title: Diagnosis of mantle cell lymphoma on tissue acquired by fine needle aspiration in conjunction with immunocytochemistry and cytokinetic studies. Possibilities and limitations.
abstract: 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.
authors.affiliation: Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Wojcik
authors.forename: R L
authors.initials: RL
authors.lastname: Katz
authors.forename: T V
authors.initials: TV
authors.lastname: Fanning
authors.forename: A
authors.initials: A
authors.lastname: el-Naggar
authors.forename: N G
authors.initials: NG
authors.lastname: Ordonez
authors.forename: D
authors.initials: D
authors.lastname: Johnston
mesh_terms: 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
chemical_list: D000911:Antibodies, Monoclonal; D018956:CD5 Antigens; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D009687:Nuclear Proteins; D018809:Proliferating Cell Nuclear Antigen