Shiller Shirley Michelle, Zieske Arthur, Holmes Houston, Feldman Andrew L, Law Mark E, Saad Rana
Department of Pathology, Baylor University Medical Center, Dallas, TX, USA.
Cancer Genet. 2011 Mar;204(3):162-4. doi: 10.1016/j.cancergencyto.2010.08.016.
Distinguishing mantle cell lymphoma (MCL), from low-grade B-cell lymphoma is important because MCL is clinically more aggressive and is treated differently. Though most MCL overexpress cyclinD1 (CCND1) and have a t(11;14)(q13;q32), MCL that are negative for CCND1 exist. Some have translocations involving cyclinD2 (CCND2) and either the immunoglobulin heavy chain or kappa light chain locus. We present a CD5-positive, CCND1-negative B-cell lymphoma with a novel translocation involving CCND2 and the immunoglobulin lambda (IGL) gene. A 64-year-old male underwent resection of a polypoid mass of the ileum. Histology showed atypical, medium-sized lymphoid cells positive for CD20, CD5, CD43, and CCND2 by immunohistochemistry, and negative for CCND1, CCND3, and p27. Fluorescence in situ hybridization was negative for CCND1 abnormalities, but demonstrated a CCND2/IGL fusion. Clinical workup revealed stage IV disease. Current diagnostic criteria are insufficient for subclassifying this case, highlighting the need for additional studies on CCND2-translocated B-cell lymphomas to guide therapy appropriately.
区分套细胞淋巴瘤（MCL）与低度B细胞淋巴瘤很重要，因为MCL在临床上侵袭性更强，治疗方式也不同。尽管大多数MCL过度表达细胞周期蛋白D1（CCND1）且具有t(11;14)(q13;q32)，但也存在CCND1阴性的MCL。一些MCL存在涉及细胞周期蛋白D2（CCND2）以及免疫球蛋白重链或κ轻链基因座的易位。我们报告一例CD5阳性、CCND1阴性的B细胞淋巴瘤，其具有涉及CCND2和免疫球蛋白λ（IGL）基因的新型易位。一名64岁男性接受了回肠息肉样肿物切除术。组织学检查显示，免疫组化结果显示非典型中等大小淋巴细胞CD20、CD5、CD43和CCND2呈阳性，CCND1、CCND3和p27呈阴性。荧光原位杂交显示CCND1无异常，但存在CCND2/IGL融合。临床检查显示为IV期疾病。目前的诊断标准不足以对该病例进行亚分类，这凸显了对CCND2易位B细胞淋巴瘤进行更多研究以适当指导治疗的必要性。
