Malignant lymphoma of small cleaved lymphocytes of the follicular mantle
zone
M Palutke, L Eisenberg, I Mirchandani, P Tabaczka and M Husain
We describe a highly unusual lymphocytic lymphoma. It appeared to originate
in the mantle zones of hyperplastic follicles that had large reactive
centers. The tumor cells in the mantle zone were small lymphocytes with
cleaved or very irregular nuclei. They had coarse and abundant IgM, kappa
surface immunoglobulin markers, and receptors for complement. The tumor
involvement was generalized at the time of discovery. The diagnosis of a
malignant lymphoma was initially made with difficulty because of the
presence of reactive follicular centers as well as a polyclonal
hypergammaglobulinemia and large numbers of interfollicular plasma cells
and plasmacytoid lymphocytes containing all classes of immunoglobulin.
However, 2 yr later, the follicular centers were replaced by tumor nodules
composed of lymphocytes identical in appearance and immunologic type to
those seen originally. This case illustrates that not all nodular lymphomas
are follicular center cell (FCC) neoplasms and that morphological
transformation from small round to small cleaved lymphocytes and a
corresponding increase in surface immunoglobulins may take place in the
follicular mantle zone. The patient had a high titer of antibody to
Epstein-Barr virus (EBV) and a poor lymphocyte response to concanavalin A,
but neither the tumor cells nor the plasmacytoid lymphocytes contained EBV
DNA.
Volume 59,
Issue 2,
pp. 317-322,
02/01/1982
Copyright © 1982 by The American Society of Hematology
