09 March 2020 : Case report
Composite Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma and Mantle Cell Lymphoma; Small Cell Variant: A Real Diagnostic Challenge. Case Presentation and Review of Literature
Challenging differential diagnosis, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology
Feryal Ibrahim1ACDEF, Ahmad Al Sabbagh1F, Aliaa Amer2BDEF, Dina S. Soliman13CEF*, Hesham Al Sabah4AEDOI: 10.12659/AJCR.921131
Am J Case Rep 2020; 21:e921131
Abstract
BACKGROUND: Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and mantle cell lymphoma (MCL) both have a common origin arising from mature CD5+ B-lymphocytes. Their distinction is crucial since MCL is a considerably more aggressive disease. Composite lymphoma consisting of CLL/SLL and MCL has been rarely reported. This type of composite lymphoma may be under-diagnosed as the 2 neoplasms have many features in common, both morphologically and immunophenotypically.
CASE REPORT: We report the case of a 57-year-old male patient who presented with a 4-month history of recurrent abdominal pain and distention with hepatosplenomegaly. Peripheral blood showed a high leukocytes count (46.7×10³/uL) with marked lymphocytosis of 35.0×10³/uL, mostly small mature-looking, with some showing nuclear irregularities, with approximately 3% prolymphocytes. Immunophenotyping by flow cytometry and immunohistochemistry revealed 2 immunophenotypically distinct abnormal CD5+monotypic B-cell populations. Fluorescence in situ hybridization (FISH) on peripheral blood demonstrated IGH/CCND1 rearrangement consistent with t(11;14) in 65% of cells analyzed. Accordingly, based on compilation of findings from morphology, flow cytometry, immunohistochemistry, and FISH, A diagnosis of composite lymphoma consisting of MCL; small cell variant and CLL/SLL was concluded.
CONCLUSIONS: We describe a case of composite lymphoma of MCL (small cell variant) and CLL/SLL that emphasizes the crucial role of the multiparametric approach, including vigilant cyto-histopathologic examination, immunophenotyping by flow cytometry and immunohistochemistry, as well as genetic testing, to achieve the correct diagnosis.
Keywords: Composite Lymphoma, Leukemia, Lymphocytic, Chronic, B-Cell, Lymphoma, Mantle-Cell, Biomarkers, Tumor, Diagnosis, Differential, Flow Cytometry, Gene Rearrangement, Immunohistochemistry, Immunophenotyping, In Situ Hybridization, Fluorescence, Oncogene Proteins, Fusion
In Press
05 Mar 2024 : Case report
Simultaneous Transcatheter Closure of a Ventricular Septal Defect and Pulmonary Valvuloplasty: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.942032
06 Mar 2024 : Case report
Successful Healing of Periapical Pathology with Partial Pulpotomy in a Mature Permanent Molar: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.942937
12 Mar 2024 : Case report
Successful Treatment of Lithium-Induced Nephrogenic Diabetes Insipidus with Celecoxib: A Promising Therapeu...Am J Case Rep In Press; DOI: 10.12659/AJCR.943244
13 Mar 2024 : Case report
Recurrent Marginal Zone Lymphoma with Bone Marrow Involvement Detected by ¹⁸F-FDG PET/CT and Biopsy: A Diag...Am J Case Rep In Press; DOI: 10.12659/AJCR.943275
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250