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

Published

Journal Article (Review)

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.

Full Text

Duke Authors

Cited Authors

  • Hoeller, S; Zhou, Y; Kanagal-Shamanna, R; Xu-Monette, ZY; Hoehn, D; Bihl, M; Swerdlow, SH; Rosenwald, A; Ott, G; Said, J; Dunphy, CH; Bueso-Ramos, CE; Lin, P; Wang, M; Miranda, RN; Tzankov, A; Medeiros, LJ; Young, KH

Published Date

  • January 2013

Published In

Volume / Issue

  • 44 / 1

Start / End Page

  • 110 - 121

PubMed ID

  • 22944294

Pubmed Central ID

  • 22944294

Electronic International Standard Serial Number (EISSN)

  • 1532-8392

International Standard Serial Number (ISSN)

  • 0046-8177

Digital Object Identifier (DOI)

  • 10.1016/j.humpath.2012.04.022

Language

  • eng