CD5– Mantle Cell Lymphoma

Liu, Zach; Dong, Henry Y.; Gorczyca, Wojciech; Tsang, Patricia; Cohen, Patti; Stephenson, Christine F.; Berger, Carol S.; Wu, Chaowei; Weisberger, James

doi:10.1309/te56-a43x-29tt-5h8g

Cited by 111 publications

(71 citation statements)

References 32 publications

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“…Absence of CD5 expression has been described in up to 10% of all MCL cases. 22 However, reports of cases that have converted from a CD5-positive to a CD5-negative immunophenotype, or that show concurrent CD5-positive and CD5-negative tumors at different sites are unusual. 23 Reports of aberrant CD10 expression by MCL are also rare, and most often associated with blastoid morphology.…”

Section: Discussionmentioning

confidence: 99%

Sequence analysis proves clonal identity in five patients with typical and blastoid mantle cell lymphoma

et al. 2007

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Mantle cell lymphoma (MCL) is typically composed of small irregular lymphoid cells. Blastoid variants, composed of lymphoblast-like (classic type) or large (pleomorphic type) cells, arise de novo or in patients with typical MCL. Although it has been assumed that blastoid variant represents histologic transformation of typical MCL, the clonal relationship between the two tumors has rarely been assessed at the molecular level. We identified five patients with typical MCL who subsequently developed the blastoid variant. There were two men and three women with a median age of 65 years (range, 34-70) at diagnosis of typical MCL involving lymph nodes. The median interval between typical and blastoid MCL was 36 months (range, 11-103). Subsequent blastoid variant MCL involved soft tissue (two), lymph node (one), ileum (one), or rectum (one). All typical and blastoid neoplasms were positive for CD20, cyclin D1, and monotypic surface immunoglobulin light chain, and all typical cases were positive for CD5. Two blastoid neoplasms lost CD5 expression, one of which aberrantly expressed CD10. Immunostaining for Ki-67 showed a median proliferative fraction of 20% in typical and 70% in blastoid neoplasms. Sequence analysis of the VDJ regions of the rearranged IgH allele proved clonal identity in each set of paired samples in all five patients. These results support the concept that blastoid MCL arising in patients with typical MCL represents histologic transformation of the original neoplastic clone. Keywords: mantle cell lymphoma; blastoid; histologic transformation Mantle cell lymphoma (MCL) is a distinct type of B-cell lymphoma characterized by the t(11;14)(q13; q32) and cyclin D1 overexpression. Histologically, MCL is typically composed of a monotonous population of small to medium-sized lymphoid cells with slightly irregular nuclear contours and a relatively low mitotic rate. Immunophenotypically, MCL expresses monotypic surface immunoglobulin, pan-B-cell antigens, and CD5, and is usually negative CD10 and CD23. 1,2 A histologically more aggressive form of MCL, blastoid variant, also occurs, either de novo or in patients with typical MCL. Two types of blastoid MCL are described, consisting of either lymphoblast-like (classic type) or large (pleomorphic type) cells with a high proliferative fraction. [3][4][5][6] In patients who have both typical and blastoid variant MCL, either simultaneously or sequentially, the relationship between these neoplasms is not well studied. One might assume that both the typical and blastoid variant MCL are clonally related, analogous to low-grade follicular lymphoma and diffuse large B-cell lymphoma. However, in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) who develop diffuse large B-cell lymphoma, so-called Richter's syndrome, molecular genetic analysis indicates that the CLL/SLL and diffuse large B-cell lymphoma are clonally related in approximately 50% of cases. 7,8 In our review of the literature, we have identified only three patients in which the clonal...

