Mantle Cell Lymphoma

Morphological sub-types:

• Small cell (round or slightly indented nucleus with dense chromatin – often confused with CLL)
• Pleomorphic (more cytoplasm than typical mantle cell)
• Blastoid (monomorphic with a dispersed chromatin pattern and prominent nucleoli)
• Marginal-zone like (may have small cytoplasmic projections)

Morphological features:

• Medium-sized lymphoid cells
• Mature, clumped chromatin
• Pleomorphic appearance
• Cleft, irregular nuclei
• Nucleoli (small) may be seen
• Scanty, basophilic  cytoplasm
• Some cells appear blastic (in blastoid variant, most cells resemble blasts)

Differential diagnosis:

• Chronic lymphocytic leukaemia
• Marginal zone lymphoma
• Blastoid variant
  • Acute lymphoid leukaemia
  • Leukaemic aggessive lymphoma

Further investigations:

• Flow cytometry: typically CD20++/5+/10-/23-/smIgM+/LAIR1+/200-
• FISH for t(11;14) – cyclin D1 (aka bcl1)