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首页> 外文期刊>Journal of Hematopathology >Mantle cell lymphoma and chronic lymphocytic leukemia: report of a rare disease association and review of the literature
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Mantle cell lymphoma and chronic lymphocytic leukemia: report of a rare disease association and review of the literature

机译：套细胞淋巴瘤和慢性淋巴细胞性白血病：罕见疾病协会的报告和文献复习

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We report the case of an 86-year-old female who presented with lymphadenopathy, lymphocytosis, and thrombocytopenia. Peripheral blood immunophenotypic analysis identified two lymphoid B cell populations that differ in CD23, CD200, and CD43 expression and in the intensity of CD5, CD20, CD79b, and kappa light chain. By fluorescence in situ hybridization (FISH) analysis, approximately 30% of the mononuclear cells were positive for the t(11;14)(q13;q32) and 40% for trisomy 12; analysis of the two populations separated by fluorescence activated cell sorting showed that t(11;14) occurs exclusively in CD23−/CD200−/CD43− cells and trisomy 12 in the CD23+/CD200+/CD43+ population. Lymph node biopsy showed a typical small lymphocytic lymphoma morphology, with an effaced architecture and a predominantly diffuse proliferation of small to medium-sized lymphoid cells and pseudo-follicles with the characteristic features of proliferation centers. In addition, a different type of randomly dispersed nodules was present, composed of cells slightly larger than the monomorphic lymphocytic proliferation that occupied most of the lymph node. Staining for Cyclin D1 and FISH for CCND1 showed protein expression and gene breaks restricted to these areas. Conventional cytogenetic analysis revealed two separate clones, one with trisomy 12 and the other with t(11;14)(q13;q32), both as unique clonal abnormalities. IGH analysis supports the presence of two populations with a different clonal origin. Taken together, these results provide strong evidence for the presence of a composite small lymphocytic lymphoma/chronic lymphocytic leukemia and mantle cell lymphoma. This association has been described in very rare cases that we briefly review.
机译：我们报告了一位患有淋巴结肿大，淋巴细胞增多和血小板减少症的86岁女性的病例。外周血免疫表型分析确定了两个淋巴B细胞群，它们的CD23，CD200和CD43表达以及CD5，CD20，CD79b和kappa轻链的强度不同。通过荧光原位杂交（FISH）分析，大约30％的单核细胞对t（11; 14）（q13; q32）呈阳性，而40％对三体性12呈阳性。通过荧光激活细胞分选对两个种群的分析表明，t（11; 14）仅出现在CD23- / CD200- / CD43-细胞中，而三体性12出现在CD23 + / CD200 + / CD43 +种群中。淋巴结活检显示典型的小淋巴细胞淋巴瘤形态，具有有效的结构，小至中型淋巴样细胞和假卵泡主要扩散扩散，具有增殖中心的特征。另外，存在不同类型的随机分散的结节，其组成比稍大于占据大部分淋巴结的单态淋巴细胞增殖的细胞大。 Cyclin D1和CCND1的FISH染色显示蛋白质表达和基因断裂仅限于这些区域。常规细胞遗传学分析显示两个单独的克隆，一个具有三体性12，另一个具有t（11; 14）（q13; q32），均为独特的克隆异常。 IGH分析支持存在两个具有不同克隆起源的种群。综上所述，这些结果为复合性小淋巴细胞淋巴瘤/慢性淋巴细胞性白血病和套细胞淋巴瘤的存在提供了有力的证据。这种关联已在极少数情况下进行了描述，我们对此进行了简要回顾。

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