title: CD5-positive, cyclinD1-negative mantle cell lymphoma with a translocation involving the CCND2 gene and the IGL locus.
abstract: Distinguishing mantle cell lymphoma (MCL), from low-grade B-cell lymphoma is important because MCL is clinically more aggressive and is treated differently. Though most MCL overexpress cyclinD1 (CCND1) and have a t(11;14)(q13;q32), MCL that are negative for CCND1 exist. Some have translocations involving cyclinD2 (CCND2) and either the immunoglobulin heavy chain or kappa light chain locus. We present a CD5-positive, CCND1-negative B-cell lymphoma with a novel translocation involving CCND2 and the immunoglobulin lambda (IGL) gene. A 64-year-old male underwent resection of a polypoid mass of the ileum. Histology showed atypical, medium-sized lymphoid cells positive for CD20, CD5, CD43, and CCND2 by immunohistochemistry, and negative for CCND1, CCND3, and p27. Fluorescence in situ hybridization was negative for CCND1 abnormalities, but demonstrated a CCND2/IGL fusion. Clinical workup revealed stage IV disease. Current diagnostic criteria are insufficient for subclassifying this case, highlighting the need for additional studies on CCND2-translocated B-cell lymphomas to guide therapy appropriately.
authors.affiliation: Department of Pathology, Baylor University Medical Center, Dallas, TX, USA. michelleshiller@yahoo.com
authors.forename: Shirley Michelle
authors.initials: SM
authors.lastname: Shiller
authors.forename: Arthur
authors.initials: A
authors.lastname: Zieske
authors.forename: Houston
authors.initials: H
authors.lastname: Holmes
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Feldman
authors.forename: Mark E
authors.initials: ME
authors.lastname: Law
authors.forename: Rana
authors.initials: R
authors.lastname: Saad
mesh_terms: D019046:Bone Marrow Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism; D018956:CD5 Antigens / Q000096:biosynthesis*; D002881:Chromosomes, Human, Pair 12; D002892:Chromosomes, Human, Pair 22; D019938:Cyclin D1 / Q000378:metabolism; D056742:Cyclin D2 / Q000235:genetics*; D003937:Diagnosis, Differential; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism; D006801:Humans; D007146:Immunoglobulin lambda-Chains / Q000235:genetics*; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D014178:Translocation, Genetic
chemical_list: C080336:CCND2 protein, human; D018956:CD5 Antigens; D056742:Cyclin D2; D007146:Immunoglobulin lambda-Chains; D019938:Cyclin D1