{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:06:22Z","timestamp":1753877182332,"version":"3.41.2"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Tonsillar marginal zone hyperplasia may mimic mucosa-associated lymphoid tissue lymphoma, a rare diagnosis in children. Histologically, both entities can demonstrate expansion of the marginal zone with disruption of follicular architecture. However, marginal zone hyperplasia may appear polyclonal by flow cytometry. We present two pediatric tonsillectomy cases with tonsillar marginal zone hyperplasia and discuss the diagnostic challenges this poses in the pediatric population. Both tonsillectomies demonstrated expansion of marginal zones with partial architectural effacement, and flow cytometric analysis of both cases detected lambda light chain restricted, CD20(bright) B cells without CD38. Authors have suggested that the lambda restricted B cells in this setting represent na\u00efve, unmutated B cells with preferential, but polyclonal, lambda expression. Our cases are in line with this thought. While robust, BIOMED-2 primer PCR can show dominant IgK peaks, which may be misinterpreted. This presents a diagnostic pitfall in the workup of pediatric tonsils that community pathologists must consider.<\/jats:p>","DOI":"10.1093\/jscr\/rjae622","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T20:11:51Z","timestamp":1732738311000},"source":"Crossref","is-referenced-by-count":0,"title":["Young and na\u00efve B cells are a diagnostic pitfall in pediatric tonsillectomies"],"prefix":"10.1093","volume":"2024","author":[{"given":"Sophie","family":"Tillotson","sequence":"first","affiliation":[{"name":"College of Medicine, University of Florida , 1600 SW Archer Rd, Gainesville, FL 32610 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Shi","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Florida , 1600 SW Archer Rd, Gainesville, FL 32610 ,","place":["United States"]},{"name":"Penn State Health Milton S. Hershey Medical Center , 500 University Dr, Hershey, PA 17033 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Pathology , Immunology and Laboratory Medicine, , 1600 SW Archer Rd, Gainesville, FL 32610 ,","place":["United States"]},{"name":"College of Medicine, University of Florida , Immunology and Laboratory Medicine, , 1600 SW Archer Rd, Gainesville, FL 32610 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert P","family":"Seifert","sequence":"additional","affiliation":[{"name":"Department of Pathology , Immunology and Laboratory Medicine, , 1600 SW Archer Rd, Gainesville, FL 32610 ,","place":["United States"]},{"name":"College of Medicine, University of Florida , Immunology and Laboratory Medicine, , 1600 SW Archer Rd, Gainesville, FL 32610 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"volume-title":"WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues","year":"2017","author":"Swerdlow","key":"2024112720113936000_ref1"},{"key":"2024112720113936000_ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.21037\/aol-20-28","article-title":"Epidemiology of marginal zone lymphoma","volume":"5","author":"Cerhan","year":"2021","journal-title":"Ann Lymphoma"},{"key":"2024112720113936000_ref3","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1056\/NEJMra2102568","article-title":"Marginal-zone lymphomas","volume":"386","author":"Rossi","year":"2022","journal-title":"N Engl J Med"},{"key":"2024112720113936000_ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.mpdhp.2015.12.001","article-title":"Paediatric marginal zone lymphoma and hyperplasia","volume":"22","author":"Ganapathi","year":"2016","journal-title":"Diagn Histopathol"},{"key":"2024112720113936000_ref5","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1002\/pbc.20575","article-title":"MALT lymphoma in children: a report from the NHL-BFM study group","volume":"47","author":"Claviez","year":"2006","journal-title":"Pediatr Blood Cancer"},{"key":"2024112720113936000_ref6","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1097\/PAS.0000000000000735","article-title":"EBV-negative aggressive NK-cell Leukemia\/lymphoma: clinical, pathologic, and genetic features","volume":"41","author":"Nicolae","year":"2017","journal-title":"Am J Surg Pathol"},{"key":"2024112720113936000_ref7","doi-asserted-by":"publisher","first-page":"3343","DOI":"10.1182\/blood-2004-01-0385","article-title":"Atypical marginal zone hyperplasia of mucosa-associated lymphoid tissue: a reactive condition of childhood showing immunoglobulin lambda light-chain restriction","volume":"104","author":"Attygalle","year":"2004","journal-title":"Blood"},{"key":"2024112720113936000_ref8","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1111\/his.12511","article-title":"Childhood florid follicular hyperplasia with immunoglobulin light-chain restriction in the gastrointestinal tract","volume":"65","author":"Martinez-Lopez","year":"2014","journal-title":"Histopathology"},{"key":"2024112720113936000_ref9","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1002\/ajh.22132","article-title":"Atypical marginal zone hyperplasia of tonsil with immunoglobulin light chain restriction","volume":"87","author":"Kaur","year":"2012","journal-title":"Am J Hematol"},{"key":"2024112720113936000_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqw151.004","article-title":"Atypical marginal zone hyperplasia is a mimic for marginal zone lymphoma in pediatric patients","volume":"146","author":"Ali","year":"2016","journal-title":"Am J Clin 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B-cell non-Hodgkin lymphomas using BIOMED-2 protocol","volume":"16","author":"Ghorbian","year":"2014","journal-title":"Clin Transl Oncol"},{"key":"2024112720113936000_ref14","doi-asserted-by":"publisher","first-page":"5596","DOI":"10.4049\/jimmunol.164.11.5596","article-title":"Heterogeneity of tonsillar subepithelial B lymphocytes, the splenic marginal zone equivalents","volume":"164","author":"Dono","year":"2000","journal-title":"J Immunol"}],"container-title":["Journal of Surgical Case 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