Chronic lymphocytic leukemia/small lymphocytic lymphoma with trisomy 12 and focal cyclin d1 expression: a potential diagnostic pitfall

Arch Pathol Lab Med. 2005 Jan;129(1):92-5. doi: 10.5858/2005-129-92-CLSLLW.

Abstract

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and mantle cell lymphoma usually are distinctly different in regard to clinical presentation, morphology, immunophenotype, and molecular/genetic findings. In spite of this, select cases may show overlapping characteristics and represent a diagnostic challenge. Cyclin D1 immunohistochemical staining is usually envisioned as a definitive method for resolving this differential diagnosis, with positivity supporting a diagnosis of mantle cell lymphoma. We report a case involving a 58-year-old man with a diagnosis of CLL/SLL for several years. A lymph node excision was performed after increased adenopathy was noted in the cervical region. The excised lymph node showed typical morphologic findings of CLL/SLL, including the presence of characteristic proliferation centers. Cyclin D1 staining, using 3 different antibodies, was present in scattered prolymphocytes and paraimmunoblasts, mostly within proliferation centers. Fluorescence in situ hybridization and conventional cytogenetics demonstrated trisomy 12 and an absence of t(11;14) in lymph node tissue. Focal cyclin D1 expression by immunohistochemistry in nodal CLL/SLL is quite unusual and is discussed as a potential diagnostic pitfall.

Publication types

  • Case Reports

MeSH terms

  • Chromosomes, Human, Pair 12 / genetics*
  • Cyclin D1 / biosynthesis*
  • Cyclin D1 / immunology
  • Diagnosis, Differential
  • Humans
  • Immunophenotyping / methods
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis*
  • Lymphoma, Mantle-Cell / diagnosis*
  • Male
  • Middle Aged
  • Trisomy / diagnosis*
  • Trisomy / genetics

Substances

  • Cyclin D1