodules and patchy ground-glass opacities. A surgical biopsied specimen showed an atypical pattern of interstitial pneumonia with numerous lymphoid follicles. Among the infiltrating lymphocytes in the lung, only the monoclonality of the T-cells was proven by a gene rearrangement analysis, but there was no cytological atypicality or genetic disorder revealed by testing the bone marrow aspirate. A diagnosis of Sjögren’s syndrome was made based on the patient’s other symptoms and these negative findings. The patient’s pulmonary lesions have been successfully treated and remission has been maintained for over three years with corticosteroid treatment alone.ConclusionThe present patient was an atypical case of lymphoproliferative pulmonary involvement in a patient with Sjögren’s syndrome. Although monoclonality of the infiltrating T-cells was proven, the clinical course and the findings of the imaging and laboratory examinations were inconsistent with the previously-reported cases of primary pulmonary T-cell lymphoma. This suggests that the monoclonality of lymphocytes does not always define malignancy. The diagnosis of malignant lymphoma or lymphoproliferative diseases should be made clinically, pathologically and cytogenetically to rule out other similar diseases.

Evaluation of a panel of expert pathologists: review of the diagnosis and histological classification of Hodgkin and non-Hodgkin lymphomas in a population-based cancer registry

Correct histological classification of malignant lymphomas is important but has always been a difficult challenge. Since 2001 the World Health Organization (WHO) classification has been used, which should make it easier to define distinct disease entities. The purpose of this study was to evaluate the usefulness of a panel of expert hematopathologists in reviewing the diagnosis of malignant lymphomas and to examine whether the discordance between primary and panel diagnoses has declined throughout the years. All patients with a primary malignant lymphoma diagnosed between 2000–2001 and 2005–2006 were identified through the population based cancer registry. All diagnoses were reviewed by a panel of three expert pathologists. In 2000–2001, 344 patients were included, and in 2005–2006, 370 patients. The overall discordance rate decreased from 14% in 2000–2001 to 9% in 2005–2006 (p = 0.06). We were able to identify lymphoma subgroups with the highest discordance rates and lowest discordance rates (mantle cell lymphoma and classical Hodgkin lymphoma), which remained unchanged throughout the years. Based on these results we would propose to review all cases of malignant lymphoma with the exception of mantle cell lymphoma and classical Hodgkin lymphoma, when the initial pathologist has no doubt about the diagnosis.

Barriers and facilitators to effective communication experienced by patients with malignant lymphoma at all stages after diagnosis

This study aims to gain insight into patient-perceived communication barriers and facilitators at different stages after the diagnosis of malignant lymphoma. We have detected patterns to explain when these factors influence communication predominantly. A qualitative approach was applied, derived from the context mapping framework. A total of 28 patients completed a set of assignments about their experiences with provider-patient communication during medical consultations. Subsequently, these patients and nine companions shared their experiences during a semistructured (group) interview, which was recorded on audiotape. The audiotapes and assignments were analysed with MAXQDA software. From the patients' viewpoint, communicating effectively appears to depend on their own attributes (e.g. emotions), the health care professionals' attributes (e.g. attitude) and external factors (e.g. time pressure). Three patient communication states were identified: (i) overwhelmed, passive; (ii) pro-active, self-motivated; and (iii) proficient, empowered. Patients seem to behave differently in the three communication states. This study lists patient-perceived communication barriers and facilitators and identifies three different communication states, which indicate when certain barriers and facilitators are encountered. These findings may support health care professionals to tailor the provision of support and information and remove communication barriers accordingly. Additionally, they provide input for interventions to support patients in effective communication.

An atypical presentation of sporadic ovarian Burkitt’s lymphoma: case report and review of the literature

Primary non-Hodgkin’s lymphoma of the ovary is a rare occurrence. An ovarian involvement by non-Hodgkin lymphoma (NHL) may include one of the four subtypes of lymphoma: diffuse large B-cell lymphoma, Burkitt’s lymphoma (BL), lymphoblastic lymphoma or anaplastic large cell lymphoma. Burkitt’s lymphoma is a rare entity with a specific poorly differentiated pattern.Most women experience an ovarian BL with abdominal pelvic pain, abnormal vaginal bleeding, bowel obstruction, urinary frequency, incontinence and abdominal mass. Sometimes these warning signs may be absent, causing a late and more difficult diagnosis.Here we report a case of a primary ovarian Burkitt’s lymphoma with bilateral involvement in a 57 year old patient. She firstly presented neurological symptoms in the upper limbs and she was treated with surgery and combined chemotherapy. The diagnosis of malignant lymphoma was established after bilateral adnexectomy and histological study of the excised tissue.

The use of serum interleukin-2 receptor value for diagnosis of malignant lymphoma.

e19507 Background: Serum soluble interleukin-2 receptor (sIL2R) has been anecdotally used for diagnosis of malignant lymphoma (ML). However, sensitivity and specificity have not been evaluated; therefore, there is no consensus for the appropriate cut-off value for diagnosis of ML. Methods: We retrospectively analyzed sIL2R values at initial presentation in the patients who were diagnosed with ML. We compared them with the sIL2R values in the patients who presented with lymphadenopathy but were not diagnosed with ML. Results: In 496 patients with ML, 232 patients were diagnosed with diffuse large B-cell lymphoma (DLBCL), 109 with follicular lymphoma (FL), 40 with T-cell lymphoma (TCL), 39 with Hodgkin lymphoma (HL), 16 with marginal zone B-cell lymphoma (MZBCL), 12 with mantle cell lymphoma (MCL) and 21 with others. In the 69 control patients who did not have ML, 22 patients were diagnosed with metastatic lymph nodes of cancer, 14 with reactive lymph nodes, 12 with Kikuchi’s disease (histiocytic necrotizing lymphadenitis), 6 with granulomatous lymphadenitis (including mycobacterial infection), 3 with sarcoidosis, 2 with infectious mononucleosis (in combination with clinical diagnosis), 1 with Castleman’s disease and 9 with others. Mean value of sIL2R in the patients with ML was 4223U/ml (95% confidence interval, CI: 3251-5196). It was significantly higher than that in patients not having ML (mean: 1072U/ml, 95%CI: 788-1356, p&lt;0.0001, t-test). The sensitivity and specificity were calculated based on our results. When the cut-off value was set at 1000U/ml, sensitivity for diagnosis of ML was 64% and specificity was 68%. When the cut-off value was set at 2000U/ml, sensitivity was 41% and specificity was 86%. According to histologic subtypes, mean sIL2R values were 4592U/ml (95%CI: 3690-6088) in DLBCL, 2166U/ml (95%CI: 1669-2664) in FL, 6510U/ml (95%CI: 3692-9329) in TCL, 1395U/ml (95%CI: 550-2240) in MZBCL, 2956U/ml (95%CI: 1736-4175) in HL and 3264U/ml (95%CI: 1734-4795) in MCL. Mean sIL2R value in each histologic subtype, except for MZBCL, was significantly higher than that in patients not having ML. Conclusions: Our study suggests that sIL2R value is useful for diagnosis of ML other than MZBCL.