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Article: Mantle cell lymphoma in leukemic phase: Characterization of its broad cytologic spectrum with emphasis on the importance of distinction from other chronic lymphoproliferative disorders

TitleMantle cell lymphoma in leukemic phase: Characterization of its broad cytologic spectrum with emphasis on the importance of distinction from other chronic lymphoproliferative disorders
Authors
Issue Date1999
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741
Citation
Cancer, 1999, v. 86 n. 5, p. 850-857 How to Cite?
AbstractBACKGROUND. Mantle cell lymphoma is a mature, virgin B-cell neoplasm characterized immunologically by a panB+, CD5+, CD23-, cyclin D1 + phenotype and genetically by t(11;14)(q13;q32) with overexpression of the cyclin D1 (bcl-1) gene. It usually presents as advanced stage disease, involving lymph nodes, spleen, bone marrow, and extranodal sites, particularly the gastrointestinal tract. However, frank leukemic presentation with high white cell counts is uncommon and can be difficult to distinguish from other chronic lymphoproliferative disorders. The aim of this study was to characterize the morphologic spectrum of leukemic mantle cell lymphoma. METHODS. During the period July 1994 through October 1998, 14 patients with mantle cell lymphoma in leukemic phase were diagnosed at the Department of Pathology, Queen Elizabeth Hospital, Hong Kong. The diagnosis of mantle cell lymphoma was based on histologic and immunocytochemical findings and was confirmed by cyclin D1 immunoreactivity in all cases. The clinical records and laboratory results were reviewed. Peripheral blood smears, bone marrow, and other tissue biopsies were examined, with particular attention to the cytologic features of the leukemic mantle cells. RESULTS. Mantle cell lymphoma in leukemic phase showed a very aggressive clinical course. Eight patients died at a mean of 13 months, and only 1 patient was disease free. Morphologically, the leukemic mantle cells exhibited a broad morphologic spectrum, with several cytologic patterns identified: 1) mixed small and medium-sized cells, 2) predominantly medium-sized cells, 3) predominantly large cells, and 4) giant cells. Despite variations in the size and nuclear shape, the leukemic mantle cells could usually be recognized by the nuclear irregularity and clefting, moderately dense but evenly distributed chromatin, small nucleoli, and scant cytoplasm. CONCLUSIONS. Recognition of the characteristic cytologic features of leukemic mantle cells can help to distinguish them from other chronic lymphoproliferative disorders. In contrast to the latter, the clinical course is aggressive and response to conventional chemotherapy is poor.
Persistent Identifierhttp://hdl.handle.net/10722/148170
ISSN
2015 Impact Factor: 5.649
2015 SCImago Journal Rankings: 3.188
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWong, KFen_US
dc.contributor.authorChan, JKCen_US
dc.contributor.authorSo, JCCen_US
dc.contributor.authorYu, PHen_US
dc.date.accessioned2012-05-29T06:11:13Z-
dc.date.available2012-05-29T06:11:13Z-
dc.date.issued1999en_US
dc.identifier.citationCancer, 1999, v. 86 n. 5, p. 850-857en_US
dc.identifier.issn0008-543Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/148170-
dc.description.abstractBACKGROUND. Mantle cell lymphoma is a mature, virgin B-cell neoplasm characterized immunologically by a panB+, CD5+, CD23-, cyclin D1 + phenotype and genetically by t(11;14)(q13;q32) with overexpression of the cyclin D1 (bcl-1) gene. It usually presents as advanced stage disease, involving lymph nodes, spleen, bone marrow, and extranodal sites, particularly the gastrointestinal tract. However, frank leukemic presentation with high white cell counts is uncommon and can be difficult to distinguish from other chronic lymphoproliferative disorders. The aim of this study was to characterize the morphologic spectrum of leukemic mantle cell lymphoma. METHODS. During the period July 1994 through October 1998, 14 patients with mantle cell lymphoma in leukemic phase were diagnosed at the Department of Pathology, Queen Elizabeth Hospital, Hong Kong. The diagnosis of mantle cell lymphoma was based on histologic and immunocytochemical findings and was confirmed by cyclin D1 immunoreactivity in all cases. The clinical records and laboratory results were reviewed. Peripheral blood smears, bone marrow, and other tissue biopsies were examined, with particular attention to the cytologic features of the leukemic mantle cells. RESULTS. Mantle cell lymphoma in leukemic phase showed a very aggressive clinical course. Eight patients died at a mean of 13 months, and only 1 patient was disease free. Morphologically, the leukemic mantle cells exhibited a broad morphologic spectrum, with several cytologic patterns identified: 1) mixed small and medium-sized cells, 2) predominantly medium-sized cells, 3) predominantly large cells, and 4) giant cells. Despite variations in the size and nuclear shape, the leukemic mantle cells could usually be recognized by the nuclear irregularity and clefting, moderately dense but evenly distributed chromatin, small nucleoli, and scant cytoplasm. CONCLUSIONS. Recognition of the characteristic cytologic features of leukemic mantle cells can help to distinguish them from other chronic lymphoproliferative disorders. In contrast to the latter, the clinical course is aggressive and response to conventional chemotherapy is poor.en_US
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741en_US
dc.relation.ispartofCanceren_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshBone Marrow Examinationen_US
dc.subject.meshCyclin D1 - Metabolismen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshImmunohistochemistryen_US
dc.subject.meshImmunophenotypingen_US
dc.subject.meshLeukemia - Metabolism - Pathologyen_US
dc.subject.meshLymphoma, Non-Hodgkin - Metabolism - Pathology - Ultrastructureen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.titleMantle cell lymphoma in leukemic phase: Characterization of its broad cytologic spectrum with emphasis on the importance of distinction from other chronic lymphoproliferative disordersen_US
dc.typeArticleen_US
dc.identifier.emailSo, JCC:scc@pathology.hku.hken_US
dc.identifier.authoritySo, JCC=rp00391en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1002/(SICI)1097-0142(19990901)86:5<850::AID-CNCR22>3.0.CO;2-Zen_US
dc.identifier.pmid10463985-
dc.identifier.scopuseid_2-s2.0-0033197944en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033197944&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume86en_US
dc.identifier.issue5en_US
dc.identifier.spage850en_US
dc.identifier.epage857en_US
dc.identifier.isiWOS:000082133200022-
dc.publisher.placeUnited Statesen_US

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