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Extranodal mantle cell lymphoma mimicking marginal zone cell lymphoma
I Anagnostopoulos1, H D Foss, M Hummel
1Consultation and Reference Centre for Haematopathology, Institute of Pathology, Klinikum Benjamin Franklin, Free University Berlin, Hindenburgdamm 30, D-12200 Berlin, Germany.
Histopathology
|March 21, 2002
Summary
Mantle cell lymphoma can initially mimic marginal zone lymphoma, presenting a diagnostic challenge. Thorough immunohistological analysis is crucial for accurate B-cell non-Hodgkin's lymphoma diagnosis.
Area of Science:
- Hematopathology
- Oncology
- Immunology
Background:
- Mantle cell lymphoma (MCL) and marginal zone lymphoma (MZL) are distinct B-cell non-Hodgkin's lymphomas (NHLs).
- Accurate differentiation is critical for appropriate treatment and prognosis.
- Diagnostic challenges can arise from overlapping clinical and morphological features.
Observation:
- A case initially diagnosed as extranodal marginal zone B-cell lymphoma based on palatine tonsil involvement.
- The lymphoma cells exhibited growth within marginal zones with a B-cell phenotype and light chain restriction.
- Subsequent relapse revealed diffuse cells expressing CD5, CD43, and cyclin D1, characteristic of MCL.
Findings:
- Re-evaluation of the initial biopsy confirmed MCL immunophenotype (cyclin D1+, IgD+, IgM+, CD5+) in the marginal zone-infiltrating cells.
- Both initial and relapsed lesions shared identical clonal immunoglobulin gene rearrangements.
- This indicates that the initial presentation was an atypical manifestation of MCL.
Implications:
- This case highlights the importance of comprehensive immunohistological evaluation in B-cell NHLs.
- Broad antibody panels are essential to avoid misdiagnosis, especially in cases involving the marginal zone.
- Recognizing MCL's potential to mimic MZL improves diagnostic accuracy and patient management.