Clonal proliferation of cyclin D1–positive mantle lymphocytes in an asymptomatic patient: an early-stage event in the development or an indolent form of a mantle cell lymphoma?

• Published in: Human pathology 2005-11, Vol.36 (11), p.1232-1237
• Main Authors: Espinet, Blanca, Solé, Francesc, Pedro, Carme, Garcia, Mar, Bellosillo, Beatriz, Salido, Marta, Florensa, Lourdes, Camacho, Francisca I., Baró, Teresa, Lloreta, Josep, Serrano, Sergi
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Biopsy; Blood; Bone marrow; Bone Marrow - pathology; CD5; Cell cycle; Chromosome Aberrations; Cyclin D1; Cyclin D1 - metabolism; Cyclin-dependent kinases; Cytogenetics; Deoxyribonucleic acid; Diagnosis, Differential; DNA; Female; Gene Rearrangement, B-Lymphocyte, Heavy Chain; Granuloma; Hematologic and hematopoietic diseases; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Indolent lymphocytosi; Investigative techniques, diagnostic techniques (general aspects); Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymph Nodes - pathology; Lymphadenitis - pathology; Lymphatic Diseases - diagnosis; Lymphatic Diseases - pathology; Lymphatic system; Lymphocytes; Lymphocytes - blood; Lymphocytes - pathology; Lymphoma; Lymphoma, Mantle-Cell - diagnosis; Lymphoma, Mantle-Cell - genetics; Lymphoma, Mantle-Cell - pathology; Lymphoma, Mantle-Cell - physiopathology; Mantle cell lymphoma; Medical sciences; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Phase transitions; Polymerase Chain Reaction; Studies; t(11; 14)(q13; q32)
• ISSN: 0046-8177; 1532-8392
• DOI: 10.1016/j.humpath.2005.08.021

Mantle cell lymphoma (MCL) is a B-cell neoplasm with a relatively aggressive clinical course. There is a very small subgroup of patients who present with atypical lymphocytes in peripheral blood, with or without lymphocytosis, lymphadenopathy, or splenomegaly, and with an indolent clinical course. They frequently show mutated IgV H genes and CD5 negativity. We report an asymptomatic elderly patient who presented with a single submandibular lymphadenopathy. The biopsy showed immunophenotype and t(11;14)(q13;q32) consistent with MCL. The abnormal lymphoid population was also detected in peripheral blood and bone marrow. The patient has remained asymptomatic for 5 years without receiving any therapy. It is uncertain whether these cases represent an early-stage event in the development or an indolent form of MCL. The existence of such asymptomatic patients with an indolent clinical course should induce a strict clinical judgment in terms of therapeutic decisions.