原发性淋巴结边缘 B 细胞淋巴瘤 (NMZL) 很少见，且组织学差异很大。由于一般缺乏淋巴结边缘区淋巴瘤的特异性标志物，其大细胞表现很难与结节弥漫性大 B 细胞淋巴瘤 (nDLBCL) 区分开来。使用 NMZL 综合队列和 nDLBCL 对照队列，我们​​进行了对两个亚组进行甲基化组分析。队列之间的甲基化组显着不同，但 NMZL 队列中的甲基化组却出乎意料地同质。这使我们能够描述 NMZL 在其所有值范围内的形态谱。通过形态计量学探讨了 NMZL 与 nDLBCL 在生长模式和细胞学方面的相当大的重叠，从而产生了一种通过简单测量细胞大小和核大小来分离两者的操作工具。这被整合到一个分层方法中，包括参数生长模式、滤泡定植、滤泡树突网络、IgD 表达和 Ki-67 率的评分系统，并提出了我们在此提出的分类器的提案。基于的研究将 NMZL 的形态谱扩展到大细胞形态，并提供了一种将其与 nDLBCL 区分开的传统方法。© 美国临床病理学会，2024 年。

Primary nodal marginal B-cell lymphoma (NMZL) is rare and histologically very variable. Its large-cell presentation is difficult to distinguish from nodal diffuse large B-cell lymphoma (nDLBCL) due to the absence of specific markers for nodal marginal zone lymphomas in general.Using a comprehensive cohort of NMZLs and a control cohort of nDLBCLs, we conducted a methylome analysis on subgroups of both.The methylomes were strikingly different between the cohorts but unexpectedly homogeneous within the NMZL cohort. This allowed us to describe the morphologic spectrum of NMZL in all its value ranges. The considerable overlap in growth pattern and cytology of NMZL with nDLBCL was explored morphometrically, leading to an operational tool for separating both by a simple measurement of cell size and nuclear size. This was integrated in a hierarchical approach, including a scoring system for the parameter growth pattern, follicular colonization, follicular dendritic network, IgD expression, and Ki-67 rate, and led to a proposal for a classifier that we present here.This methylome-based study extends the morphological spectrum of NMZL towards large cell morphology and offers a conventional way to distinguish it from nDLBCL.© American Society for Clinical Pathology, 2024.