Clonal proliferation of cyclin D1-positive mantle lymphocytes in an asymptomatic patient: an early-stage event in the development or an indolent form of a mantle cell lymphoma?
Mantle cell lymphoma (MCL) is a B-cell neoplasm with a relatively aggressive clinical course. There is a very small subgroup of patients who present with atypical lymphocytes in peripheral blood, with or without lymphocytosis, lymphadenopathy, or splenomegaly, and with an indolent clinical course. They frequently show mutated IgV(H) genes and CD5 negativity. We report an asymptomatic elderly patient who presented with a single submandibular lymphadenopathy. The biopsy showed immunophenotype and t(11;14)(q13;q32) consistent with MCL. The abnormal lymphoid population was also detected in peripheral blood and bone marrow. The patient has remained asymptomatic for 5 years without receiving any therapy. It is uncertain whether these cases represent an early-stage event in the development or an indolent form of MCL. The existence of such asymptomatic patients with an indolent clinical course should induce a strict clinical judgment in terms of therapeutic decisions.
Espinet
Blanca
B
Servei de Patologia (Laboratori de Citogenètica i Biologia Molecular, Laboratori de Citologia Hematològica, Laboratori de Patologia), Hospital del Mar, IMAS, URNHE, PRBB, Barcelona 08003, Spain. bespinet@imas.imim.es
Solé
Francesc
F
Pedro
Carme
C
Garcia
Mar
M
Bellosillo
Beatriz
B
Salido
Marta
M
Florensa
Lourdes
L
Camacho
Francisca I
FI
Baró
Teresa
T
Lloreta
Josep
J
Serrano
Sergi
S
D000368:Aged; D001853:Bone Marrow / Q000473:pathology; D002869:Chromosome Aberrations; D019938:Cyclin D1 / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008198:Lymph Nodes / Q000473:pathology; D008199:Lymphadenitis / Q000473:pathology; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000473:pathology*; D008214:Lymphocytes / Q000097:blood / Q000473:pathology; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology* / Q000503:physiopathology; D016133:Polymerase Chain Reaction
D019938:Cyclin D1