Composite mantle cell lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma: a clinicopathologic and molecular study

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• 作者：Sylvia Hoeller ; MD^a ; ^b ; Yi Zhou ; MD ; PhD^a ; Rashmi Kanagal-Shamanna ; MD^a ; Zijun Y. Xu-Monette ; PhD^a ; Daniela Hoehn ; MD ; PhD^a ; Michel Bihl ; PhD^b ; Steven H. Swerdlow ; MD^c ; Andreas Rosenwald ; MD ; PhD^d ; German Ott ; MD^e ; Jonathan Said ; MD^f ; Cherie H. Dunphy ; MD^g ; Carlos E. Bueso-Ramos ; MD ; PhD^a ; Pei Lin ; MD^a ; Michael Wang ; MD^h ; Roberto N. Miranda ; MD^a ; Alexander Tzankov ; MD^b ; L. Jeffrey Medeiros ; MD^a ; Ken H. Young ; MD ; PhD^a ; ^{khyoung@mdanderson.org}
• 关键词：Mantle cell lymphoma ; Small lymphocytic lymphoma/chronic lymphocytic leukemia ; Cyclin D1
• 刊名：Human Pathology
• 出版年：2013
• 出版时间：January, 2013
• 年：2013
• 卷：44
• 期：1
• 页码：110-121
• 全文大小：4095 K

文摘

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Summary

Mantle cell lymphoma (MCL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) share many features and both arise from CD5 + B-cells; their distinction is critical as MCL is a more aggressive neoplasm. Rarely, cases of composite MCL and CLL/SLL have been reported. Little is known about the nature of these cases and, in particular, the clonal relationship of the 2 lymphomas. Eleven composite MCL and CLL/SLL cases were identified. The clinical, morphologic and immunophenotypic features of the MCL and CLL/SLL were characterized. IGH (immunoglobulin heavy chain) gene analysis was performed on microdissected MCL and CLL/SLL components to assess their clonal relationship. Ten patients had lymphadenopathy, and 7 patients had bone marrow involvement. The MCL component had the following growth patterns: in situ (n = 1), mantle zone (n = 3), nodular and diffuse (n = 3), diffuse (n = 3), and interstitial in the bone marrow (the only patient without lymphadenopathy) (n = 1); 6 MCLs had blastoid or pleomorphic and 5 small lymphocytic features. The CLL/SLL component was nodular (n = 9) or diffuse (n = 2). All MCL were CD5⁺ and cyclin D1⁺ with t(11;14) translocation. All CLL/SLL were CD5⁺, CD23⁺ and negative for cyclin D1 or t(11;14). IGH gene analysis showed that the MCL and CLL/SLL components displayed different sized fragments, indicating that the MCL and CLL/SLL are likely derived from different neoplastic B-cell clones. The lack of a clonal relationship between the MCL and CLL/SLL components suggests that MCL and CLL/SLL components represent distinct disease processes and do not share a common progenitor B-cell.