Difference between revisions of "Mantle cell lymphoma"

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| Synonyms  =
| Synonyms  =
| Micro      = small monomorphic (uniform size, shape and staining) lymphoid population with abundant mitoses, +/-scattered epithelioid histiocytes (should not be confused with tingible-body macrophages), +/-sclerosed blood vessels
| Micro      = small monomorphic (uniform size, shape and staining) lymphoid population with abundant mitoses, +/-scattered epithelioid histiocytes (should not be confused with tingible-body macrophages), +/-sclerosed blood vessels
| Subtypes  =
| Subtypes  = blastic variant
| LMDDx      = other [[small cell lymphomas]] (esp. [[MALT lymphoma]]), [[Burkitt lymphoma]]
| LMDDx      = other [[small cell lymphomas]] (esp. [[MALT lymphoma]]), [[Burkitt lymphoma]]
| Stains    =
| Stains    =
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| Rads      =
| Rads      =
| Endoscopy  =
| Endoscopy  =
| Prognosis  = poor
| Prognosis  = moderately aggressive to poor
| Other      =
| Other      =
| ClinDDx    =
| ClinDDx    =
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==General==
==General==
*Relatively aggressive - guarded prognosis.<ref name=pmid10583923>{{Cite journal  | last1 = Hankin | first1 = RC. | last2 = Hunter | first2 = SV. | title = Mantle cell lymphoma. | journal = Arch Pathol Lab Med | volume = 123 | issue = 12 | pages = 1182-8 | month = Dec | year = 1999 | doi = 10.1043/0003-9985(1999)1231182:MCL2.0.CO;2 | PMID = 10583923 }}</ref>
*Relatively aggressive - guarded prognosis.<ref name=pmid10583923>{{Cite journal  | last1 = Hankin | first1 = RC. | last2 = Hunter | first2 = SV. | title = Mantle cell lymphoma. | journal = Arch Pathol Lab Med | volume = 123 | issue = 12 | pages = 1182-8 | month = Dec | year = 1999 | doi = 10.1043/0003-9985(1999)1231182:MCL2.0.CO;2 | PMID = 10583923 }}</ref>
 
*Rare ~ 2% of non-Hogkin's lymphoma in a series of over 4000 patients.<ref name=pmid18723950>{{cite journal |author=Gujral S, Agarwal A, Gota V, ''et al.'' |title=A clinicopathologic study of mantle cell lymphoma in a single center study in India |journal=Indian J Pathol Microbiol |volume=51 |issue=3 |pages=315–22 |year=2008 |pmid=18723950 |doi= |url=}}</ref>
GI tract - typically:<ref name=pmid22236942/>
GI tract - typically:<ref name=pmid22236942/>
*Abdominal pain (~37% of cases) or GI bleeding (~26% of cases).
*Abdominal pain (~37% of cases) or GI bleeding (~26% of cases).
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==Microscopic==
==Microscopic==
Features:<ref>Good, D. 17 August 2010.</ref>
Features:<ref>Good, D. 17 August 2010.</ref>
*Small monomorphic (uniform size, shape and staining) lymphoid population.
*Typically a small monomorphic (uniform size, shape and staining) lymphoid population.
**May be "large" (blastic variant of mantle cell lymphoma) with 1 or 2 nucleoli.<ref name=pmid17917091>{{cite journal |author=Todorovic M, Pavlovic M, Balint B, ''et al.'' |title=Immunophenotypic profile and clinical characteristics in patients with advanced stage mantle cell lymphoma |journal=Med. Oncol. |volume=24 |issue=4 |pages=413–8 |year=2007 |pmid=17917091 |doi= |url=}}</ref>
*Abundant mitoses.
*Abundant mitoses.
*Scattered epithelioid histiocytes (should not be confused with tingible-body macrophages).
*Scattered epithelioid histiocytes (should not be confused with tingible-body macrophages).
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*Other [[small cell lymphomas]], esp. [[marginal zone lymphoma]].
*Other [[small cell lymphomas]], esp. [[marginal zone lymphoma]].
*[[Burkitt's lymphoma]].
*[[Burkitt's lymphoma]].
*Large B-cell lymphoma - for blastic variant of MCL.<ref name=pmid11681422>{{cite journal |author=Bernard M, Gressin R, Lefrère F, ''et al.'' |title=Blastic variant of mantle cell lymphoma: a rare but highly aggressive subtype |journal=Leukemia |volume=15 |issue=11 |pages=1785–91 |year=2001 |month=November |pmid=11681422 |doi= |url=}}</ref>


