Indolent mantle cell lymphoma with nodal involvement and mutated immunoglobulin heavy chain genes

Nodit, Laurentia; Bahler, David W.; Jacobs, Samuel A.; Locker, Joseph; Swerdlow, Steven H.

doi:10.1053/s0046-8177(03)00410-6

Cited by 89 publications

(77 citation statements)

References 28 publications

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“…These have been designated as in situ FL or in situ MCL, referring to the fact that the clonal population is restricted in its distribution to its normal anatomic location, the germinal center or mantle zone, respectively (Table 3; Figure 2). [69][70][71][72][73][74][75][76] These lesions should be distinguished from partial involvement of the lymph node by overt lymphomas. Cases of in situ FL, or intrafollicular neoplasia, as alternatively termed in the WHO classification, represent expansions of CD10 and BCL2-positive lymphoid cells carrying the t(14;18) translocation found in germinal centers of an otherwise reactive lymph node.…”

Section: Early Lesions In Lymphoid Neoplasmsmentioning

confidence: 99%

“…79 Early involvement of lymph nodes by cells carrying the t(11;14) translocation and overexpressing cyclin D1 have been reported in several individual cases. 69,71,73,74,76 The cyclin D1-expressing cells are predominantly found in the inner area of the mantle zone of the follicles, but usually the rest of the mantle and the follicle have a For personal use only. on May 10, 2018. by guest www.bloodjournal.org From reactive appearance.…”

Section: Early Lesions In Lymphoid Neoplasmsmentioning

confidence: 99%

“…Some of these patients have circulating t(11;14)-positive cells, but they have not developed a clinically significant neoplasm after several years of follow-up, even without treatment. 71,73 However, some cases may progress to overt MCL. 76 Similar to the t(14;18) translocation, persisting circulating clones carrying the t(11;14) translocation may be detected in healthy persons, again without evidence of progression.…”

Section: Early Lesions In Lymphoid Neoplasmsmentioning

confidence: 99%

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The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications

Campo

Swerdlow

Harris

et al. 2011

Blood

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1,414

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The World Health Organization classification of lymphoid neoplasms updated in 2008 represents a worldwide consensus on the diagnosis of these tumors and is based on the recognition of distinct diseases, using a multidisciplinary approach. The updated classification refined the definitions of well-recognized diseases, identified new entities and variants, and incorporated emerging concepts in the understanding of lymphoid neoplasms. However, some questions were unresolved, such as the extent to which specific genetic or molecular alterations define certain tumors, and the status of provisional entities, categories for which the World Health Organization working groups felt there was insufficient evidence to recognize as distinct diseases at this time. In addition, since its publication, new findings and ideas have been generated. This review summarizes the scientific rationale for the classification, emphasizing changes that have had an effect on practice guidelines. The authors address the criteria and significance of early or precursor lesions and the identification of certain lymphoid neoplasms largely associated with particular age groups, such as children and the elderly. The issue of borderline categories having overlapping features with large B-cell lymphomas, as well as several provisional entities, is reviewed. These new observations chart a course for future research in the field. (Blood. 2011

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Section: Early Lesions In Lymphoid Neoplasmsmentioning

confidence: 99%

Section: Early Lesions In Lymphoid Neoplasmsmentioning

confidence: 99%

Section: Early Lesions In Lymphoid Neoplasmsmentioning

confidence: 99%

See 1 more Smart Citation

The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications

Campo

Swerdlow

Harris

et al. 2011

Blood

1,782

1,414

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“…For comparison, we investigated the expression of SOX11 by immunohistochemistry in a series of 37 conventional nodal MCL and found strong nuclear expression (in more than 50% of tumor cells) in 91% of cases. Thus, considering levels above 20% as positive, the expression of SOX11 is significantly lower in cases of indolent leukemic MCL than in typical nodal MCL (P<0.00001, Variant indolent mantle cell leukemia haematologica | 2011; 96 (8) 1123 Fisher's exact test) ( [5], add(2)(p13) [12],add(6)(q13) [2]add(8)(p23) [15],t (11;14)(q13:q32) [16],-13 [10],der(13)t(13;17)(p11.2;q21) [6],t15 [3],-17 [12],add (20) Flow cytometry of the peripheral blood was conducted in all cases. The median absolute abnormal B-cell count at diagnosis was 6.351¥10 9 /L (range, 1.072-12.780¥10 9 /L).…”

