{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:13:24Z","timestamp":1788513204095,"version":"build-2803163510"},"reference-count":73,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Extranodal marginal zone lymphoma (EMZL) represents a unique paradigm among indolent B\u2010cell neoplasms, in which lymphomagenesis is frequently driven by chronic antigenic stimulation within tissue\u2010specific microenvironments. Persistent infectious or autoimmune triggers promote the development of ectopic lymphoid tissue and sustain B\u2010cell activation, while recurrent genetic alterations\u2014most prominently those that converge on NF\u2010\u03baB signaling\u2014enable progressive escape from antigen dependence. This dual biological foundation explains both the indolent clinical course of most cases and the remarkable therapeutic vulnerability of early\u2010stage, infection\u2010driven disease. Clinically, EMZL arise across a wide range of anatomical sites, each characterized by distinct etiologic associations and patterns of progression. As a result, management strategies must be tailored to disease site, stage, and biological context, with a consistent preference for the least intensive intervention capable of achieving durable disease control. Pathogen\u2010directed antibiotic therapy and involved\u2010site radiotherapy can be curative in localized disease. In contrast, systemic anti\u2010CD20\u2010based immunochemotherapy and targeted agents are reserved for disseminated, refractory, or biologically autonomous lymphomas. Recent advances in molecular profiling, functional imaging, and response assessment are refining risk stratification and treatment selection, shifting therapeutic goals toward early depth of response and quality of life rather than maximal cytotoxic intensity. EMZL thus serves as a model for biologically informed, precision\u2010oriented management of indolent lymphoid malignancies.<\/jats:p>","DOI":"10.1111\/ejh.70245","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T07:08:26Z","timestamp":1782198506000},"page":"849-863","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extranodal Marginal Zone Lymphoma: Integrating Etiology, Microenvironment, and Genetics Into Clinical Decision\u2010Making"],"prefix":"10.1111","volume":"117","author":[{"given":"Mamdouh","family":"Skafi","sequence":"first","affiliation":[{"name":"Emergency and Internal Medicine Department Saint Joseph Hospital  East Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santino","family":"Caserta","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco\u2010Hematology AO of Cosenza  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrica Antonia","family":"Martino","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco\u2010Hematology AO of Cosenza  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Vigna","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco\u2010Hematology AO of Cosenza  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Bruzzese","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco\u2010Hematology AO of Cosenza  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Amodio","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine University of Catanzaro  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8055-3259","authenticated-orcid":false,"given":"Marco","family":"Fiorillo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Health and Nutritional Science University of Calabria  Rende Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Lucia","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco\u2010Hematology AO of Cosenza  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziella","family":"D'Arrigo","sequence":"additional","affiliation":[{"name":"Istituto di Fisiologia Clinica del CNR di Reggio Calabria Consiglio Nazionale Delle Ricerche  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Olivito","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco\u2010Hematology AO of Cosenza  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Labanca","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco\u2010Hematology AO of Cosenza  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6339-632X","authenticated-orcid":false,"given":"Francesco","family":"Mendicino","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco\u2010Hematology AO of Cosenza  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Eugenia","family":"Alvaro","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco\u2010Hematology AO of Cosenza  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Tripepi","sequence":"additional","affiliation":[{"name":"Istituto di Fisiologia Clinica del CNR di Reggio Calabria Consiglio Nazionale Delle Ricerche  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fortunato","family":"Morabito","sequence":"additional","affiliation":[{"name":"AIL Sezione di Cosenza  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5256-0726","authenticated-orcid":false,"given":"Massimo","family":"Gentile","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco\u2010Hematology AO of Cosenza  Cosenza Italy"},{"name":"Department of Pharmacy, Health and Nutritional Science University of Calabria  