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Boşoteanu LA, Gheorghe E, Aşchie M, Cozaru GC, Deacu M, Bălțătescu GI, Orășanu CI, Boşoteanu M. CD8-Lymphocytic Phenotype Significance in Primary Multiple and Familial Melanoma with Various CDKN2A Mutational Status. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2151. [PMID: 38138255 PMCID: PMC10744472 DOI: 10.3390/medicina59122151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: In the realm of the rising incidence of cutaneous and mucous melanoma, CDKN2A mutations characterize familial and multiple primary melanoma cases. The involvement of tumor-infiltrating lymphocytes (TILs) is interconnected with survival rates, but may extend even further. The aim of this study is to verify the accuracy of the classical "naked eye" count of CD8-positive T cells comprised within the tumoral population and peritumoral infiltrate versus that obtained via a special software run by the aid of artificial intelligence (AI), used to determine the percentage of CD8-positive TILs. Materials and Methods: The present retrospective cross-sectional study conducted over a period of 5 years (2018-2022) focused on patients diagnosed with mucous and/or cutaneous melanoma, with a positive family history for melanoma, or personal antecedents of primary malignant melanocytic lesions. The 23 selected cases were diagnosed histopathologically, tested for CDKN2A mutations through fluorescent hybridization in situ, and CD8 immunohistochemistry was performed. The included slides were evaluated both manually (naked-eye examination) and automatically (via QuPath platform) for quantifying the CD8-positive TILs. Results: The number of CD8-positive TILs in melanoma samples has been more accurately identified through the use of an AI-mediated software as compared to the human-eye evaluation performed by experimental pathologists. A higher percentage of CD8-positive intratumoral lymphocytes versus stromal lymphocytes was positively associated with more numerous metastatic sites. Conclusions: The CD8 lymphocytic phenotype harbors major significance in the context of familial and multiple primary melanoma and may comprise a cost-effective investigation meant to help in the establishment of melanoma prognosis and response to immunotherapy.
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Affiliation(s)
- Luana-Andreea Boşoteanu
- Department of Dermatovenerology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
- Institute of Doctoral Studies, Doctoral School of Medicine, “Ovidius” University of Constanţa, 900573 Constanţa, Romania
| | - Emma Gheorghe
- Department of Dermatology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanţa, Romania
- Department of Histology, Faculty of Medicine, “Ovidius” University of Constanţa, 900527 Constanţa, Romania
| | - Mariana Aşchie
- Clinical Service of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanţa, Romania
- Department of Pathology, Faculty of Medicine, “Ovidius” University of Constanţa, 900527 Constanţa, Romania
- Department VIII—Medical Sciences, Academy of Romanian Scientists, 030167 Bucharest, Romania
| | - Georgeta Camelia Cozaru
- Clinical Service of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanţa, Romania
- Center for Research and Development of The Morphological and Genetic Studies of Malignant Pathology (CEDMOG), 900591 Constanţa, Romania
| | - Mariana Deacu
- Clinical Service of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanţa, Romania
- Department of Pathology, Faculty of Medicine, “Ovidius” University of Constanţa, 900527 Constanţa, Romania
| | - Gabriela Izabela Bălțătescu
- Clinical Service of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanţa, Romania
- Center for Research and Development of The Morphological and Genetic Studies of Malignant Pathology (CEDMOG), 900591 Constanţa, Romania
| | - Cristian Ionuț Orășanu
- Clinical Service of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanţa, Romania
- Center for Research and Development of The Morphological and Genetic Studies of Malignant Pathology (CEDMOG), 900591 Constanţa, Romania
| | - Mǎdǎlina Boşoteanu
- Clinical Service of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanţa, Romania
- Department of Pathology, Faculty of Medicine, “Ovidius” University of Constanţa, 900527 Constanţa, Romania
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2
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Lee J, Cohen JA, Wrone DA, Gru AA. Primary cutaneous follicle center lymphoma with aberrant CD8 expression. J Cutan Pathol 2021; 49:403-407. [PMID: 34797569 DOI: 10.1111/cup.14173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/05/2021] [Accepted: 11/01/2021] [Indexed: 11/30/2022]
Abstract
We report an unusual case of primary cutaneous follicle center lymphoma (PCFCL) with aberrant expression of the T-cell marker CD8. The patient is a 48-year-old male with no significant past medical history who presented with red indurated plaques on the abdomen. A punch biopsy showed abnormal lymphoid follicles in the dermis with reduced mantle zones and decreased tingible body macrophages. The epidermis was uninvolved. The follicles expressed CD20, PAX-5, and bcl-6 by immunohistochemistry. CD8, however, was strongly positive, highlighting neoplastic cells, which were negative for any additional T-cell markers. TIA and granzyme B were also negative. The patient underwent further staging workup, without evidence of nodal involvement. His course has been indolent thus far. In summary, we present a case of PCFCL with aberrant expression of the T-cell marker CD8, a finding not previously reported in the literature and a potential diagnostic pitfall.