Section: Pathological Featuresmentioning

confidence: 99%

“…Case reports of patients with lymphadenopathy and minimal involvement by MCL document prolonged survival even without therapy. 4,5 Indeed, selected asymptomatic patients may be managed expectantly, without risk of worsening their longterm prognosis. 7 There is immunological and genomic evidence that two distinct subgroups of mantle cell leukemia exist with different clinical courses (aggressive versus indolent clinical behavior).…”

Section: Introductionmentioning

confidence: 99%

Indolent mantle cell leukemia: a clinicopathological variant characterized by isolated lymphocytosis, interstitial bone marrow involvement, kappa light chain restriction, and good prognosis

Ondrejka¹,

Lai²,

Smith³

et al. 2011

Haematologica

168

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BackgroundCases of mantle cell lymphoma with indolent behavior have been reported, but are poorly identified by current clinical risk models. Early studies found peripheral blood involvement to be an adverse prognostic factor; however, cases of a seemingly indolent variant of mantle cell lymphoma, characterized by peripheral blood involvement and minimal nodal disease, have been incompletely described, particularly with regard to bone marrow findings. We report a series of leukemic phase mantle cell lymphomas with a non-progressive or slowly progressive course. Design and MethodsCases presenting with mantle cell lymphoma limited to the peripheral blood/bone marrow from 2000-2010 were identified. Diagnoses were established by morphology, flow cytometric analysis and requisite evidence of IGH-CCND1@ by fluorescence in-situ hybridization or t(11;14)(q13;q32) by cytogenetics. Patients with lymphadenopathy, splenomegaly and gastrointestinal symptomatology were excluded. ResultsPatients (n=8, median age 60.5 years) were asymptomatic with mild lymphocytosis (8.7¥10 9 /L; range, 4.5-14.2¥10 9 /L) and cytology typical of mantle cell lymphoma. Flow cytometric analysis showed that all expressed CD5, CD19, CD20, variable CD23, and a striking kappa immunoglobulin light chain restriction (7/8 cases). Bone marrow biopsy at diagnosis showed interstitial single or small lymphoid aggregates with similar patterns of CD20 and cyclin D1 immunostaining which were not readily discernable by hematoxylin and eosin stain. SOX11 was negative (4/5) or only weakly expressed (1/5). The median follow-up was 27 months (range, 5-109 months) and all patients, but one, are alive with no clinical evidence of disease. The prevalence of indolent mantle cell lymphoma presenting only with lymphocytosis, among all mantle cell lymphomas diagnosed during the same period, was 3%. ConclusionsLeukemic mantle cell lymphoma limited to blood and bone marrow is an indolent variant characterized by mild-moderate lymphocytosis, interstitial low-level bone marrow involvement, simple karyotype, kappa light chain expression, cyclin D1 expression with lack of SOX11, and slow or absent clinical progression. Some cases may represent a mantle cell lymphoma counterpart to chronic lymphocytic leukemia -phenotype monoclonal B-cell lymphocytosis. Recognition of this variant could inform treatment decisions and possibly avoid unnecessary treatment.

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2021

Flow Cytometry of Hematological Malignancies

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Indolent mantle cell lymphoma with nodal involvement and mutated immunoglobulin heavy chain genes

Cited by 89 publications

References 28 publications

The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications

The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications

Indolent mantle cell leukemia: a clinicopathological variant characterized by isolated lymphocytosis, interstitial bone marrow involvement, kappa light chain restriction, and good prognosis

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