59 yrs female with clinical diagnosis of B-CLL/SLL. Previous histology (original diagnoses):
2000: SPLEEN: B-SLL/CLL (without IH).
2007: Threpine: B mantle cell lymphoma (CyclinD1+).
The patient was treated as B mantle cell lymphoma.
Revised and IH typed/retyped data:
2000: SPLEEN: HCL vs SMzL?. The diffuse B infiltrate: CD20+/CD79a+; HCL+; CD23-; CD43-; CD5-; Single CyclinD1+ cells; IgM/IgD+. The cleariness of cytoplasm as in HCL.
2007: Low grade B NHL, most probably MzL: The diffuse B infiltrate: CD20+; CD23-; CD43-; CD5-; Single CyclinD1+ cells; IgM/IgD+; single HCL+ cells. FDC CD23+ rudimentary network (folliculotropism). There are any histo signs of HCL.
2008: Threpine: Low grade B NHL: HCL vs MzL?: In part HCL "clear" difuse infiltration. The same immunophenotype with stronh HCL/CD20+ positivity, CD23/CD5(-). FDC CD23+ rudimentary network (folliculotropism).
The question/problem: 1. In 2007 and in part in 2008 threpine the classic HCL histopicture is absent. 2. Bcl6+ in 2008 threpine. 3. The possibility of primary splenic marginal zone lymphoma ("with willous lymphos") with HCL and (aberant) cyclinD1+ expression???
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