Transformation of Indolent Mantle Cell Lymphoma to Pleomorphic Mantle Cell Lymphoma Case Report and Review of Clinical and Morphologic Variants
Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USA.Archives of pathology & laboratory medicine (Impact Factor: 2.84). 08/2012; 136(8):871-5. DOI: 10.5858/arpa.2012-0197-CR
We report a case of indolent mantle cell lymphoma with progression to pleomorphic mantle cell lymphoma 8 years after initial presentation. The first lymph node biopsy showed expanded mantle zones composed of uniformly small B lymphocytes. A cyclin D1 immunohistochemical stain was negative and the patient was observed. Eight years later, the patient developed symptomatic splenomegaly. Microscopic examination of the spleen revealed expanded mantle zones with an increased number of large cells with irregular nuclear contours. Immunohistochemistry for cyclin D1 was positive. A repeat cyclin D1 immunohistochemical staining performed on the initial lymph node biopsy was positive, indicating an inadequate initial study. Immunoglobulin heavy-chain gene rearrangement studies confirmed clonal identity. A revised diagnosis of indolent mantle cell lymphoma with progression to pleomorphic mantle cell lymphoma was rendered. The differential diagnosis of mantle cell lymphoma, including clinical and morphologic variants, is discussed.
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ABSTRACT: Context: Non-Hodgkin's lymphomas (NHL) primarily involving the orbit, is relatively uncommon. Rarely two pathologically different NHL cell types have been found to be coexistent. Case Report: We report a case of orbital lymphoma in a 62-year-old male with rare histopathological findings secondary to transformation of once cell type into another. Tissue diagnosis and molecular studies led to revelation of diffuse large B cell lymphoma evolving from MALT lymphoma. Conclusion: Proliferation of two morphologically and phenotypically different B cells resulting in malignancy has not been found in the orbit so far. They are usually aggressive tumors and require chemo-immunotherapy.North American Journal of Medical Sciences 08/2014; 6(8):422-4. DOI:10.4103/1947-2714.139307
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ABSTRACT: Transformation is the evolution of an indolent lymphoma/leukemia to an aggressive lymphoma, typically harboring a very poor prognosis. This phenomenon is well described in humans, but underestimated in dogs although recognized as a possible evolution of indolent lymphomas/leukemias. In canine chronic leukemias, blast crisis (mainly in myeloid) and Richter syndrome (transformation into a high grade lymphoma) (mainly in B-cell lymphocytic leukemia) have been reported. Transformation is a possible event also in canine low grade lymphomas, although rare. The increased knowledge has also generated new questions and posed challenges that need to be addressed to improve outcome, including the recognition of the clinical characteristics at diagnosis associated with a higher risk of transformation in an attempt of anticipating the typical evolution.Journal of Veterinary Science 09/2015; 2. DOI:10.3389/fvets.2015.00042 · 1.16 Impact Factor
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