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[Small lymphocytic lymphoma/chronic lymphocytic leukemia with t(11;14)]
1Third Department of Internal Medicine, Kyoto Prefectural University of Medicine.
[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|October 30, 2001
Summary
This study presents a rare case of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) with features overlapping with mantle cell lymphoma (MCL). The patient exhibited lymphadenopathy, splenomegaly, and bone marrow abnormalities, highlighting diagnostic challenges in B-cell malignancies.
Area of Science:
- Hematology
- Oncology
- Immunophenotyping
Background:
- Small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) and mantle cell lymphoma (MCL) are distinct B-cell malignancies.
- Both SLL/CLL and MCL are characterized by CD5-positive B-cell populations.
Observation:
- An 83-year-old woman presented with lymphadenopathy, splenomegaly, and bone marrow abnormalities.
- Histological and immunophenotypic analysis revealed SLL/CLL characteristics.
- Fluorescent in situ hybridization (FISH) detected t(11;14) translocation, and cyclin D1 was expressed.
Findings:
- The patient's tumor cells exhibited an immunophenotype of CD5+, 10-, 19+, 20+, 23-, IgM+D+.
- The presence of t(11;14) and cyclin D1 expression, typically associated with MCL, alongside SLL/CLL features, suggests a potential borderline case.
- This case challenges the typical diagnostic criteria for SLL/CLL and MCL.
Implications:
- This case underscores the importance of integrated diagnostic approaches, combining histology, immunophenotyping, cytogenetics, and molecular studies.
- Accurate differentiation between SLL/CLL and MCL is crucial for appropriate treatment selection and prognosis.
- Further research into B-cell malignancies with overlapping features may refine diagnostic classifications and therapeutic strategies.