CD5-undetected by immunohistochemistry, t(11;14)(q13;q32)-positive conjunctival mantle cell lymphoma: a case report.
Most primary ocular adnexal lymphomas are extranodal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT). A few cases of ocular adnexal mantle cell lymphomas have been reported in the literature. We present a case of mantle cell lymphoma presenting as conjunctival mass. A 58-year-old man presented with a palpable mass in the left lower tarsal conjunctiva incidentally detected one month previously. Histopathologic examination showed proliferation of monomorphous small-to-medium sized lymphoid cells. On immunohistochemistry, tumor cells were positive for CD20, bcl-2, and cyclin D1, and negative for CD5. PCR analysis for immunoglobulin heavy chain gene rearrangement showed monoclonal B-cell proliferation. t(11;14)(q13;q32), involving the CCND1 and IGH genes, was detected in interphase fluorescent in situ hybridization using formalin-fixed, paraffin-embedded tissue; however, MALT1 gene translocation was not observed. The final diagnosis was mantle cell lymphoma. There was no lymphadenopathy; however, bone marrow involvement of the lymphoma was suspected. The patient has been receiving systemic chemotherapy. This case emphasizes the differential diagnosis of conjunctival mantle cell lymphoma from extranodal marginal zone B-cell lymphomas of MALT regarding the clinical and pathological aspects.
Department of Pathology, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongro-gu, Seoul 110-799, Republic of Korea.
Seol-Bong
SB
Yoo
Young A
YA
Kim
Yoon Kyung
YK
Jeon
Chul-Woo
CW
Kim
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018956:CD5 Antigens / Q000032:analysis*; D049109:Cell Proliferation; D003230:Conjunctival Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000276:immunology / Q000473:pathology; D019938:Cyclin D1 / Q000235:genetics*; D003937:Diagnosis, Differential; D015972:Gene Expression Regulation, Neoplastic; D015322:Gene Rearrangement, B-Lymphocyte; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics*; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D033162:Incidental Findings; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis*; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014178:Translocation, Genetic
C530104:CCND1 protein, human; D018956:CD5 Antigens; D007143:Immunoglobulin Heavy Chains; D019938:Cyclin D1