{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T18:48:14Z","timestamp":1778525294228,"version":"3.51.4"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>Mucosa-associated lymphoid tissue (MALT) lymphomas often express IgM and IRTA1 with only a minority demonstrating plasmacytic differentiation. However, like primary cutaneous marginal zone lymphoproliferative disorders (PCMZLPD), thyroid MALT lymphomas (T-MALT-L) frequently show plasmacytic differentiation and IgG positivity. Whether T-MALT-L share other features with PCMZLPD, including frequent IgG4 positivity and infrequent IRTA1 expression, and how IRTA1 staining compares to that in Hashimoto thyroiditis (HT) are unknown. Therefore, the clinicopathologic features of 18 T-MALT-L were assessed, and their IRTA1 expression compared with that in 5 HT cases. All T-MALT-L cases included a B-lymphoid component. Plasmacytic differentiation was present in 15 cases and was extensive in 12. Fourteen cases were IgG+ including 2 IgG4+ (12 \u03ba+, 2 \u03ba\u2212\/\u03bb\u2212). One case was IgA\u03bb+. Plasmacytic cells were uniformly CD19+\/CD56\u2212 but CD138\u2212 in 7\/15 cases. IRTA1+ cells were present in 16\/16 cases, ranging from scattered cells to &gt;50%. They were often concentrated in \u201cMALT ball\u201d-type lymphoepithelial lesions, perifollicular regions, and sometimes in germinal centers. IRTA1 positivity was also present in all HT cases, although it was never very extensive and often had a perifollicular distribution, occasionally with sparse aggregates and positive cells within rare thyroid follicles. Thus, T-MALT-L share some features with PCMZLPD but are more similar to noncutaneous MALT lymphomas, with prominent lymphoepithelial lesions, ubiquitous although variable IRTA1 positivity, and infrequent IgG4 positivity. Plasmacytic differentiation is also common although CD138 loss is frequent and light chain staining may be absent. IRTA1 staining may help in the differential diagnosis with HT, although there is some overlap in staining patterns.<\/jats:p>","DOI":"10.1097\/pas.0000000000002005","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T21:49:57Z","timestamp":1675374597000},"page":"370-378","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["The Distinctive Nature of Thyroid MALT Lymphomas Including IRTA1 Expression"],"prefix":"10.1097","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6853-1017","authenticated-orcid":false,"given":"Eric D.","family":"Carlsen","sequence":"first","affiliation":[{"name":"Department of Pathology, Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam R.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Pathology, UPMC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"Cook","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven H.","family":"Swerdlow","sequence":"additional","affiliation":[{"name":"Department of Pathology, UPMC"},{"name":"Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,12,12]]},"reference":[{"key":"R1-20250608","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1159\/000502204","article-title":"Mucosa-associated lymphoid tissue lymphoma of the thyroid gland: a systematic review of the literature","volume":"9","author":"Karvounis","year":"2020","journal-title":"Eur Thyroid J"},{"key":"R2-20250608","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1093\/ajcp\/aqz145","article-title":"Hashimoto thyroiditis in primary thyroid non-Hodgkin lymphoma","volume":"153","author":"Travaglino","year":"2020","journal-title":"Am J Clin Pathol"},{"key":"R3-20250608","first-page":"43","article-title":"Follicular colonization in thyroid lymphoma","volume":"141","author":"Isaacson","year":"1992","journal-title":"Am J Pathol"},{"key":"R4-20250608","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1097\/00000478-200005000-00001","article-title":"Malignant lymphoma of the thyroid gland: a clinicopathologic study of 108 cases","volume":"24","author":"Derringer","year":"2000","journal-title":"Am J Surg Pathol"},{"key":"R5-20250608","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.5858\/2007-131-1673-SMDIEM","article-title":"Site-specific morphologic differences in extranodal marginal zone B-cell lymphomas","volume":"131","author":"Rawal","year":"2007","journal-title":"Arch Pathol Lab