Rende Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.21037\/Aol\u201020\u201028"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/Ajh.27058"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/Bjh.19064"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.Beha.2016.09.002"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/102656"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/Blood.2024028268"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12094\u2010023\u201003307\u20101"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/Blood\u20102008\u201012\u2010195453"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408\u2010026\u201001535\u20106"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/Blood.2024028269"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.Beha.2016.12.001"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/Hematology.2022000362"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/Nejmra2102568"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/Hon.3152"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/Nejm199309303291402"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/Blood\u20102003\u201012\u20104434"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/Jco.2008.21.3991"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/J.1365\u20102141.2002.03613.X"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/Cncr.27704"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2007.08.012"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25325"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102017\u201003\u2010771915"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.6994"},{"key":"e_1_2_14_24_2","doi-asserted-by":"crossref","unstructured":"Erratum in: Journal of Clinical Oncology 2017 Jul 10;35(20):2342.https:\/\/doi.org\/10.1200\/JCO.2017.74.4441.","DOI":"10.1200\/JCO.2017.74.3971"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26715"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2021.1909468"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102592"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102141.2006.06437.x"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201032259\u20105"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408\u2010024\u201001162\u2010z"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.14740\/jh2103"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc1409"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140\u20106736(93)91408\u2010e"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140\u20106736(93)91409\u2010f"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199405053301803"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djh102"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.14289"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm\u201025\u2010114"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2017.01.001"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2009.005983"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102006\u201006\u2010030494"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2010.76"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.4852"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.3960\/jslrt.24034"},{"key":"e_1_2_14_45_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v14.i1.153"},{"key":"e_1_2_14_46_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1508559"},{"key":"e_1_2_14_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.1715"},{"key":"e_1_2_14_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379\u2010018\u20100064\u20100"},{"key":"e_1_2_14_49_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14010176"},{"key":"e_1_2_14_50_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.11548"},{"key":"e_1_2_14_51_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.11635"},{"key":"e_1_2_14_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2024.105683"},{"key":"e_1_2_14_53_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01701\u20102015"},{"key":"e_1_2_14_54_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.53.1.34"},{"key":"e_1_2_14_55_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603708"},{"key":"e_1_2_14_56_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdn760"},{"key":"e_1_2_14_57_1","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.214.79"},{"key":"e_1_2_14_58_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.41.4466"},{"key":"e_1_2_14_59_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol\u20102019\u2010314008"},{"key":"e_1_2_14_60_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41433\u2010020\u201001198\u2010y"},{"key":"e_1_2_14_61_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21330"},{"key":"e_1_2_14_62_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102017\u201007\u2010795302"},{"key":"e_1_2_14_63_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102016\u201010\u2010747345"},{"key":"e_1_2_14_64_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201021\u20101704"},{"key":"e_1_2_14_65_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00010"},{"key":"e_1_2_14_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(25)02435\u20103"},{"key":"e_1_2_14_67_1","doi-asserted-by":"publisher","DOI":"10.1002\/hon.2563"},{"key":"e_1_2_14_68_1","doi-asserted-by":"publisher","DOI":"10.1002\/hon.2181"},{"key":"e_1_2_14_68_2","doi-asserted-by":"crossref","unstructured":"Erratum in: Hematology\/Oncology Clinics of North America 2016 Jun;34(2):117.https:\/\/doi.org\/10.1002\/hon.2291.","DOI":"10.1002\/hon.2291"},{"key":"e_1_2_14_69_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201068310\u2010w"},{"key":"e_1_2_14_70_1","doi-asserted-by":"publisher","DOI":"10.1002\/hon.2578"},{"key":"e_1_2_14_71_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17703"},{"key":"e_1_2_14_72_1","doi-asserted-by":"publisher","DOI":"10.1158\/2643\u20103230.BCD\u201021\u20100029"}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.70245","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ejh.70245","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.70245","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:22:46Z","timestamp":1788510166000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ejh.70245"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,23]]},"references-count":73,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/ejh.70245"],"URL":"https:\/\/doi.org\/10.1111\/ejh.70245","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,23]]},"assertion":[{"value":"2026-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}