Massimo G, Teresa A, Arianna DN, et al. - Experts investigated the B cell Ig heavy-chain repertoires by next-generation sequencing in 30 nodal marginal zone lymphoma (NMZL) cases. Most of the cases were mutated. Results exhibited that NMZL cases have a biased usage of specific immunoglobulin heavy-chain variable (IGHV) region genes. Furthermore, in all (100%) of the mutated cases and ongoing somatic hypermutations, intraclonal diversity has been authenticated through hundreds of reads. The mutational pattern to discover and quantify antigen selection pressure was discovered and a positive selection in four cases was seen, whilst in the remaining cases, an unspecific stimulation was noticed. In conclusion, between cases with mutated and unmutated IGHV genes, the disease-specific survival and the progression-free survival were significantly distinctive highlighting mutational status as a potential new biomarker in NMZL.