Med"},{"key":"R6-20250608","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1111\/j.1365-2559.1985.tb02972.x","article-title":"Primary malignant lymphoma of the thyroid--a tumour of mucosa-associated lymphoid tissue: review of seventy-six cases","volume":"9","author":"Anscombe","year":"1985","journal-title":"Histopathology"},{"key":"R7-20250608","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1016\/S0046-8177(88)80287-9","article-title":"Primary B cell lymphoma of the thyroid and its relationship to Hashimoto\u2019s thyroiditis","volume":"19","author":"Hyjek","year":"1988","journal-title":"Hum Pathol"},{"key":"R8-20250608","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ajcp\/74.1.1","article-title":"Malignant lymphoma and other lymphoproliferative disorders of the thyroid gland. A clinicopathologic study of 245 cases","volume":"74","author":"Compagno","year":"1980","journal-title":"Am J Clin Pathol"},{"key":"R9-20250608","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/0002-9610(66)90275-3","article-title":"Primary malignant lymphoma of the thyroid. Review of forty-six cases","volume":"111","author":"Woolner","year":"1966","journal-title":"Am J Surg"},{"key":"R10-20250608","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1016\/j.surg.2009.09.020","article-title":"Prognosis of primary thyroid lymphoma: demographic, clinical, and pathologic predictors of survival in 1,408 cases","volume":"146","author":"Graff-Baker","year":"2009","journal-title":"Surgery"},{"key":"R11-20250608","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1159\/000333113","article-title":"Primary thyroid marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue type: clinical manifestation and outcome of a rare disease\u2014consortium for improving survival of lymphoma study","volume":"127","author":"Oh","year":"2012","journal-title":"Acta Haematol"},{"key":"R12-20250608","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1210\/jc.2017-01478","article-title":"Long-term outcomes of 107 cases of primary thyroid mucosa-associated lymphoid tissue lymphoma at a single Medical Institution in Japan","volume":"103","author":"Watanabe","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"R13-20250608","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1097\/PAS.0000000000001363","article-title":"Class-switched primary cutaneous marginal zone lymphomas are frequently IgG4-positive and have features distinct from IgM-positive cases","volume":"43","author":"Carlsen","year":"2019","journal-title":"Am J Surg Pathol"},{"key":"R14-20250608","doi-asserted-by":"crossref","first-page":"1830","DOI":"10.1097\/PAS.0b013e3181f72835","article-title":"Cutaneous marginal zone lymphomas have distinctive features and include 2 subsets","volume":"34","author":"Edinger","year":"2010","journal-title":"Am J Surg Pathol"},{"key":"R15-20250608","doi-asserted-by":"crossref","first-page":"3355","DOI":"10.1182\/blood-2008-01-132415","article-title":"The majority of cutaneous marginal zone B-cell lymphomas expresses class-switched immunoglobulins and develops in a T-helper type 2 inflammatory environment","volume":"112","author":"van Maldegem","year":"2008","journal-title":"Blood"},{"key":"R16-20250608","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1182\/blood.2022015851","article-title":"The International Consensus Classification of Mature Lymphoid Neoplasms: a report from the Clinical Advisory Committee","volume":"140","author":"Campo","year":"2022","journal-title":"Blood"},{"key":"R17-20250608","doi-asserted-by":"crossref","first-page":"1568","DOI":"10.1038\/modpathol.2013.106","article-title":"Primary cutaneous marginal zone lymphomas with plasmacytic differentiation show frequent IgG4 expression","volume":"26","author":"Brenner","year":"2013","journal-title":"Mod Pathol"},{"key":"R18-20250608","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/cup.14111","article-title":"IRTA1 positivity helps identify a MALT-lymphoma-like subset of primary cutaneous marginal zone lymphomas, largely but not exclusively defined by IgM expression","volume":"49","author":"Carlsen","year":"2022","journal-title":"J Cutan Pathol"},{"key":"R19-20250608","doi-asserted-by":"crossref","first-page":"2662","DOI":"10.1182\/blood.V99.8.2662","article-title":"IRTAs: a new family of immunoglobulinlike receptors differentially