CD5-undetected by immunohistochemistry, t(11;14)(q13;q32)-positive conjunctival mantle cell lymphoma: a case report

Pathol Res Pract. 2008;204(10):779-83. doi: 10.1016/j.prp.2008.04.009. Epub 2008 Jun 24.

Abstract

Most primary ocular adnexal lymphomas are extranodal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT). A few cases of ocular adnexal mantle cell lymphomas have been reported in the literature. We present a case of mantle cell lymphoma presenting as conjunctival mass. A 58-year-old man presented with a palpable mass in the left lower tarsal conjunctiva incidentally detected one month previously. Histopathologic examination showed proliferation of monomorphous small-to-medium sized lymphoid cells. On immunohistochemistry, tumor cells were positive for CD20, bcl-2, and cyclin D1, and negative for CD5. PCR analysis for immunoglobulin heavy chain gene rearrangement showed monoclonal B-cell proliferation. t(11;14)(q13;q32), involving the CCND1 and IGH genes, was detected in interphase fluorescent in situ hybridization using formalin-fixed, paraffin-embedded tissue; however, MALT1 gene translocation was not observed. The final diagnosis was mantle cell lymphoma. There was no lymphadenopathy; however, bone marrow involvement of the lymphoma was suspected. The patient has been receiving systemic chemotherapy. This case emphasizes the differential diagnosis of conjunctival mantle cell lymphoma from extranodal marginal zone B-cell lymphomas of MALT regarding the clinical and pathological aspects.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • CD5 Antigens / analysis*
  • Cell Proliferation
  • Conjunctival Neoplasms / diagnosis*
  • Conjunctival Neoplasms / drug therapy
  • Conjunctival Neoplasms / genetics
  • Conjunctival Neoplasms / immunology
  • Conjunctival Neoplasms / pathology
  • Cyclin D1 / genetics*
  • Diagnosis, Differential
  • Gene Expression Regulation, Neoplastic
  • Gene Rearrangement, B-Lymphocyte
  • Humans
  • Immunoglobulin Heavy Chains / genetics*
  • Immunohistochemistry*
  • In Situ Hybridization, Fluorescence
  • Incidental Findings*
  • Lymphoma, B-Cell, Marginal Zone / diagnosis*
  • Lymphoma, Mantle-Cell / diagnosis*
  • Lymphoma, Mantle-Cell / drug therapy
  • Lymphoma, Mantle-Cell / genetics
  • Lymphoma, Mantle-Cell / immunology
  • Lymphoma, Mantle-Cell / pathology
  • Male
  • Middle Aged
  • Translocation, Genetic

Substances

  • CCND1 protein, human
  • CD5 Antigens
  • Immunoglobulin Heavy Chains
  • Cyclin D1