{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T17:14:29Z","timestamp":1772126069677,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,4,8]],"date-time":"2015-04-08T00:00:00Z","timestamp":1428451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["pathsocjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pathology"],"published-print":{"date-parts":[[2015,7]]},"abstract":"Abstract<\/jats:title>Many hyperplasias and lymphomas of marginal zone B\u2010cells are associated with infection. We identified six children and one adolescent with cervical lymphadenopathy showing prominent polyclonal nodal marginal zone hyperplasia (pNMZH<\/jats:styled-content>) and four adolescents with monoclonal paediatric nodal marginal zone lymphoma (pNMZL<\/jats:styled-content>). The clonality status was assessed using BIOMED<\/jats:styled-content>\u20102\u2010IG PCR<\/jats:styled-content> analysis. Haemophilus influenzae<\/jats:italic> was identified in all six cases of pNMZH<\/jats:styled-content> that could be tested by direct culture (N<\/jats:italic> = 3) or a very sensitive PCR<\/jats:styled-content> for the H. influenzae<\/jats:italic> gyrase gene in frozen materials (N<\/jats:italic> = 5). H. influenzae<\/jats:italic> was not detected in three pNMZLs<\/jats:styled-content> and 28 non\u2010specific reactive cervical lymph nodes of age\u2010matched controls, except for a single control node that was obtained during oropharyngeal surgery for a cleft palate showing very low copy numbers of H. influenzae<\/jats:italic>. pNMZH<\/jats:styled-content> patients were younger than pNMZL<\/jats:styled-content> patients (median age 12 versus 21 years). pNMZH<\/jats:styled-content> showed a prominent nodular appearance with variable fibrosis without acute inflammation. Within the nodules, the expanded germinal centres and variably sized marginal zones were colonized by activated B\u2010cells with weak expression of IgD<\/jats:styled-content> and lack of CD10<\/jats:styled-content> and\/or BCL6<\/jats:styled-content> expression. Some areas showed skewed light chain expression in plasma cells (4\/5 cases lambda). In four cases tested, this was confirmed by flow cytometry for surface Ig (3\/4 cases lambda). In contrast, pNMZL<\/jats:styled-content> showed more extensive expansion of marginal zones by centrocytoid cells and often expression of BCL2<\/jats:styled-content> protein. Several H.\u00a0influenzae<\/jats:italic> strains are known to interact with the constant part of IgD<\/jats:styled-content> on human B\u2010cells, leading to their polyclonal proliferation and activation. We speculate that in vivo<\/jats:italic> stimulation of IgD<\/jats:styled-content>+ marginal zone B\u2010cells by this bacterium may be implicated in this particular lymphadenopathy that should be distinguished from monoclonal pNMZL<\/jats:styled-content>. Copyright \u00a9 2015 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.<\/jats:p>","DOI":"10.1002\/path.4524","type":"journal-article","created":{"date-parts":[[2015,2,26]],"date-time":"2015-02-26T05:34:23Z","timestamp":1424928863000},"page":"302-314","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Paediatric nodal marginal zone B\u2010cell lymphadenopathy of the neck: a Haemophilus influenzae<\/i>\u2010driven immune disorder?"],"prefix":"10.1002","volume":"236","author":[{"given":"Philip M","family":"Kluin","sequence":"first","affiliation":[{"name":"Department of Pathology and Medical Biology University Medical Centre Groningen, University of Groningen Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anton W","family":"Langerak","sequence":"additional","affiliation":[{"name":"Department of Immunology, Erasmus MC University Medical Centre Rotterdam Rotterdam The 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