expressed in B cells","volume":"99","author":"Miller","year":"2002","journal-title":"Blood"},{"key":"R20-20250608","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1111\/j.1365-2559.2012.04289.x","article-title":"IRTA1 is selectively expressed in nodal and extranodal marginal zone lymphomas","volume":"61","author":"Falini","year":"2012","journal-title":"Histopathology"},{"key":"R21-20250608","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.humpath.2016.09.011","article-title":"Immunohistochemical analysis of the novel marginal zone B-cell marker IRTA1 in malignant lymphoma","volume":"59","author":"Ikeda","year":"2017","journal-title":"Hum Pathol"},{"key":"R22-20250608","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1093\/ajcp\/aqy144","article-title":"IRTA1 and MNDA expression in marginal zone lymphoma: utility in differential diagnosis and implications for classification","volume":"151","author":"Wang","year":"2019","journal-title":"Am J Clin Pathol"},{"key":"R26-20250608","doi-asserted-by":"crossref","first-page":"e558","DOI":"10.3324\/haematol.2018.214957","article-title":"Novel insights into the genetics and epigenetics of MALT lymphoma unveiled by next generation sequencing analyses","volume":"104","author":"Cascione","year":"2019","journal-title":"Haematologica"},{"key":"R27-20250608","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.3324\/haematol.2018.191601","article-title":"Novel GPR34 and CCR6 mutation and distinct genetic profiles in MALT lymphomas of different sites","volume":"103","author":"Moody","year":"2018","journal-title":"Haematologica"},{"key":"R28-20250608","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1002\/cncr.27773","article-title":"Survival of patients with marginal zone lymphoma: analysis of the Surveillance, Epidemiology, and End Results database","volume":"119","author":"Olszewski","year":"2013","journal-title":"Cancer"},{"key":"R29-20250608","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00428-021-03186-3","article-title":"Mutational landscape of marginal zone B-cell lymphomas of various origin: organotypic alterations and diagnostic potential for assignment of organ origin","volume":"480","author":"Vela","year":"2022","journal-title":"Virchows Arch"},{"key":"R30-20250608","doi-asserted-by":"crossref","first-page":"3497","DOI":"10.1038\/s41375-021-01289-z","article-title":"Thyroid MALT lymphoma: self-harm to gain potential T-cell help","volume":"35","author":"Wu","year":"2021","journal-title":"Leukemia"},{"key":"R31-20250608","doi-asserted-by":"crossref","first-page":"3768","DOI":"10.1182\/blood-2004-09-3502","article-title":"WHO-EORTC classification for cutaneous lymphomas","volume":"105","author":"Willemze","year":"2005","journal-title":"Blood"},{"key":"R32-20250608","first-page":"354","article-title":"EORTC classification for primary cutaneous lymphomas: a proposal from the Cutaneous Lymphoma Study Group of the European Organization for Research and Treatment of Cancer","volume":"90","author":"Willemze","year":"1997","journal-title":"Blood"},{"key":"R33-20250608","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1038\/s41375-022-01620-2","article-title":"The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms","volume":"36","author":"Alaggio","year":"2022","journal-title":"Leukemia"},{"key":"R34-20250608","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1002\/1097-0142(19870901)60:5<969::AID-CNCR2820600509>3.0.CO;2-Z","article-title":"Immunologic and immunohistologic analysis of 27 cases with thyroid lymphomas","volume":"60","author":"Aozasa","year":"1987","journal-title":"Cancer"},{"key":"R35-20250608","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/0167-5699(85)90030-1","article-title":"Are kappa and lambda light-chain-bearing B cells functionally distinct?","volume":"6","author":"Swerdlow","year":"1985","journal-title":"Immunol Today"},{"key":"R36-20250608","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1111\/his.12854","article-title":"IgG4-positive extranodal marginal zone lymphoma arising in Hashimoto\u2019s thyroiditis: clinicopathological and cytogenetic features of a hitherto undescribed condition","volume":"68","author":"Tan","year":"2016","journal-title":"Histopathology"},{"key":"R37-20250608","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.anl.2012.12.004","article-title":"Mucosa-associated