Hyperplasia of Mantle/Marginal Zone B Cells With Clear Cytoplasm in Peripheral Lymph Nodes

Hunt, John P.; Chan, Joel A.; Samoszuk, Michael; Brynes, Russell K.; Hernández, A.M.; Bass, Randall D.; Weisenburger, Dennis D.; Müller-Hermelink, Konrad; Nathwani, Bharat N.

doi:10.1309/p2m2-jea3-yyqf-0p38

Cited by 29 publications

(13 citation statements)

References 17 publications

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“…Recently, Hant et al reported hyperplasia of mantle zone lymphocytes with clear cytoplasm in peripheral lymph nodes and discussed the problems of differentiating nodal marginal zone B-cell lymphoma or mantle cell lymphoma (MCL) [5]. The present three cases confirmed this observation in reactive lymphoid hyperplasia of the terminal ileum.…”

Section: Discussionsupporting

confidence: 82%

Focal Lymphoid Hyperplasia of the Terminal Ileum Presenting Mantle Zone Hyperplasia with Clear Cytoplasm. A Report of Three Cases

Kojima

Shimizu

Sameshima

et al. 2008

Pathol. Oncol. Res.

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We report three unusual cases of focal lymphoid hyperplasia of the ileocecal valve. The gross specimens showed thickening of the ileocecal valve. Low power magnification showed a dense lymphoid infiltrate in the mucosa and submucosa. This condition was characterized by reactive lymphoid follicles with large reactive germinal centers surrounded by a pale cuff of mantle zone lymphocytes presenting a marginal zone distribution pattern. These cells had intermediate- to- medium-sized round or slightly indented nuclei and a broad rim of clear cytoplasm. However, immunohistochemical study demonstrated that both the mantle zone lymphocytes and the pale cuff of the lymphoid cells were CD20+, sIgM+, sIgD+, CD5-, CD10-, CD23-, CD43-, Bcl-2+, Bcl-6-, CyclinD1-. The polytypic nature of these cells was demonstrated by immunohistochemistry and polymerase chain reaction. This unusual mantle cell hyperplasia with clear cytoplasm associated with focal lymphoid hyperplasia in middle-aged and elderly patients should be differentiated from the extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue type or mantle cell lymphoma showing a marginal zone distribution pattern. To avoid overdiagnosis and overtreatment, it is suggested that immunophenotypic and genotypic studies might be required, and careful attention should be paid to the morphologic examination.

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Section: Discussionsupporting

confidence: 82%

Focal Lymphoid Hyperplasia of the Terminal Ileum Presenting Mantle Zone Hyperplasia with Clear Cytoplasm. A Report of Three Cases

Kojima

Shimizu

Sameshima

et al. 2008

Pathol. Oncol. Res.

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“…2 MCL with a mantle zone growth pattern can be confused with either marginal zone lymphoma or reactive follicular hyperplasia. 6 Our study presents two cases of MCL with a pure mantle zone pattern, representing an in situ-like MCL.…”

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confidence: 95%

“In situ-like” mantle cell lymphoma: a report of two cases: Figure 1

et al. 2006

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Mantle cell lymphoma (MCL) is a B cell neoplasm that most often shows a diffuse growth pattern. Two cases of MCL are reported here, both with a previous diagnosis of lymphoid hyperplasia. Morphologically, germinal centres are hyperplasic with a normal or discretely enlarged mantle zone, where foci of irregularly shaped small lymphocytes are seen. These are positive for CD20, CD5 and cyclin D1, confirming a diagnosis of in situ-like MCL. This type differs from the mantle zone pattern in that the neoplastic mantle zone is very thin and there is very little or no spread of tumour cells into interfollicular areas. To the best of our knowledge, this is the first report on such a pattern of MCL, which is important to recognise, as it can be confused with lymphoid hyperplasia.

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“…Finally, as suggested by Hunt et al, 28 reactive lymph node lesions may rarely show mantle cell hyperplasia with clear cytoplasm. In our study, an association of mantle cell hyperplasia with clear cytoplasm and LV of HVCD has a relatively high incidence (27%).…”

Section: -21mentioning

confidence: 68%

“Follicular Variant” of Hyaline-vascular Type of Castleman's Disease : Histopathological and Immunohistochemical Study of 11 Cases

Kojima

Shimizu

Ikota

et al. 2008

J Clin Exp Hematopathol

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Occasionally, the hyaline-vascular type of Castleman's disease (HVCD) contains numerous lymphoid follicles which usually occupy more than 50% of the lesion. Such lesions are called the follicular variant (FV) of HVCD. To clarify the histological and immunohistochemical findings of lymphoid follicles in the FV of HVCD, we examined 11 such cases. Histologically, five types of lymphoid follicles were delineated. Lymphoid follicles ; (i) with normal germinal centers (GCs) ; (ii) showing follicular lysis ; (iii) with progressive transformation of GC (PTGC) ; (iv) where the large nodule of mantle zone lymphocytes contained multiple small atrophic GCs (multiple GC pattern) ; and (v) where the large, often irregularly shaped nodules of mantle cells radically penetrated small vessels with inconspicuous GCs. These nodules somewhat resembled primary lymphoid follicles (primary follicular pattern). The majority of lymphoid follicles in all 11 cases were of the primary follicular pattern and/or multiple GC pattern. However, three lesions also contained normal germinal GC, while two contained normal GC, follicular lysis and PTGC and one other contained normal GC and PTGC. Moreover, in 3 cases of primary follicular pattern, the majority of the lymphoid follicles were surrounded by a pale cuff of mantle cells. Because of the presence of numerous lymphoid follicles, the FV of HVCD should be sometimes differentiated from Hodgkin lymphoma and low-grade B-cell lymphomas showing follicular growth pattern. Recognition of the histological and immunohistochemical findings of the FV of HVCD is needed to avoid overdiagnosis. 〔J Clin Exp Hematopathol 48(2) : 39-45, 2008〕

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Hyperplasia of Mantle/Marginal Zone B Cells With Clear Cytoplasm in Peripheral Lymph Nodes

Cited by 29 publications

References 17 publications

Focal Lymphoid Hyperplasia of the Terminal Ileum Presenting Mantle Zone Hyperplasia with Clear Cytoplasm. A Report of Three Cases

Focal Lymphoid Hyperplasia of the Terminal Ileum Presenting Mantle Zone Hyperplasia with Clear Cytoplasm. A Report of Three Cases

“In situ-like” mantle cell lymphoma: a report of two cases: Figure 1

“Follicular Variant” of Hyaline-vascular Type of Castleman's Disease : Histopathological and Immunohistochemical Study of 11 Cases

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