title: Mantle cell lymphoma with a unique pattern of CD5 expression: a case report with review of the literatures.
abstract: Mantle cell lymphoma (MCL) is a unique subtype of B-cell non-Hodgkin's lymphoma characterized by chromosomal translocation t(11;14)(q13;q32), positive CD5, and nuclear cyclin D1 overexpression with unfavorable prognosis. We report herein a case of MCL in a 73-year-old male diagnosed with diffuse large B-cell lymphoma (ileal tumor) at another hospital, who subsequently relapsed with CD5-negative MCL. At the 1st relapse, he developed neck lymph node swelling, of which biopsy showed proliferation of atypical large pleomorphic cells with CD5-negativity by both immunohistochemistry and flow cytometry. At the 2nd relapse, he again developed an ileal tumor, of which biopsy showed positivity for CD5, CD20, and cyclin D1. In MCL, CD5-negative expression has sometimes been reported as having pleomorphic and blastoid variants. The present case was also histologically the pleomorphic type, but the CD5 expression changed from negative at the onset and the 1st relapse to positive at the 2nd relapse. This is a rare and interesting case because of the different expression of CD5 at all stage. This phenomenon made the diagnosis of MCL difficult.
authors.affiliation: Department of Hematology, Gifu Prefectural General Medical Center, Gifu, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yamada
authors.forename: Naoe
authors.initials: N
authors.lastname: Goto
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tsurumi
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Takata
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Sato
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yoshino
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kito
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Iwata
mesh_terms: D000368:Aged; D018951:Antigens, CD20 / Q000378:metabolism; D001483:Base Sequence; D018956:CD5 Antigens / Q000378:metabolism*; D019938:Cyclin D1 / Q000378:metabolism; D017931:DNA Primers / Q000235:genetics; D017809:Fatal Outcome; D005434:Flow Cytometry; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008969:Molecular Sequence Data; D012008:Recurrence; D017422:Sequence Analysis, DNA; D014057:Tomography, X-Ray Computed
chemical_list: D018951:Antigens, CD20; C530104:CCND1 protein, human; D018956:CD5 Antigens; D017931:DNA Primers; D007143:Immunoglobulin Heavy Chains; D019938:Cyclin D1