Conjunctival mass as an initial presentation of mantle cell lymphoma: a case report
1 Institute of Hematopathology, Dr Daneshbod Pathology Laboratory, Shiraz, Iran
2 Institute of Ophthalmology, Dr. Bagheri clinic, Shiraz, Iran
3 Institute of Hematology -Oncology, Nemazee Hospital, Shiraz, Iran
4 Institute of Radiation- Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
5 Institute of Trauma and surgery, Rajaee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
6 Dr Daneshbod Pathology Laboratory, Dept. of Hematopathology, Shiraz, 7134777118, Iran
BMC Research Notes 2012, 5:671 doi:10.1186/1756-0500-5-671Published: 4 December 2012
To describe a rare manifestation of mantle cell lymphoma (MCL) in conjunctiva, with clinical, hisologic, immunohistologic and genetic findings together with review of the Literature.
Most 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 right conjunctival mass of at least three months duration in a 64-year-old man. Histopathologic examination showed a proliferation of monomorphous small-to-medium-sized lymphoid cells with cleaved nuclei in the subconjunctiva. By immunohistochemistry, the infiltrate was positive for CD20, CD5, BCL-2, cyclin D1, and the transcription factor SOX11. Fluorescent in situ hybridization demonstrated the presence of IGH-CCND1 fusion indicating t(11;14).
A rigorous approach to initial diagnosis and staging of small cell lymphomas of the ocular adnexa is needed. The recognition of ocular MCL requires appropriate immunohistochemical staining and/or genetic confirmation to differentiate this rare form of presentation of MCL from other more frequent small cell lymphomas.