A Push to Consider Mantle Cell Lymphoma in Adults with Leukemia/Lymphoma with Blastoid Morphology.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Nkechi Arinze, Nivin Omar, Amany Keruakous, Ravindra Kolhe, Natasha Savage
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引用次数: 0

Abstract

Mantle cell lymphoma (MCL) is an intermediate-grade B-cell lymphoma, representing 2.8% of all non-Hodgkin lymphomas in the US. It is associated with t(11;14)(q13; q23), which leads to the overexpression of cyclin D1, consequently promoting cell proliferation. MCL usually expresses CD19, CD20, CD43, surface immunoglobulins, FMC7, BCL2, cyclin D1, CD5, and SOX11. Herein is a case of a 67-year-old male, referred to our facility with shortness of breath, anemia (hemoglobin of 5.3 g/dL), thrombocytopenia (12 × 109/L), and leukocytosis (283 × 109/L). A peripheral blood smear showed marked lymphocytosis with blastoid morphology. Morphologic examination of the bone marrow biopsy revealed a diffuse sheet of blastoid cells expressing CD20 and CD10, but without CD5 or cyclin D1. Given these features, a differential diagnosis of diffuse large B-cell lymphoma (DLBCL) with germinal center derivation, high-grade follicular lymphoma, and Burkitt lymphoma was considered, with the latter not favored due to morphology. Additional studies revealed positive SOX11, and fluorescence in situ hybridization (FISH) studies detected t(11;14). These additional studies supported diagnosis of the blastoid variant of MCL. In conclusion, we present a unique and challenging case of MCL without cyclin D1 or CD5, but with an expression of CD10 and SOX11, along with t(11;14). Pathologists should explicitly consider the blastoid variant of MCL when dealing with mature B-cell neoplasms with blastoid morphology in adults, and utilize a broad panel of ancillary studies, including FISH and SOX11.

Abstract Image

Abstract Image

推动考虑成人白血病/具有芽细胞形态的淋巴瘤的套细胞淋巴瘤。
套细胞淋巴瘤(MCL)是一种中等级别的B细胞淋巴瘤,占美国所有非霍奇金淋巴瘤的2.8%。它与t(11;14)(q13;q23)有关,导致细胞周期蛋白D1过表达,从而促进细胞增殖。MCL通常表达CD19、CD20、CD43、表面免疫球蛋白、FMC7、BCL2、细胞周期蛋白D1、CD5和SOX11。这是一例67岁的男性病例,因呼吸急促、贫血(血红蛋白5.3 g/dL)、血小板减少症(12×109/L)和白细胞增多症(283×109/L。外周血涂片显示有明显的淋巴细胞增多和卵裂球样形态。骨髓活检的形态学检查显示,有一片表达CD20和CD10,但不含CD5或细胞周期蛋白D1的卵裂球样细胞。鉴于这些特征,考虑对具有生发中心衍生的弥漫性大B细胞淋巴瘤(DLBCL)、高级滤泡性淋巴瘤和伯基特淋巴瘤进行鉴别诊断,后者因形态学原因不受青睐。其他研究显示SOX11阳性,荧光原位杂交(FISH)研究检测到t(11;14)。这些额外的研究支持MCL的卵裂球变体的诊断。总之,我们提出了一种独特且具有挑战性的MCL病例,该病例没有细胞周期蛋白D1或CD5,但有CD10和SOX11以及t的表达(11;14)。病理学家在处理成人中具有卵裂球形态的成熟B细胞肿瘤时,应明确考虑MCL的卵裂球变体,并利用广泛的辅助研究,包括FISH和SOX11。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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