lymphoid tissue lymphoma of the thyroid with abundant IgG4-positive plasma cells","volume":"40","author":"Miki","year":"2013","journal-title":"Auris Nasus Larynx"},{"key":"R38-20250608","doi-asserted-by":"crossref","first-page":"e232233","DOI":"10.1136\/bcr-2019-232233","article-title":"CD138-negative plasma cell myeloma: a diagnostic challenge and a unique entity","volume":"12","author":"Setiadi","year":"2019","journal-title":"BMJ Case Rep"},{"key":"R39-20250608","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1182\/blood.2019001845","article-title":"CD138(-) plasma cell myeloma","volume":"134","author":"Shuai","year":"2019","journal-title":"Blood"},{"key":"R40-20250608","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1002\/cyto.b.20571","article-title":"Marginal zone B cell lymphomas with extensive plasmacytic differentiation are neoplasms of precursor plasma cells","volume":"80","author":"Meyerson","year":"2011","journal-title":"Cytometry B Clin Cytom"},{"key":"R41-20250608","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1136\/bjo.2004.047092","article-title":"Plasmacellular differentiation in extranodal marginal zone B cell lymphomas of the ocular adnexa: an analysis of the neoplastic plasma cell phenotype and its prognostic significance in 136 cases","volume":"89","author":"Coupland","year":"2005","journal-title":"Br J Ophthalmol"},{"key":"R42-20250608","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s00428-015-1858-9","article-title":"The many faces of small B cell lymphomas with plasmacytic differentiation and the contribution of MYD88 testing","volume":"468","author":"Swerdlow","year":"2016","journal-title":"Virchows Arch"},{"key":"R43-20250608","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1046\/j.1365-2141.1998.00623.x","article-title":"The myeloma cell antigen syndecan-1 is lost by apoptotic myeloma cells","volume":"100","author":"Jourdan","year":"1998","journal-title":"Br J Haematol"},{"key":"R44-20250608","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1097\/PAS.0b013e318240590a","article-title":"Gamma heavy-chain disease: defining the spectrum of associated lymphoproliferative disorders through analysis of 13 cases","volume":"36","author":"Bieliauskas","year":"2012","journal-title":"Am J Surg Pathol"},{"key":"R45-20250608","first-page":"893","article-title":"Gamma-chain heavy-chain disease with primary thyroid plasmacytoma","volume":"110","author":"Otto","year":"1986","journal-title":"Arch Pathol Lab Med"},{"key":"R46-20250608","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1016\/j.cca.2012.04.020","article-title":"Gamma heavy chain disease in a patient with underlying lymphoplasmacytic lymphoma of the thyroid. Report of a case and comparison with other reported cases with thyroid involvement","volume":"413","author":"Tan","year":"2012","journal-title":"Clin Chim Acta"},{"key":"R47-20250608","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1097\/01.md.0000085058.63483.7f","article-title":"Gamma-heavy chain disease: review of 23 cases","volume":"82","author":"Wahner-Roedler","year":"2003","journal-title":"Medicine (Baltimore)"},{"key":"R48-20250608","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1093\/ajcp\/78.4.427","article-title":"The histopathology of gamma heavy-chain disease","volume":"78","author":"Wester","year":"1982","journal-title":"Am J Clin Pathol"},{"key":"R49-20250608","doi-asserted-by":"crossref","first-page":"e154","DOI":"10.3324\/haematol.2014.108688","article-title":"Gamma heavy chain disease lacks the MYD88 L265p mutation associated with lymphoplasmacytic lymphoma","volume":"99","author":"Hamadeh","year":"2014","journal-title":"Haematologica"}],"container-title":["American Journal of Surgical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PAS.0000000000002005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T21:01:22Z","timestamp":1749416482000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PAS.0000000000002005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,12]]},"references-count":46,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1097\/pas.0000000000002005","relation":{},"ISSN":["0147-5185"],"issn-type":[{"value":"0147-5185","type":"print"}],"subject":[],"published":{"date-parts":[[2022,12,12]]}}}