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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Mantle cell lymphoma - intermed mag.jpg | |||
| Width = | |||
| Caption = Mantle cell lymphoma. [[H&E stain]]. | |||
| 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 | |||
| Subtypes = blastic variant | |||
| LMDDx = other [[small cell lymphomas]] (esp. [[MALT lymphoma]]), [[Burkitt lymphoma]] | |||
| Stains = | |||
| IHC = cyclin D1 +ve, CD5 +ve, CD43 +ve, CD20 +ve, CD23 -ve | |||
| EM = | |||
| Molecular = t(11;14)(q13;q32) / IGH-CCND1 | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[lymph node]], GI tract, other sites | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = not common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = moderately aggressive to poor | |||
| Other = | |||
| ClinDDx = | |||
| Tx = | |||
}} | |||
'''Mantle cell lymphoma''', abbreviated '''MCL''', is less common [[small cell lymphoma]] that is relatively aggressive when compared to other small cell lymphomas. | |||
==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> | |||
*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/> | |||
*Abdominal pain (~37% of cases) or GI bleeding (~26% of cases). | |||
==Gross== | |||
*GI tract: polypoid lesions (~50% of cases).<ref name=pmid22236942>{{Cite journal | last1 = Kim | first1 = JH. | last2 = Jung | first2 = HW. | last3 = Kang | first3 = KJ. | last4 = Min | first4 = BH. | last5 = Lee | first5 = JH. | last6 = Chang | first6 = DK. | last7 = Kim | first7 = YH. | last8 = Son | first8 = HJ. | last9 = Rhee | first9 = PL. | title = Endoscopic findings in mantle cell lymphoma with gastrointestinal tract involvement. | journal = Acta Haematol | volume = 127 | issue = 3 | pages = 129-34 | month = | year = 2012 | doi = 10.1159/000333139 | PMID = 22236942 }}</ref> | |||
==Microscopic== | |||
Features:<ref>Good, D. 17 August 2010.</ref> | |||
*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. | |||
*Scattered epithelioid histiocytes (should not be confused with tingible-body macrophages). | |||
*Sclerosed blood vessels. | |||
DDx: | |||
*Other [[small cell lymphomas]], esp. [[marginal zone 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=== | |||
<gallery> | |||
Image:Mantle cell lymphoma - low mag.jpg | MCL - low mag. (WC) | |||
Image:Mantle cell lymphoma - intermed mag.jpg | MCL - intermed. mag. (WC) | |||
Image:Mantle cell lymphoma - low mag - cyclin D1.jpg | MCL - low mag. - cyclin D1. (WC) | |||
Image:Mantle cell lymphoma - intermed mag - cyclin D1.jpg | MCL - intermed. mag. - cyclin D1. (WC) | |||
</gallery> | |||
www: | |||
*[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== | |||
*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> | |||
*CD43 +ve. | |||
*Cyclin D1 +ve -- '''key immunostain'''. | |||
**[[AKA]] BCL1, AKA CCND1.<ref name=omim168461>{{OMIM|168461}}</ref> | |||
Others: | |||
*CD23 -ve. | |||
**Positive in [[CLL]]. | |||
==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> | |||
==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== | |||
*[[Small cell lymphomas]]. | |||
*[[Ileal nodular lymphoid hyperplasia]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Small cell lymphomas]] |