Mantle cell lymphoma

05942878 楊X健 Age: 67 Sex: M

PATHOLOGICAL DIAGNOSIS:

Bone marrow, iliac crest, core biopsy: Small B-cell lymphoma/leukemia (See Note).

MICROSCOPIC FINDING:

The bone marrow shows hypercellularity with hemopoietic components accounting for about 70-80% of the marrow space, with decrease of normal hemopoietic element. The morphology, maturation process and distribution of the myeloid and erythroid lineages are within normal limits.Megakaryocytes are increased in quantity and atypical in morphology.There is patch infiltration of lymphocytes accounting for 20-30% of mononuclear cells. They are positive for CD20 and CD5 and negative for CD23. Cyclin D1 shows weak positive but SOX-11 is negative. Neither dysplasia, nor evidence of excess of blast ormyelofibrosis is noted. The BM aspiration also reveals dense small lymphocyticinfiltration. Some larger cells reminiscent of prolymphocytes are noted.

Note: Taken together the clinical & hematological features, the differential is between chronic lymphocytic leukemia and mantle cell lymphoma/leukemia.The Ki67 index of mantle cell lymphoma is ~5%. Together with the cytogenetic data which show the presence of t(11;14)(q13;q32), a mantle cell lymphoma/leukemia is considered.

Cytogenetics: 43~45,X,-Y[19],add(1)(q21)[19],add(2)(p21)[19],add(3)(q21)[19],?i(8)(q10)[2],add(11)(p15)[8],t(11;14)(q13;q32)[10],-14[3],add(14)(q24)[7],-15[19],add(15)(p12)[17],add(17)(p13)[18],add(19)(p13)[4],-21[14],+mar1[14],+mar2[2][cp19]/46,XY[8]

Age: 62 Sex: M

PATHOLOGICAL DIAGNOSIS:

Bone marrow, iliac crest, core biopsy: Chronic lymphocytic leukemia.

MICROSCOPIC FINDING:

The bone marrow shows nearly normal cellularity with hemopoietic components accounting for 40-50% of the marrow space, and M/E ratio of 2-3:1. The morphology, maturation process and distribution of the three lineages are within normal limits. Megakaryocytes are normal in morphology and quantity. There is patch infiltration of small lymphocytes, which are positive for CD20 and negative for CD3. Neither dysplasia, nor evidence of excess of blast or myelofibrosis is noted. The BM aspiration also reveals normocellularity with M/E ratio of 2-3:1. Increased small lymphocytes with prolymphocytes are noted. Taken together the clinical & hematological features, chronic lymphocytic leukemia is considered. The tumor cells are weakly positive for CD5 but

negative for CD10 or CD23. Cyclin D1 shows scattered positive cells with occasionally increased in numbermore than that see in negative cases. If there is lymphadenopathy, biopsy is recommended.

Cytogenetics: 46,XY \ normal male karyotype.

Follicular lymphoma with blastic transformation

17166037 廖X芬

Follicular lymphoma with blastic transformation and B-cell lymphoma, unclassifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma

R-HDAC+HD-MTX