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Affiliation(s)
- Jack Lee
- Department of Dermatology, University of Virginia, Charlottesville, Virginia, USA
| | | | - David A Wrone
- Penn Medicine Princeton Medical Center, Plainsboro Township, New Jersey, USA
| | - Alejandro A Gru
- Department of Dermatology, University of Virginia, Charlottesville, Virginia, USA.,Department of Pathology, University of Virginia, Charlottesville, Virginia, USA
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3
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Suzuki Y, Yoshida T, Wang G, Aoki T, Katayama T, Miyamoto S, Miyazaki K, Iwabuchi K, Danbara M, Nakayama M, Horie R, Nakamine H, Sato Y, Nakamura N, Niitsu N. Incidence and clinical significance of aberrant T-cell marker expression on diffuse large B-cell lymphoma cells. Acta Haematol 2013; 130:230-7. [PMID: 23816831 DOI: 10.1159/000348550] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 01/29/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Aberrant expression of T-cell markers is occasionally observed in B-cell lymphomas. We conducted a retrospective study to establish its incidence and to determine its relationship with clinical features of patients with diffuse large B-cell lymphoma (DLBCL). PATIENTS AND METHODS We reviewed DLBCL patients diagnosed between January 2002 and April 2009. Patients fulfilled the following criteria: (1) age >18 years, (2) HIV negative, (3) B-cell lymphoma confirmed by restricted expression of surface immunoglobulin light chains by flow cytometry (FCM). Aberrant T-cell marker expression (ATCME) was defined as positivity for CD2, CD3, CD4, CD7, and/or CD8 on DLBCL cells by FCM. Phenotyping was also performed by immunohistochemistry (IHC). Patients were grouped according to positive or negative ATCME and their clinical features including survival were compared. RESULTS Of 150 patients, 11 (7.3%) showed ATCME; CD2 and CD7 were most often expressed. ATCME was less often detected and the signal was weaker using IHC. There were no statistically significant differences in clinical features between the two groups. CONCLUSIONS FCM may be useful to detect ATCME in a small amount of lymphoma cells. The mechanism responsible for ATCME, and whether it contributes in any way to the pathogenesis of B-cell neoplastic transformation, requires clarification.
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Affiliation(s)
- Yuhko Suzuki
- Department of Hematology, Kitasato University School of Medicine, Sagamihara, Japan
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4
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Carulli G, Stacchini A, Marini A, Ciriello MM, Zucca A, Cannizzo E, Aliberti S, Demurtas A, Novero D, Calcagno L, Callegari T, Petrini M. Aberrant expression of CD8 in B-cell non-Hodgkin lymphoma: a multicenter study of 951 bone marrow samples with lymphomatous infiltration. Am J Clin Pathol 2009; 132:186-90; quiz 306. [PMID: 19605812 DOI: 10.1309/ajcpncohs92arwrq] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
T-cell antigen expression can be observed in B-cell non-Hodgkin lymphoma (B-NHL). Although CD5 is expressed in B-cell chronic lymphocytic leukemia (B-CLL) and mantle cell lymphoma, the presence of other T-cell antigens is less common. This article reports a retrospective multicenter analysis in which flow cytometry was used to evaluate aberrant CD8 expression on the pathologic B cells of 951 bone marrow samples from patients with various types of B-NHL. In a total of 18 patients, CD8 was coexpressed: 10 had B-CLL; 1, small lymphocytic lymphoma (SLL); 1, marginal zone lymphoma; 1, lymphoplasmacytic lymphoma; 2, diffuse large B-cell lymphoma; and 3, follicular lymphoma. There was a 1.89% overall frequency of CD8 coexpression in which B-CLL/SLL had a higher frequency (3.03%) than did the other B-cell neoplasms (1.18%). Most cases were characterized by a favorable outcome.
