Early lymph node involvement by mantle cell lymphoma limited to the germinal center: report of a case with a novel "follicular in situ" growth pattern

Am J Clin Pathol. 2011 Aug;136(2):276-81. doi: 10.1309/AJCP6KFFGTC8PLVR.

Abstract

Recently, several reports have described cases of "in situ" mantle cell lymphoma (MCL) in which scattered cyclin D1+ cells were present within the mantle zones of reactive-appearing lymphoid follicles. In this report, we describe an unusual histologic pattern of in situ MCL that was identified in a staging lymph node for colonic adenocarcinoma resected 4 years before a diagnosis of symptomatic MCL. Retrospective immunohistochemical studies showed scattered cyclin D1-expressing cells within otherwise reactive germinal centers but not in the surrounding mantle zones. The presence of early MCL cells limited to reactive germinal centers represents a novel "follicular in situ" growth pattern for MCL, which overlaps morphologically with reactive follicular hyperplasia and follicular lymphoma and which could have implications for MCL pathogenesis.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / pathology
  • Aged
  • Colonic Neoplasms / pathology
  • Diagnostic Errors*
  • Gene Rearrangement, B-Lymphocyte, Heavy Chain
  • Germinal Center / metabolism
  • Germinal Center / pathology*
  • Humans
  • Immunohistochemistry
  • Lymph Nodes / metabolism
  • Lymph Nodes / pathology*
  • Lymphoma, Follicular / pathology*
  • Lymphoma, Mantle-Cell / metabolism
  • Lymphoma, Mantle-Cell / pathology*
  • Male
  • Neoplasms, Multiple Primary / pathology
  • Polymerase Chain Reaction*