Mantle Cell Lymphoma With Mantle Zone Growth Pattern: A Clinicopathologic Study of 35 Cases

• Published in: American journal of clinical pathology 2019-08, Vol.152 (2), p.132-145
• Main Authors: Ji Yuan, Li, Shaoying, Liu, Xin, Ruijun Jeanna Su, Chen, Mingyi, Wu, Xiaojun, Zheng, Gang, Smith, Lynette M, Wang, Lifu, Li, Yanxia, Liu, Cynthia, Zhou, Jiehao, Shen, Qi, Zhang, Linsheng, Wang, Endi, Xu, Mina L, Pan, Zenggang
• Format: Article
• Language: English
• Subjects: CD5 antigen; Chemotherapy; Cyclin D1; Cytology; Growth patterns; Lymph nodes; Lymphoma; Mantle cell lymphoma; Morphology; Patients
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1093/ajcp/aqz043

Objectives To characterize the clinical and pathologic features of mantle cell lymphoma with mantle zone growth pattern (MCL-MZGP). Methods The clinicopathologic data from 35 cases of MCL-MZGP obtained in 12 centers were analyzed. Results The patients with MCL-MZGP typically sought treatment at high clinical stages (81%). Intriguingly, 40% (14/35) of cases were incidentally noted. The lymph nodes with MCL-MZGP showed preserved architecture and expanded mantles containing lymphoma cells with classic or small cell cytology. MCL-MZGP was positive for BCL2 (96%, bright), CD5 (82%, moderate), cyclin D1 (100%), and SOX11 (89%). Clinically, our study revealed no significant difference in the overall survival between patients managed with observation alone and those who received chemotherapy. Conclusions MCL-MZGP was often incidentally identified and resembled reactive mantles. Therefore, recognition of this unusual morphology emphasizes the utility of cyclin D1 immunostain in the cases with suspicious morphology. However, the clinical significance of these findings is still unclear.