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Blastoid Variant of Mantle Cell Lymphoma with Leukemic Presentation - A Rare Case Report
Ruchee Khanna1, Sushma Belurkar1, P Lavanya2
1Associate Professor, Department of Pathology, Kasturba Medical College, Manipal, Karnataka, India.
Insights
The blastoid variant of Mantle Cell Lymphoma (MCL) can be challenging to diagnose morphologically. This case highlights the importance of immunophenotyping and molecular studies for accurate diagnosis of this rare lymphoma subtype.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Mantle Cell Lymphoma (MCL) is an aggressive Non-Hodgkin's lymphoma.
- The blastoid variant, accounting for 10-15% of MCL cases, presents diagnostic challenges due to morphological mimicry.
Observation:
- A 45-year-old male presented with fever, fatigability, and inguinal swelling.
- Peripheral blood smear revealed thrombocytopenia and 53% abnormal cells.
- Bone marrow examination showed 43% abnormal lymphoid cells.
Findings:
- The patient was diagnosed with the blastoid variant of MCL.
- Diagnosis was confirmed using routine morphology, bone marrow biopsy immunohistochemistry, and peripheral blood flow cytometric immunophenotyping.
Implications:
- Accurate diagnosis of blastoid MCL variant is crucial for appropriate treatment planning.
- Immunophenotyping and molecular studies are essential adjuncts to morphology in diagnosing challenging lymphoma subtypes.
Abstract:
Mantle Cell Lymphoma (MCL) is a type of Non-Hodgkin's lymphoma and has a wide spectrum of histopathological subtypes of which the blastoid or the blastic variant constitutes 10-15% of all cases. It is difficult to diagnose blastoid variant of MCL on the basis of morphology alone as it mimics lymphoblastic lymphoma and centroblastic large cell lymphoma, hence additional analysis like immunophenotyping and molecular studies aid in its diagnosis. We present a case of 45-year-old male who presented to medicine OPD with chief complaints of fever, fatigability and inguinal swelling. Complete blood count, peripheral smear and bone marrow examination was performed. Peripheral smear showed thrombocytopenia along with 53% abnormal cells. On bone marrow examination 43% abnormal lymphoid cells were seen. This case was diagnosed as blastoid variant of MCL on the basis of routine morphology and immunohistochemistry on bone marrow biopsy and flow cytometric immunophenotyping on peripheral blood.
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