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Composite mantle cell and follicular lymphoma. A case report

Raquel B Ilgenfritz1, Agnès Le Tourneau, Michel Arborio

  • 1Department of Pathology, Hotel Dieu, 75 181 Paris Cedex 04, France. raquel.fritz@gmail.com

Human Pathology
|August 30, 2008
PubMed

Insights

This study identified two distinct small B-cell lymphomas, mantle cell lymphoma and follicular lymphoma, co-existing within a single lymph node. While both lymphomas originated from a monoclonal population, their specific clonal origins remain unconfirmed.

Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Small B-cell lymphomas are a heterogeneous group of lymphoid malignancies.
  • Mantle cell lymphoma (MCL) and follicular lymphoma (FL) are distinct subtypes with unique clinical and biological features.
  • Co-occurrence of different lymphoma subtypes within the same lymph node is rare.

Observation:

  • Morphologically distinct areas within a lymph node exhibited characteristics of both classic mantle cell lymphoma and follicular lymphoma.
  • Immunohistochemistry confirmed the presence of CD20+, CD5+, cyclin D1+ cells (MCL) and CD20+, CD10+, Bcl2+ cells (FL).
  • Polymerase chain reaction detected specific gene rearrangements (Bcl-1 MTC and Bcl-2 MBR) confirming the diagnosis of both lymphomas.

Findings:

  • The study confirmed the presence of a monoclonal B-cell population within the lymph node.
  • Distinct immunophenotypic and morphologic patterns of MCL and FL were identified in separate zones.
  • While a single immunoglobulin heavy chain rearrangement was detected, it did not definitively link both lymphoma populations to the same clonal origin.

Implications:

  • This case highlights the possibility of concurrent distinct B-cell lymphomas within a single lymph node.
  • Understanding the coexistence of different lymphoma subtypes is crucial for accurate diagnosis and treatment strategies.
  • Further research is needed to elucidate the mechanisms underlying the simultaneous development of distinct lymphomas from a single clone.

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