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An Unusual Case of Leukemic Mantle Cell Lymphoma With a Blastoid Component Showing Loss of CD5 and Aberrant Expression of CD10

William G. Morice MD, PhD, Janice M. Hodnefield MS, Paul J. Kurtin MD, Curtis A. Hanson MD
DOI: http://dx.doi.org/10.1309/UD2C6JVPWHXQQ217 122-127 First published online: 1 July 2004


Characteristically, mantle cell lymphoma (MCL) expresses surface immunoglobulin (sIg), CD19, CD20, and CD5 and lacks CD10 and CD23. Rare CD5– MCL variants have been described. This report describes a case of leukemic MCL with morphologically and immunophenotypically distinct classic MCL and blastoid-variant MCL (BV-MCL) components. The classic MCL had typical morphologic features and immunophenotype (κ sIg light chain–restricted and CD5+; CD10– and CD23–). The BV-MCL had larger nuclei and open chromatin; these cells also were κsIg light chain–restricted; however, they were CD10+ and CD5–. Fluorescence in situ hybridization studies demonstrated cyclin D1–immunoglobulin heavy chain gene fusion in both components; the bone marrow biopsy cellularity was replaced by CD10+ and cyclin D1+ and CD5– BV-MCL. This case illustrates the phenotypic heterogeneity of MCL and underscores the need for histopathologic correlation and, in some instances, ancillary genetic studies to accurately classify B-cell lymphomas.

Key Words:
  • Mantle cell lymphoma
  • Flow cytometric immunophenotyping
  • B-cell chronic lymphoproliferative disorders