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Tumor Engraftment in a Xenograft Mouse Model of Human Mantle Cell Lymphoma
Published on: March 30, 2018
[Aggressive non-nodal mantle cell lymphoma with challenging subtype classification at presentation].
Akari Yoda1,2, Ayato Sumioka1, Ibuki Takatsuka1
1Department of Hematology, Hamamatsu Medical Center.
Summary
This case highlights a challenging diagnosis of mantle cell lymphoma (MCL), presenting atypically as leukemic non-nodal MCL (nnMCL) but behaving aggressively like conventional MCL.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma.
- Leukemic non-nodal MCL (nnMCL) is a rare subtype with distinct clinical behavior.
- Accurate classification is crucial for appropriate treatment strategies.
Purpose of the Study:
- To describe a challenging case of MCL with features overlapping conventional MCL and nnMCL.
- To illustrate the diagnostic and therapeutic considerations in such borderline cases.
Main Methods:
- Patient presentation: neutropenia, anemia, circulating blast-like cells.
- Bone marrow biopsy: identified 62.8% lymphoid blast-like cells consistent with MCL.
- Immunophenotyping and SOX11 positivity confirmed MCL.
- 18F-FDG PET-CT revealed diffuse bone uptake and new nodal lesions.
- Genetic analysis showed a complex karyotype; Ki-67 index was high.
Main Results:
- Initial presentation suggested nnMCL due to lack of nodal involvement.
- 18F-FDG PET-CT demonstrated systemic disease progression.
- Atypical features (SOX11+, high Ki-67, complex karyotype, rapid progression) favored conventional MCL.
- Treatment followed a protocol for aggressive conventional MCL.
Conclusions:
- Distinguishing between conventional MCL and nnMCL can be challenging.
- Pathological features, genetic abnormalities, and clinical course guide treatment decisions.
- Aggressive treatment protocols are warranted for MCL cases with concerning features, regardless of initial classification.
