Diagnosis of mantle cell lymphoma on tissue acquired by fine needle aspiration in conjunction with immunocytochemistry and cytokinetic studies. Possibilities and limitations.
OBJECTIVE
To investigate the cytokinetic features of mantle cell lymphoma (MCL) and determine if there are measurable differences between mantle zone (MCL-MZ) and diffuse (MCL-D) types of MCL.


METHODS
Forty-five fine needle aspirates (FNAs) from 36 patients with MCL were reviewed. Immunohistochemistry, using a panel of kappa, lambda, CD5 and CD3, was applied in all cases. Ki-67 positivity using digital image analysis was measured in 29 cases. Flow cytometric analysis was performed on 40 specimens with DNA and RNA indices, and S + G2M phase was assessed.


RESULTS
The great majority of cases (42 cases, 94%) were positive for CD5. There was a predominance of lambda-positive cases (lambda:kappa 2:1). MCL-D had higher mean Ki-67 values as compared to MCL-MZ (14.4% vs. 6.5%), but the differences were not statistically significant (P = .07). The majority of cases were diploid (35, 87%). MCL-D had significantly higher mean values for RNA index (P = .005). There was no significant difference in percentage of S + G2M between MCL-MZ and MCL-D; however, the diffuse type had higher mean values as compared to the mantle zone type (5.4 vs. 3.7).


CONCLUSIONS
Tissue obtained by FNA is adequate for a diagnosis of MCL. However, while certain proliferation and RNA markers did show a trend toward being lower in MCL-MZ, differentiation between MCL-MZ and MCL-D cannot be made based on these alone; histologic architecture is necessary.
Wojcik
E M
EM
Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Katz
R L
RL
Fanning
T V
TV
el-Naggar
A
A
Ordonez
N G
NG
Johnston
D
D
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D001707:Biopsy, Needle; D018956:CD5 Antigens / Q000378:metabolism; D002455:Cell Division; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007120:Immunochemistry; D019394:Ki-67 Antigen; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000378:metabolism; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism
D000911:Antibodies, Monoclonal; D018956:CD5 Antigens; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D009687:Nuclear Proteins; D018809:Proliferating Cell Nuclear Antigen