Mantle cell lymphoma, blastoid (centroblastic) variantが疑われた一例

Abstract

A 64-year-old man with chronic hepatitis (type C) presented with left abdominal to back pain and cervical lymph nodes swelling in Nov. 1995. Biopsy specimen from cervical lymph nodes was diagnosed as malignant lymphoma. Physical examination revealed systemic lymph nodes swelling, splenomegaly and bone marrow involvement. He received two courses of CHOP and MEVP therapy without much effect and died after five months later. Tissue specimen showed diffuse atypical lymphocytes infiltration and no residual atrophic germinal centers are found. Most of the tumor cells showed medium to large sized and round (without cleaving) nuclei and a predominant nucleolus. Starry sky appearance and frequent mitoses are observed, suggesting rapidly proliferating nature.Immunohistchemical study on paraffin section and flow cytometrical analysis demonstrated that CD5, CD20, CD21, sIgM and sIgD were positive on neoplastic cells but CD3 and CD10 were negative. These morphological and immunohistchemical findings lead us to diagnose this lymphoma as blastoid (centroblastic) variant of mantle cell lymphoma.