LAUSR

Marginal zone lymphoma (MZL) is a mature B‐cell neoplasm in which the tumor often involves the peripheral blood especially in splenic MZL cases.1 When lymphoma cells are present in the peripheral blood, the abnormal lymphoid population typically shows morpho‐ logical heterogeneity (mostly lymphoplasmacytoid cells or lympho‐ cytes with nuclear clefts.1,2 The presence of villous lymphocytes may be found in peripheral blood, some author defining the “MZL with villous lymphocytes” entity when more than 30% of the lym‐ phoid cells are villous lymphocytes.3 Thus, the blood smear exam‐ ination remains a crucial time for the diagnosis and the follow up of MZL cases. It is well known that ethylenediaminetetraacetic acid (EDTA) can cause in vitro agglutination of various blood cell types (most of the time platelets and less frequently neutrophils).4 The involvement of lymphocytes is very unusual as the frequency of this phenomenon has been estimated at less than one case out of 45 000 blood cell counts.5 Nevertheless, when it occurs, it usually is in a context of B‐ cell chronic lymphoproliferative disorder, comprising MZL.5 Platelet satellitism involving circulating MZL lymphocytes has also been ob‐ served.6 But lymphoagglutination and platelet satellitism around lymphocytes in MZL context have been rarely reported (only in iso‐ lated cases or small series), and frequency of these two phenomena is still unknown. In this single‐center and retrospective study, we performed a morphologic evaluation of peripheral blood smears from a panel of MZL cases to assess the incidence of this phenomenon in this pecu‐ liar pathological context. To our knowledge, it is the first report of the frequency of lymphoagglutination and platelet satellitism around lymphocytes in MZL patients with peripheral blood dissemination.