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Open Access Highly Accessed Case Report

Conjunctival mass as an initial presentation of mantle cell lymphoma: a case report

Mahsa Khanlari1, Babak Bagheri2, Reza Vojdani3, Mohammad Mohammadianpanah4, Shahram Paydar5 and Yahya Daneshbod16*

Author affiliations

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

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Citation and License

BMC Research Notes 2012, 5:671  doi:10.1186/1756-0500-5-671

Published: 4 December 2012

Abstract

Background

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.

Case presentation

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).

Conclusion

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.

Keywords:
Lymphoma; Orbit; Conjunctiva; Mantle cell lymphoma; t(11;14); SOX 11