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5
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Abstract
It is not uncommon for some B-lineage non-Hodgkin lymphomas (NHLs) to aberrantly coexpress T-cell markers, particularly CD5, as well as CD7, CD2, CD4, and/or CD8 in rare cases. Cases of CD3-positive B-cell NHL, however, have not previously been described in the literature. We present 4 cases of large B-cell lymphoma aberrantly coexpressing T-cell marker CD3 and B-lineage markers as well as demonstrating clonal rearrangement of the immunoglobulin genes but not the gamma T-cell receptor gene. To our knowledge, this represents the first series report of B-cell NHL coexpressing T-lineage-specific marker CD3. The identification of such cases indicates that the use of CD3 antibody alone in paraffin sections may lead to an incorrect determination of cell lineage in some B-cell NHL. Immunohistochemistry using additional cell lineage specific markers or molecular analysis for antigen receptor gene rearrangements are necessary for correct determination of the cell lineage in such cases.
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Abstract
Mantle cell lymphoma (MCL) is a well-defined lymphoid neoplasm characterized by a proliferation of mature B lymphocytes expressing CD5 that may show a spectrum of morphological and phenotypic features broader than initially described. Although some patients may follow an indolent clinical evolution, in most of them the tumour has an aggressive behaviour with poor response to conventional chemotherapy. The genetic hallmark is the t(11;14)(q13;q32) translocation leading to the overexpression of cyclin D1, which is considered the initial oncogenic event. In addition to this translocation, MCL may carry a high number of secondary chromosomal and molecular alterations that target regulatory elements of the cell cycle machinery and senescence (BMI1/INK4/ARF/CDK4/RB1), DNA damage response pathways (ATM/CHK2/p53), and cell survival signals. The knowledge of these mechanisms and their influence on the behaviour of the tumour are facilitating the development of prognostic models with a more precise prediction of the clinical evolution of the patients. This information coupled with the availability of a new generation of innovative drugs targeting basic molecular process of the tumour cells, should facilitate the design of new therapeutic protocols able to overcome the resistance of this aggressive lymphoma to conventional treatments and improve the life expectancy of the patients.
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Affiliation(s)
- Pedro Jares
- Haematopathology Section, Laboratory of Pathology, and Genomics Unit, Hospital Clinic, Institut de Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
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7
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Carulli G, Cannizzo E, Marini A, Rossi A, Baccelli E, Petrini M. CD8 expression in B-cell non-Hodgkin's lymphomas. Ann Hematol 2008; 87:577-9. [PMID: 18327585 DOI: 10.1007/s00277-008-0457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Accepted: 02/01/2008] [Indexed: 10/22/2022]
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Parisi-Duchêne E, Mazurier I, Moskovtchenko P. Aberrant CD8 expression in B-chronic lymphocytic leukemia: report of five cases. Acta Haematol 2006; 115:74-7. [PMID: 16424654 DOI: 10.1159/000089470] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2004] [Accepted: 05/09/2005] [Indexed: 11/19/2022]
Abstract
The expression of T cell-associated antigens on B cell non-Hodgkin lymphoma is rare. We describe 5 cases of B-chronic lymphocytic leukemia (B-CLL) with aberrant expression of CD8 on B cells. These B-CLL presented a typical immunophenotype CD19+, CD23+, FMC7- and CD5+ (except for 1 case) with a monotypic expression of surface immunoglobulin light chain kappa. The CD8 expression was confirmed on B-CLL cells by two-color flow cytometry staining. We could not find coexpression of CD3 or CD4 on B-CLL cells. The clinical implications, the sensitivity to therapy and the prognostic outcome of this aberrant expression remains to be determined.
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Affiliation(s)
- E Parisi-Duchêne
- Laboratoire d'Hématologie-Hémostase, Hôpital Pasteur, Colmar, France.
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9
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Abstract
Abstract
We report a case of mantle cell lymphoma histologically indistinguishable from marginal zone lymphoma. An 83-year-old man presented with a 9.0-cm, slowly enlarging axillary mass. Microscopically, the neoplastic process was largely interfollicular, surrounding residual follicular centers, some of which had discernible small lymphocyte mantles. Overall, the morphologic pattern was highly suggestive of marginal zone lymphoma. However, flow cytometric and immunohistochemical results, including cyclin D1 positivity, revealed an immunophenotype that fit with mantle cell lymphoma. The differential diagnosis of mantle cell lymphoma is broad, and it is well known that mantle cell lymphoma can assume a number of histologic appearances, including, infrequently, that of more indolent B-cell non-Hodgkin lymphomas. Although not pathognomonic, cyclin D1 positivity is highly specific for mantle cell lymphoma and is key in distinguishing these clinically dissimilar malignant lymphomas. In recent years, detection of cyclin D1 has expanded the recognizable histologic spectrum of mantle cell lymphoma.
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Affiliation(s)
- Erica Jacobson
- Department of Pathology and Fletcher Allen Health Care, University of Vermont College of Medicine, Burlington, VT 05405, USA.
