title: A cyclin D1-negative mantle cell lymphoma with an IGL-CCND2 translocation that relapsed with blastoid morphology and aggressive clinical behavior.
abstract: Mantle cell lymphoma (MCL) is a B cell neoplasm characterized by cyclin D1 overexpression; its prognosis is poor, especially when it exhibits a blastoid morphology. Cyclin D1-negative MCL is rare, and its pathogenesis and progression remain unclear. Herein, we describe a cyclin D1-negative, cyclin D2-positive MCL with a CCND2 and immunoglobulin lambda light chain (IGL) translocation. The patient was initially diagnosed with cyclin D1-negative MCL and achieved complete remission via combination chemotherapy and autologous stem cell transplantation. After relapsing, he was diagnosed with a blastoid variant of MCL that showed lymphoid cells with dispersed chromatin and more mitotic figures and higher p53 expression compared with the initial MCL. Despite salvage therapies, the disease became refractory, and the patient died 28 months after initiating chemotherapy. This case demonstrates that blastoid morphology in cyclin D1-negative MCL with IGL-CCND2 translocation indicates progression to a more aggressive neoplasm, similar to cyclin D1-positive MCL.
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan. kuritadaisuke2@gmail.com.|Department of Pathology, Kurume University School of Medicine, Kurume, Japan. kuritadaisuke2@gmail.com.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kurita
authors.affiliation: Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Takeuchi
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan.
authors.forename: Sumiko
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan.|Division of Hematology and Oncology, Kasukabe Municipal Hospital, Kasukabe, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Hojo
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Uchino
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Sakagami
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan.
authors.forename: Shimon
authors.initials: S
authors.lastname: Ohtake
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Miura
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Iriyama
authors.affiliation: Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugitani
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Miyoshi
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan. hatta.yoshihiro@nihon-u.ac.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hatta
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ohshima
authors.affiliation: Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Takei
mesh_terms: D019938:Cyclin D1 / Q000378:metabolism; D056742:Cyclin D2 / Q000378:metabolism*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007146:Immunoglobulin lambda-Chains / Q000378:metabolism*; D017404:In Situ Hybridization, Fluorescence / Q000379:methods; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D014178:Translocation, Genetic / Q000502:physiology
chemical_list: C530104:CCND1 protein, human; C080336:CCND2 protein, human; D056742:Cyclin D2; D007146:Immunoglobulin lambda-Chains; D019938:Cyclin D1
keywords: CCND2 gene translocation; Cyclin D1; Cyclin D2; Mantle cell lymphoma; SOX11