Mariko Yabe MD PhD Guilin Tang MD PhD Ken H Young MD PhD Sa A Wang MD Department of Hematopathology UT MD Anderson Cancer Center Houston Texas USA Case 57 yearold Caucasian ID: 805950
Download The PPT/PDF document "EHAP 2016 Lymphoma Workshop" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
EHAP 2016 Lymphoma Workshop
Mariko Yabe, MD. PhD, Guilin Tang, MD. PhD,
Ken
H. Young, MD. PhD, Sa A. Wang, MD
.
Department of Hematopathology,
UT
MD Anderson Cancer Center,
Houston
, Texas, USA
Slide2Case: 57 year-old Caucasian Woman
April 2011
Incidental findings of leukocytosis by
a routine GYN checkup
WBC
13.6 x
10
3
/
ul
(
lymphocytes 70
%),
Hb
137 g/L,
Plt
202 x10
9
/
ul
,
CT scan showed no evidence of lymphadenopathy and
hepatosplenomegaly
.
May 2011
,
Bone
marrow biopsy
(outside hospital)
Involvement
by B-cell
lymphoma, IHC negative
for
cyclin
D1
FISH positive for
IgH
/CCND1
rearrangement
in
81/200
interphase nuclei.
Morphologically,
immunohistochemically
, and by clinical presentation, the diagnosis of CLL/SLL was suggested, however due to the presence of
IgH
/CCND1
rearrangement, she was diagnosed with mantle
cell
lymphoma.
May 2011 – March 2014
She was followed up without therapy by her primary care oncologist, and remained
asymptomatic.
March 2014
She presented to UT MD Anderson Cancer Center for seeking further treatment recommendations.
Peripheral
blood examination
(3/12/2014)
WBC
20.1 x
10
3
/
ul
(
neutro
12%, atypical
lymph
87%,
mono 1
%
),
RBC
4.35 x10
9
/
ul
,
Hb
128 g/L,
Plt
171
x10
9
/
ul
PET CT
showed no evidence of lymphadenopathy and extra nodal
disease.
Slide3S14-20058 (3/14/2014)
Aspirate smear
Wright-
Giemsa
(x 1000)
Slide4S14-20058 (3/14/2014)
Aspirate smear
Wright-
Giemsa
(x 1000)
Slide5S14-20058 (3/14/2014)
Clot section
H&E (x200)
Slide6S14-20058 (3/14/2014)
Clot section
H&E (x400)
Slide7S14-20058 (3/14/2014)
Clot section
CD20
(x 400)
Slide8S14-20058 (3/14/2014)
Clot section
Cyclin D1
(x 400)
Slide9S14-20058 (3/14/2014)
Clot section
SOX 11 (x 400)
Slide10Flow
cytometry
Slide11Cytogenetics: Conventional karyotyping
Slide12Cytogenetics
: FISH
Abbott Molecular LSI
IGH/CCND1
dual
color dual fusion translocation
probe (Red
CCND1
, Green
IgH
)
Positive for
IgH
/CCND1 gene rearrangement
(
1
red, 1 green, two
fusions)
Slide13Proposed diagnosis
Small cell lymphoma of B-cell lineage, suggestive of chronic lymphocytic leukemia/ small lymphocytic lymphoma with underlying clonal evolution with formation of mantle cell
lymphoma