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Tumor Engraftment in a Xenograft Mouse Model of Human Mantle Cell Lymphoma
Published on: March 30, 2018
A unique case of mantle cell lymphoma with an aberrant CD5-/CD10+ immunophenotype and typical morphology
Vathany Sriganeshan1, Thomas R Blom, David J Weissmann
1Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL 33140, USA. vsrigane@msmc.com
Insights
Mantle cell lymphoma (MCL) can be misdiagnosed due to unusual CD5 and CD10 marker expression. This case highlights the importance of molecular studies for accurate MCL diagnosis.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Mantle cell lymphoma (MCL) is an aggressive non-Hodgkin lymphoma often mistaken for indolent lymphomas.
- Immunophenotyping, specifically CD5 and CD10 expression, is crucial for differentiating MCL from follicular lymphoma (FL).
- Typically, MCL is CD5 positive and CD10 negative, while FL is CD5 negative and CD10 positive.
Observation:
- A case of MCL was initially misdiagnosed as FL due to atypical immunophenotype at presentation.
- The lymphoma cells were negative for both CD5 and CD10 at initial diagnosis.
- Upon relapse, the cells remained CD5 negative but became CD10 positive.
Findings:
- Genetic analysis revealed a t(11;14) translocation, and CYCLIN D1 protein was expressed.
- These findings confirmed the diagnosis of MCL, despite the unusual immunophenotype.
- This represents a previously unreported immunophenotype for MCL with classical morphology.
Implications:
- This case underscores the limitations of relying solely on CD5 and CD10 for MCL diagnosis.
- It emphasizes the critical role of molecular testing (e.g., t(11;14), CYCLIN D1) in challenging lymphoma cases.
- Accurate diagnosis is vital for appropriate treatment selection and improving patient outcomes in MCL.
Abstract:
Mantle cell lymphoma (MCL) is a non-Hodgkin lymphoma with a poor prognosis that may be confused with less aggressive diseases, such as small lymphocytic lymphoma and follicular lymphoma. In many cases immunophenotyping, particularly analysis of reactivity for CD5 and CD10, is an important adjunct to morphology that usually distinguishes MCL from follicular lymphoma; the former is CD5(+)/CD10(-), whereas follicular lymphoma is the reverse. We report a case of MCL, initially diagnosed as follicular lymphoma, that at presentation expressed neither CD5 nor CD10. At relapse, it was still CD5(-), but CD10 was now detected. Studies for a t(11;14) translocation and CYCLIN D1 protein expression, however, permitted a revised diagnosis of MCL. An MCL with this immunophenotype and classical morphology has not been previously reported.
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