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Section: Discussionmentioning

confidence: 99%

Sequence analysis proves clonal identity in five patients with typical and blastoid mantle cell lymphoma

et al. 2007

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“…While distinguishing the CD5-negative cases from marginal zone lymphoma becomes more difficult, CD5-negative MCL cases are occasionally reported. 3,14,15 Liu et al 3 reported 25 cyclin D1-positive, CD5-negative MCL cases, where centrocyte-like cells proliferated in 20 cases and blast-like cells proliferated in 5 cases. Similarly to other reports, CD5-negative cases were observed in about 10% of MCL cases, warning of the risk of diagnosis sorely depending on CD5 phenotypes, and suggesting that immunohistochemical examinations such as cyclin D1 are required regardless of CD5 phenotypes when MCL is suspected clinically and morphologically.…”

Section: -13mentioning

confidence: 99%

“…In addition, a few CD5-negative cases have been reported. 3 The prognosis is poor, with an overall survival rate of about 3 years, and it is not generally curable by chemotherapy. Histologically evaluable prognostic factors include mitotic figure increase (> 20 mitotic figures per 10 high-power fields) 4 and Ki-67-positive cell proliferation.…”

Section: Introductionmentioning

confidence: 99%

CD5-Negative Mantle Cell Lymphoma Resembling Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue : A Case Report

Hashimoto

Omura

Tanaka

et al. 2012

J Clin Exp Hematopathol

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A 71-year-old male underwent an upper gastrointestinal endoscopy ; as a result of a biopsy, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) was suspected. Abdominal computed tomography scan disclosed an approximately 4-cm-large mass in the ileocecal region. After ileocecal resection, the patient was diagnosed with MALT lymphoma (CD79a + , CD20 + , CD3 -, CD5 -, CD10 -, and cyclin D1 -). He achieved complete remission after receiving chemotherapy. However, four years after the primary onset, he was diagnosed with recurrence. Although he achieved remission again by salvage therapy, six years after the primary onset, he was referred to our hospital with second recurrence. Colonoscopy revealed the appearance of multiple lymphomatous polyposis and biopsy specimens showed monotonous proliferation of centrocyte-like cells (CD79a-, and cyclin D1 + ), which were consistent with mantle cell lymphoma (MCL) except for CD5. The result of reactivity to cyclin D1 was different from that at initial diagnosis, so we reexamined the initial surgical specimens, the histological and histochemical features of which were proven to be the same as those of colonic biopsy specimens. Finally, the patient was diagnosed with CD5-negative MCL (marginal zone-like variant). As MALT lymphoma and MCL sometimes show similar histological features, they are difficult to distinguish from each other. It is necessary to take the possibility of this rare phenotype of MCL into consideration and to reexamine the initial diagnosis, especially if the clinical course is unusual for MALT lymphoma. This case is very interesting in view of its indolent clinical feature and phenotype. 〔J Clin Exp Hematopathol 52(3) : 185-191, 2012〕

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“…Absence of CD5 expression has been reported in a minority of cases, perhaps 5-10% of MCL overall. 65 A newer marker useful in the differential diagnosis of MCL is SOX11, which is positive in 490 of cases and may be particularly helpful if Cyclin D1 staining is suboptimal or otherwise difficult to interpret. 47,66 SOX11 expression has also been reported in cases recently identified as Cyclin D1-negative MCL (see Variant-Cyclin D1 Negative MCL section).…”

Section: Mantle Cell Lymphomamentioning

confidence: 99%

Nodal and leukemic small B-cell neoplasms

Cook

2013

Modern Pathology

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The small B-cell neoplasms represent some of the most frequently encountered lymphoproliferative disorders in routine surgical pathology practice. This report reviews the current diagnostic criteria for classifying small B-cell neoplasms and distinguishing them from newly recognized precursor conditions that do not appear to represent overt lymphomas. Newly available immunohistochemical stains and molecular studies that may assist in the diagnosis and classification of these neoplasms are also discussed.

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CD5– Mantle Cell Lymphoma

Cited by 111 publications

References 32 publications

Sequence analysis proves clonal identity in five patients with typical and blastoid mantle cell lymphoma

Sequence analysis proves clonal identity in five patients with typical and blastoid mantle cell lymphoma

CD5-Negative Mantle Cell Lymphoma Resembling Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue : A Case Report

Nodal and leukemic small B-cell neoplasms

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