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Published on: March 30, 2018
Mantle cell lymphoma presenting with paraproteinemia
Grzegorz Rymkiewicz1, Monika Gos, Katarzyna Błachnio
1Department of Pathology, Maria Sklodowska-Curie Memorial Institute, Warsaw, Poland. gregorzrymkiewicz@coi.waw.pl
Medical Oncology (Northwood, London, England)
|August 20, 2005
Summary
Mantle cell lymphoma (MCL) diagnosis can be challenging. This case highlights how flow cytometry and molecular tests confirmed MCL, despite initial misdiagnosis due to IgM paraproteinemia.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Mantle cell lymphoma (MCL) is typically diagnosed using histological (HP) and immunohistochemical (IH) methods.
- Accurate diagnosis is crucial for appropriate patient management and treatment strategies.
Observation:
- A 47-year-old female presented with generalized lymphadenopathy and an abnormal white blood cell count.
- Initial diagnosis favored marginal zone lymphoma (MZL) based on HP/IH and IgM paraproteinemia.
Findings:
- Flow cytometry (FCM) proved essential in differentiating MCL from MZL.
- Fluorescence in situ hybridization (FISH) and reverse transcription polymerase chain reaction (RT-PCR) for cyclin D1 mRNA definitively confirmed the MCL diagnosis.
- IgM paraproteinemia, uncommon in MCL, is characteristic of lymphoplasmacytoid lymphomas (LPL) and Waldenström's macroglobulinemia (WM).
Implications:
- This case underscores the importance of utilizing advanced diagnostic techniques like FCM and molecular testing in complex lymphoma cases.
- Recognizing rare presentations, such as IgM paraproteinemia in MCL, is vital for accurate diagnosis and avoiding misclassification.
- Improved diagnostic accuracy can lead to more timely and effective therapeutic interventions for MCL patients.