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10
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Schroers R, Hildebrandt Y, Steffens R, Becker S, Ohms G, von Bonin F, Haase D, Bertsch HP, Trümper L, Griesinger F. Immunophenotypic and genetic characterization of a CD8 positive Mantle Cell Lymphoma in a patient with concomitant Mycosis Fungoides. Eur J Haematol 2005; 75:78-84. [PMID: 15946316 DOI: 10.1111/j.1600-0609.2005.00432.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Mantle cell lymphoma (MCL) is immunophenotypically characterized by cell surface co-expression of CD19, CD20, CD5, IgM and FMC7. However, the concomitant presence of other antigens distinctive of a particular leukocyte subset, e.g. T-lymphocytes, is an exceptional finding in MCL. Here, the first case of a blastic MCL in leukaemic phase with aberrant expression of the T-cell associated antigen CD8 occurring in a patient with concomitant Mycosis fungoides is described. Comprehensive immunophenotypic analysis showed that the MCL cells expressed the typical B-lymphocytic markers, were CD5 and CD8 positive, but did not express other T-cell proteins, such as CD2, CD3, CD4, CD7, TCRalphabeta and TCRgammadelta. The MCL cells expressed both CD8alpha and CD8beta chains indicating cell surface presence of CD8alphabeta heterodimers. Intriguingly, expression of the cytotoxic enzymes perforin and granzyme A was detected by RT-PCR. Cytogenetic and molecular genetic analysis of the lymphoma cells confirmed cyclin D1 overexpression secondary to the t(11;14)(q13;32) chromosomal translocation. Furthermore, trisomy 11, trisomy 14 and extra copies of t(11;14) translocated chromosomes were detected in sub clones of the analyzed MCL cells. Clinically, an aggressive course of disease including cerebral lymphoma involvement was noted in the reported patient. Hence, systematic studies addressing the incidence, biology and clinical behavior of this form of MCL seem to be justified in future.
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MESH Headings
- Antigens, CD/blood
- Antigens, CD/genetics
- B-Lymphocytes/metabolism
- B-Lymphocytes/pathology
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 14/genetics
- Cyclin D1/biosynthesis
- Cyclin D1/genetics
- Gene Expression Regulation, Leukemic
- Granzymes
- Humans
- Lymphoma, Mantle-Cell/blood
- Lymphoma, Mantle-Cell/complications
- Lymphoma, Mantle-Cell/genetics
- Male
- Membrane Glycoproteins/blood
- Middle Aged
- Mycosis Fungoides/blood
- Mycosis Fungoides/complications
- Mycosis Fungoides/genetics
- Perforin
- Pore Forming Cytotoxic Proteins
- Serine Endopeptidases/blood
- Translocation, Genetic
- Trisomy/genetics
- Trisomy/physiopathology
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Affiliation(s)
- Roland Schroers
- Department of Hematology and Oncology, Georg-August-University, Göttingen, Germany
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11
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Lai R, McDonnell TJ, O'Connor SL, Medeiros LJ, Oudat R, Keating M, Morgan MB, Curiel TJ, Ford RJ. Establishment and characterization of a new mantle cell lymphoma cell line, Mino. Leuk Res 2002; 26:849-55. [PMID: 12127561 DOI: 10.1016/s0145-2126(02)00013-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Mantle cell lymphoma (MCL) is a distinct type of B-cell non-Hodgkin's lymphoma characterized by cyclin D1 overexpression and the cytogenetic abnormality, the t(11;14)(q13;q32). MCL cell lines have been difficult to establish and in vitro studies of these neoplasms are scarce. We describe the establishment and characteristics of a new MCL cell line, Mino. The cells are large, growing singly and in small clumps in vitro. By flow cytometry, the immunophenotype was compatible with MCL (i.e. CD5+CD20+CD23-FMC7+). Conventional cytogenetics showed hyperdiploidy with multiple complex karyotypic abnormalities, but no evidence of the t(11;14), proven to be present only by fluorescence in situ hybridization and polymerase chain reaction (PCR) methods. Western blots showed expression of cyclin D1 but no detectable cyclin D2 and cyclin D3; the retinoblastoma protein was predominantly phosphorylated. There was expression of tumor suppressor gene products including p53, p16(INK4a), and p21(WAF1). Sequencing of the TP53 gene revealed a mutation (codon 147(valine-->glycine)) in exon 5. Epstein Barr virus was absent. In summary, Mino is a new MCL cell line that may be useful to study the pathogenesis of MCL.