===Images===
===Images===
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www:
www:
*[http://path.upmc.edu/cases/case441.html MCL - several images (upmc.edu)].
*[http://path.upmc.edu/cases/case441.html MCL - several images (upmc.edu)].
[[File:4 718053471 sl 1.png|Mantle cell lymphoma]]
[[File:4 718053471 sl 2.png|Mantle cell lymphoma]]
[[File:4 718053471 sl 3.png|Mantle cell lymphoma]]
[[File:4 718053471 sl 4.png|Mantle cell lymphoma]]
[[File:4 718053471 sl 5.png|Mantle cell lymphoma]]
[[File:4 718053471 sl 6.png|Mantle cell lymphoma]]
[[File:4 718053471 sl 7.png|Mantle cell lymphoma]]<br>
Mantle cell lymphoma in a 56 year old woman.  A. A blue sea of cells spares a lymphoid follicle in the upper right corner. B. Small, round to reniform cells contrast with the larger tingible body macrophage (arrow). C-F. Tumor cells are Cyclin D1. CD20, BCL2, and CD5 positive positive.  G. About 60% of tumor cells were positive for Ki67. Tumor cells were negative for CD3, CD10, and BCL6.


==IHC==
==IHC==
*CD5 +ve.
*CD45 +ve.
*CD20 +ve.
*CD79a +ve.
*CD5 +ve -- '''important'''.
**Negative in case reports.<ref>URL: [http://path.upmc.edu/cases/case308/dx.html http://path.upmc.edu/cases/case308/dx.html]. Accessed on: 14 January 2012.</ref>
**Negative in case reports.<ref>URL: [http://path.upmc.edu/cases/case308/dx.html http://path.upmc.edu/cases/case308/dx.html]. Accessed on: 14 January 2012.</ref>
*CD43 +ve.
*CD43 +ve.
*Cyclin D1 +ve.
*Cyclin D1 +ve -- '''key immunostain'''.
**[[AKA]] BCL1, AKA CCND1.<ref name=omim168461>{{OMIM|168461}}</ref>
**[[AKA]] BCL1, AKA CCND1.<ref name=omim168461>{{OMIM|168461}}</ref>


Others:
Others:
*CD23 -ve.
*CD23 -ve.
**Positive in CLL.
**Positive in [[CLL]].


==Molecular==
==Molecular==
*t(11;14)(q13;q32) / IGH-CCND1.<ref>URL: [http://atlasgeneticsoncology.org/Anomalies/t1114ID2021.html http://atlasgeneticsoncology.org/Anomalies/t1114ID2021.html]. Accessed on: 10 August 2010.</ref>
*t(11;14)(q13;q32) / IGH-CCND1.<ref>URL: [http://atlasgeneticsoncology.org/Anomalies/t1114ID2021.html http://atlasgeneticsoncology.org/Anomalies/t1114ID2021.html]. Accessed on: 10 August 2010.</ref>
==Sign out==
<pre>
TERMINAL ILEUM, BIOPSY:
- MANTLE CELL LYMPHOMA.
COMMENT:
The tumour consists of small lymphoid cells in sheets.
The tumour stains as follows:
POSITIVE: CD20, CD5, BCL2, cyclin D1.
NEGATIVE: CD23, BCL6, CD10.
PROLIFERATION (Ki-67): 25%.
</pre>


==See also==
==See also==
*[[Small cell lymphomas]].
*[[Small cell lymphomas]].
*[[Ileal nodular lymphoid hyperplasia]].


==References==
==References==
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