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Microscopy of the right fallopian tube showed dense infiltrate of monomorphous lymphocytes with mild nuclear membrane irregularity. Immunohistochemical stains found a marked increase in CD20 B\u2009cells with Ki-67 &lt;5%. Postoperative positron emission tomography was negative for multifocal involvement. This was consistent with a primary low-grade EMZL of the right fallopian tube. We present a case of a macroscopically normal primary tubal EMZL with no evidence of preceding antigenic stimulus, thus challenging its well-established role in the lymphomagenesis of EMZL.<\/jats:p>","DOI":"10.1136\/bcr-2025-265455","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T13:40:20Z","timestamp":1747662020000},"page":"e265455","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Primary extranodal marginal zone B-cell lymphoma in a macroscopically normal fallopian tube"],"prefix":"10.1136","volume":"18","author":[{"given":"Virginia","family":"Su","sequence":"first","affiliation":[{"name":"Obstetrics & Gynaecology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce","family":"Wu","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynaecology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"2025082711335788000_18.5.e265455.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2008.07.011"},{"key":"2025082711335788000_18.5.e265455.2","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.ygyno.2017.02.043","article-title":"Primary lymphoma of the female genital tract: An analysis of 697 cases","volume":"145","author":"Nasioudis","year":"2017","journal-title":"Gynecol Oncol"},{"key":"2025082711335788000_18.5.e265455.3","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12730"},{"key":"2025082711335788000_18.5.e265455.4","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/00004347-198603000-00002","article-title":"Lymphoid tissue of the normal fallopian tube--a form of mucosal-associated lymphoid tissue (MALT)?","volume":"5","author":"Morris","year":"1986","journal-title":"Int J Gynecol Pathol"},{"key":"2025082711335788000_18.5.e265455.5","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1006\/gyno.2002.6761","article-title":"Primary extranodal marginal zone B-cell lymphoma of the fallopian tube","volume":"86","author":"Noack","year":"2002","journal-title":"Gynecol Oncol"},{"key":"2025082711335788000_18.5.e265455.6","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.gynor.2011.10.005","article-title":"Primary extranodal marginal zone B-cell lymphoma of MALT-type involving the fallopian tube","volume":"2","author":"Cho","year":"2012","journal-title":"Gynecol Oncol Case Rep"},{"key":"2025082711335788000_18.5.e265455.7","doi-asserted-by":"crossref","first-page":"e12","DOI":"10.1016\/j.ajog.2012.10.001","article-title":"A rare case of primary extranodal marginal zone B-cell lymphoma of the ovary, fallopian tube, and appendix in the setting of endometriosis","volume":"208","author":"Nezhat","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"2025082711335788000_18.5.e265455.8","doi-asserted-by":"crossref","unstructured":"Mehta N , Sch\u00f6der H , Chiu A , et al . 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