Transformation of Indolent Mantle Cell Lymphoma to Pleomorphic Mantle Cell Lymphoma Case Report and Review of Clinical and Morphologic Variants
ABSTRACT 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.08/2014; 6(8):422-4. DOI:10.4103/1947-2714.139307