09 March 2020
: Case report 
Composite Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma and Mantle Cell Lymphoma; Small Cell Variant: A Real Diagnostic Challenge. Case Presentation and Review of Literature
Challenging differential diagnosis, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology
Feryal Ibrahim ACDEF 1, Ahmad Al Sabbagh F 1, Aliaa Amer BDEF 2, Dina S. Soliman CEF 1,3*, Hesham Al Sabah AE 4DOI: 10.12659/AJCR.921131
Am J Case Rep 2020; 21:e921131
| Ref # | Immunophenotype FCM/IHC | Light chain | Cytogenetic/FISH | Clonal relationship |
|---|---|---|---|---|
| 8 | CLL: CD5, CD23 CD20+, CD43, IgDMCL: CD5, CD23, CD20, cyclin D1, IgD | CLL: KappadimMCL: Lambda | ND | No clonal relationship (IgH gene molecular studies) |
| 9 | CLL: CD19, CD22, CD23, CD25, FMC7, CD5, CD10, CD11a, CD11c,CD20, CD38, CD79b, CD103, sIgMCL: CD19, CD20, CD22, CD25, CD38, CD79b, FMC7, CD5, CD10, CD11a, CD11c, CD23, CD103,sIg (IgM) | CLL: NegativeMCL: Kappa | PB: t(11;14) in 9%. 13q14.3 deletion in 21%LN: t(11;14) In 94% | No clonal relationship (IgH gene molecular studies) |
| 10 | CLL: CD19, CD5, CD23 and FMC7, weak CD79 & weak sIg. cyclin D1MCL: CD20, CD5, CD23, cyclin D1 | CLL: NMMCL NM | FISH) on LN: Show t(11; 14).FISH on BL & BM: No translocation | No clonal relationship, t(11; 14) in MCL cells only (FISH on LN)) |
| 11 | CLL: CD19, CD20, CD5, CD22, CD23, CD10 & FMC7MCL: CD19, CD20, CD5 CD22, FMC7, IgM, CD10 and CD23 | CLL: LambdaMCL: Kappa | FISH) on PB: t(11;14), 6q-,11q- trisomy 12, 13q-, trisomy 17 | No clonal relationship (different monotypic light chain) |
| 12 (7 cases) CLL/MCL | CLL: CD5, CD20, CD23, cyclin D1MCL: CD5, CD20, CD23, cyclin D1 | CLL/MCL: Kappa (1) CLL/MCL: Lambda (1) CLL: Lambda (3), Kappa (1), ND (1)MCL: Lambda (1), Kappa (3), ND (1) | CLL: No t(11;14)MCL: t(11;14) | No clonal relationship (IgH gene molecular studies) |
| 12 (4 cases) SLL/MCL | SLL: CD5, CD20, CD23, cyclin D1MCL: CD5, CD20, CD23v, cyclin D1 | SLL: Lambda (3), Not done (1)MCL: Kappa (3), ND (1) | SLL: No t(11;14)MCL: t(11;14) | No clonal relationship (IgH gene molecular studies) |
| Current Case | CLL: CD19, CD23, CD5, CD43, CD200, CD38, cBCL2, IgD, IgM, CD79b, CD20, cyclin D1MCL: CD19, CD79b, CD20, CD5,FMC7, cBCL2, IgD, IgM, CD23,cyclin D1 | CLL: KappaMCL: Lambda | PB: t(11;14), in 65% of cells | No clonal relationship (different monotypic light chain) |
| PB – peripheral blood; NM – not mentioned; ND – not done; FCM – flow cytometry; IHC – immunohistochemistry; FISH – fluorescence hybridization; CLL – chronic lymphocytic leukemia; MCL – mantle cell lymphoma; SLL – small lymphocytic lymphoma; LN – lymph node; BM – bone marrow. | ||||