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MESH Headings
- Amino Acid Substitution
- Aneuploidy
- Antigens, CD/analysis
- Blotting, Western
- Cell Cycle Proteins/analysis
- Cell Size
- Chromosome Aberrations
- Codon/genetics
- Cyclins/analysis
- Exons/genetics
- Fatal Outcome
- Female
- Genes, p53
- Herpesvirus 4, Human
- Humans
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- Karyotyping
- Lymphoma, Mantle-Cell/chemistry
- Lymphoma, Mantle-Cell/genetics
- Lymphoma, Mantle-Cell/pathology
- Middle Aged
- Mutation, Missense
- Neoplasm Proteins/analysis
- Point Mutation
- Polymerase Chain Reaction
- Tumor Cells, Cultured/chemistry
- Tumor Cells, Cultured/pathology
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Affiliation(s)
- R Lai
- Department of Hematopathology, University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 72, Houston, TX 77030, USA.
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12
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Kaleem Z, White G, Zutter MM. Aberrant expression of T-cell-associated antigens on B-cell non-Hodgkin lymphomas. Am J Clin Pathol 2001; 115:396-403. [PMID: 11242796 DOI: 10.1309/v8yg-8pp4-b4te-9x6j] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
We describe 9 well-characterized cases of B-cell non-Hodgkin lymphoma (NHL) that showed aberrant expression of T-cell-associated antigens by 2-color flow cytometry. Cases were as follows: chronic lymphocytic leukemia/small lymphocytic lymphoma, 4; follicle center cell lymphoma, 2; mantle cell lymphoma, 1; and diffuse large B-cell lymphoma, 2. CD2 was the most commonly expressed antigen (5 cases). CD8 and CD7 were identified in 2 cases each, including 1 case that expressed both CD7 and CD4. The disease course and response to treatment were compatible with the type and stage of lymphoma. No unusually aggressive behavior was noted in any case. A control group of 59 cases of benign lymph nodes analyzed during the same period showed no aberrant expression of T-cell-associated antigens; thus, such expression is not a feature of benign lymphoid proliferations. Study of these B-cell lymphomas may prove invaluable to study aberrant activation of silent or repressed T-cell differentiation genes. CD2-expressing B-cell NHLs may represent clonal expansion of CD2+ B lymphocytes that normally constitute a small fraction of peripheral B lymphocytes and should not be confused with composite B- and T-cell lymphomas. Unless aggressive behavior is noted consistently, no aggressive treatment is justified.
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MESH Headings
- Aged
- Aged, 80 and over
- Antigens, CD/analysis
- Antigens, CD7/analysis
- B-Lymphocytes/immunology
- CD2 Antigens/analysis
- CD4 Antigens/analysis
- CD8 Antigens/analysis
- Female
- Flow Cytometry
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Lymphoma, B-Cell/immunology
- Lymphoma, Follicular/immunology
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Mantle-Cell/immunology
- Male
- Middle Aged
- T-Lymphocytes/immunology
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Affiliation(s)
- Z Kaleem
- Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish Hospital/Washington University Medical Center, St Louis, MO, USA
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13
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Lai R, Medeiros LJ. Pathologic diagnosis of mantle cell lymphoma. CLINICAL LYMPHOMA 2000; 1:197-206; discussion 207-8. [PMID: 11707830 DOI: 10.3816/clm.2000.n.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Mantle cell lymphoma (MCL) is a clinicopathologic entity with distinctive morphologic and immunophenotypic features and a characteristic cytogenetic abnormality, the t(11;14)(q13;q32). Although MCL was recognized over 30 years ago, a lack of consensus regarding its morphologic features precluded its inclusion into non-Hodgkin's lymphoma (NHL) classification schemes until relatively recently. An accurate diagnosis of MCL is of great importance, since this tumor generally carries a poor prognosis and requires more aggressive and novel treatment regimens. In this article, we briefly overview the clinical features of MCL and then focus on the pathologic diagnosis of MCL, emphasizing morphologic findings and various ancillary techniques useful in the diagnostic workup. Involvement of lymph nodes and other sites, such as the spleen, liver, gastrointestinal tract, Waldeyer's ring, bone marrow, peripheral blood, and cerebrospinal fluid are reviewed. The diagnosis of high-grade variants of MCL is a particular challenge, as these tumors exhibit a broad spectrum of morphologic findings that can be misinterpreted as other types of NHL. The molecular basis of MCL is also briefly reviewed to highlight the biologic role of the t(11;14) and cyclin D1 overexpression in this tumor and the value of immunophenotypic and molecular methods for their detection as diagnostic aids.
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Affiliation(s)
- R Lai
- Department of Hematopathology, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
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