Qiu T L, Zhang Y P, Wang Y, Wu Y J, Shi W Y, Xia Y
Department of Hematology, Lymphoma Center, Key Laboratory of Nanjing Medical University, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China.
Department of Hematology of Affiliated Hospital of Nantong University, Nantong 226001, China.
Zhonghua Xue Ye Xue Za Zhi. 2025 Feb 14;46(2):174-178. doi: 10.3760/cma.j.cn121090-20241205-00538.
Patients with leukemic non-nodal mantle cell lymphoma (nnMCL) typically exhibit an indolent clinical course, and when asymptomatic and without treatment indications, a watchful observation follow-up can be adopted. This article presents a retrospective summary of a case of nnMCL, misdiagnosed as chronic lymphocytic leukemia (CLL) and carrying a TP53 mutation, along with a literature review. The case highlights the importance of differential diagnosis between nnMCL and CLL, and suggests that for nnMCL patients, the presence of high-risk biological markers such as TP53 mutations does not necessarily indicate an immediate need for treatment; rather, a strict watch-and-wait strategy may be a more appropriate option.
白血病性非结节性套细胞淋巴瘤(nnMCL)患者通常表现出惰性临床病程,无症状且无治疗指征时,可采用密切观察随访。本文回顾性总结了1例误诊为慢性淋巴细胞白血病(CLL)且携带TP53突变的nnMCL病例,并进行文献复习。该病例突出了nnMCL与CLL鉴别诊断的重要性,提示对于nnMCL患者,存在TP53突变等高风险生物学标志物不一定意味着立即需要治疗;相反,严格的观察等待策略可能是更合适的选择。