Table of Contents
Definition / general | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Singh C. Mantle cell lymphoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colontumormcl.html. Accessed April 24th, 2024.
Definition / general
- Uncommon in colon
- Often presents as multiple lymphomatoid polyposis
- Often present in benign appearing mucosa (Curr Opin Gastroenterol 2005;21:80)
- 88% males, mean age 61 years
- Also involves stomach and small intestine
- Mean survival historically less than 3 years; may be improving with newer treatments
- Rarely coexists as incidental finding with adenocarcinoma (Arch Pathol Lab Med 2003;127:E64, Mod Pathol 2001;14:811)
Case reports
- 60 year old man with rectal tumor (Hepatogastroenterology. 2001;48:675)
- 61 year old man with diffuse involvement of GI tract without polyposis (J Gastroenterol 2004;39:995)
- 71 year old woman with ulcerative colitis (Am J Surg Pathol 1996;20:1024)
- Woman in 80s (University of Pittsburgh Case #441)
Gross description
- Nodular, sessile or polypoid lesions, widely spaced and confluent studded or cobblestone appearance
- Each polyp 2 mm to 2 cm
- May be dominant tumor mass in ileocecum
- Endoscopically normal mucosa may have small tumor infiltrates also
Gross images
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Lymphomatoid polyposis
Microscopic (histologic) description
- Mantle cells (small lymphocytes with pale cytoplasm and cleaved nuclei), often invasion of submucosa, proliferation around germinal centers and sparing of mucosa
- Late epithelial invasion and ulceration
- Note: may also be minute lymphoid infiltrates in known mantle cell patients
Microscopic (histologic) images
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80 year old woman
Positive stains
- CD20, CD5 and cyclin D1 / bcl1
- Immunohistochemistry for cyclin D1 may be more sensitive than FISH for t(11;14) or PCR for IgH (Am J Surg Pathol 2006;30:1274)
Differential diagnosis
- Inflammatory bowel disease: may need immunostains to differentiate (Dig Dis Sci 1992;37:934)
- MALT lymphoma: may present as multiple lymphomatoid polyposis but has lymphoepithelial lesions and is negative for CD5 and cyclin D1
- Multiple lymphoid polyps: benign germinal centers in children, patients with Gardner's syndrome
- Nodular lymphoid hyperplasia: benign, associated with common variable immunodeficiency syndrome
