title: Conjunctival mass as an initial presentation of mantle cell lymphoma: a case report.
abstract: BACKGROUND
  To describe a rare manifestation of mantle cell lymphoma (MCL) in conjunctiva, with clinical, hisologic, immunohistologic and genetic findings together with review of the Literature.
  
  
  METHODS
  Most 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 right conjunctival mass of at least three months duration in a 64-year-old man. Histopathologic examination showed a proliferation of monomorphous small-to-medium-sized lymphoid cells with cleaved nuclei in the subconjunctiva. By immunohistochemistry, the infiltrate was positive for CD20, CD5, BCL-2, cyclin D1, and the transcription factor SOX11. Fluorescent in situ hybridization demonstrated the presence of IGH-CCND1 fusion indicating t(11;14).
  
  
  CONCLUSIONS
  A rigorous approach to initial diagnosis and staging of small cell lymphomas of the ocular adnexa is needed. The recognition of ocular MCL requires appropriate immunohistochemical staining and/or genetic confirmation to differentiate this rare form of presentation of MCL from other more frequent small cell lymphomas.
authors.affiliation: Institute of Hematopathology, Dr Daneshbod Pathology Laboratory, Shiraz, Iran.
authors.forename: Mahsa
authors.initials: M
authors.lastname: Khanlari
authors.forename: Babak
authors.initials: B
authors.lastname: Bagheri
authors.forename: Reza
authors.initials: R
authors.lastname: Vojdani
authors.forename: Mohammad
authors.initials: M
authors.lastname: Mohammadianpanah
authors.forename: Shahram
authors.initials: S
authors.lastname: Paydar
authors.forename: Yahya
authors.initials: Y
authors.lastname: Daneshbod
mesh_terms: D015703:Antigens, CD / Q000235:genetics; D003228:Conjunctiva / Q000378:metabolism / Q000473:pathology*; D003230:Conjunctival Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology; D019938:Cyclin D1 / Q000235:genetics; D015870:Gene Expression; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics; D055751:SOXC Transcription Factors / Q000235:genetics; D014178:Translocation, Genetic
chemical_list: D015703:Antigens, CD; C529133:IGH-CCND1 fusion protein, human; D015514:Oncogene Proteins, Fusion; D019253:Proto-Oncogene Proteins c-bcl-2; C097473:SOX11 protein, human; D055751:SOXC Transcription Factors; D019938:Cyclin D1