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Large cell variants of CD5+, CD23- B-cell lymphoma/leukemia
1Department of Pathology, St Louis University School of Medicine, 1402 S. Grand, St Louis, MO 63104, USA. dunphych@slu.edu
Archives of Pathology & Laboratory Medicine
|March 22, 2001
Summary
Large cell variants of mantle cell lymphoma (MCL) are less characterized than conventional MCL. This study describes their morphology, immunophenotype, and molecular features, highlighting diagnostic challenges.
Area of Science:
- Hematologic Malignancies
- Oncology
- Immunophenotyping
Background:
- Mantle cell lymphoma (MCL) is a well-studied B-cell malignancy.
- Large cell variants of MCL, including blastic and prolymphocytoid forms, are less characterized.
- These variants, with a CD5+, CD23- immunophenotype, present diagnostic challenges.
Purpose of the Study:
- To describe the morphological, immunophenotypic, and molecular characteristics of large cell variants of B-cell lymphoma/leukemia with a mantle cell immunophenotype.
- To differentiate these variants from other hematologic processes.
Main Methods:
- Review of 19 cases of CD5+, CD23- large cell variants of B-cell lymphoma/leukemia.
- Analysis included morphology, bone marrow findings, Cyclin D1 immunostaining, and bcl-1 gene rearrangement analysis.
- Clinical data were unavailable.
Main Results:
- Blastic MCL showed diffuse lymph node involvement (100%) and infrequent bone marrow involvement (27%).
- Cyclin D1 was positive in 60% of cases, with higher sensitivity in B5-fixed tissue.
- Bcl-1 was not detected in blastic MCL but was present in prolymphocytoid MCL; Cyclin D1 and bcl-1 results showed inverse correlation.
Conclusions:
- Accurate diagnosis of large cell MCL variants requires comprehensive analysis of clinical, morphological, immunophenotypic, and molecular data.
- Distinguishing these variants from other lymphoid processes is crucial for appropriate management.