HAEM5:In situ mantle cell neoplasm: Difference between revisions
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|In situ mantle cell neoplasm | |In situ mantle cell neoplasm | ||
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==Clinical Features== | ==Clinical Features== | ||
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!Tissues with in situ mantle cell neoplasm | !Tissues with in situ mantle cell neoplasm | ||
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! colspan="5" |'''7 patients with in situ mantle cell neoplasm diagnosed with SOX11 positive neoplastic mantle cells<ref name=":0" />''' | ! colspan="5" |'''7 patients with in situ mantle cell neoplasm diagnosed with SOX11 positive neoplastic mantle cells<ref name=":0">{{Cite journal|last=Carvajal-Cuenca|first=Alejandra|last2=Sua|first2=Luz F.|last3=Silva|first3=Nhora M.|last4=Pittaluga|first4=Stefania|last5=Royo|first5=Cristina|last6=Song|first6=Joo Y.|last7=Sargent|first7=Rachel L.|last8=Espinet|first8=Blanca|last9=Climent|first9=Fina|date=2012-02|title=In situ mantle cell lymphoma: clinical implications of an incidental finding with indolent clinical behavior|url=https://pubmed.ncbi.nlm.nih.gov/22058203|journal=Haematologica|volume=97|issue=2|pages=270–278|doi=10.3324/haematol.2011.052621|issn=1592-8721|pmc=3269489|pmid=22058203}}</ref>''' | ||
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| colspan="3" |'''43% (3 of 7) patients, all males, developed overt mantle cell lymphoma''' | | colspan="3" |'''43% (3 of 7) patients, all males, developed overt mantle cell lymphoma''' | ||
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|N=1 | |N=1 | ||
|Female aged 70 y, presented in December 1999 with a slowly growing submandibular lymph node over 18 months; biopsy showed non-necrotizing granulomatous lymphadenitis with in situ mantle cell neoplasm; cytogenetics on lymph node tissue showed t(11;14)(q13;q32); PB and BM involved by leukemic mantle cells<ref name=":0" /><ref name=":4" /> | |Female aged 70 y, presented in December 1999 with a slowly growing submandibular lymph node over 18 months; biopsy showed non-necrotizing granulomatous lymphadenitis with in situ mantle cell neoplasm; cytogenetics on lymph node tissue showed t(11;14)(q13;q32); PB and BM involved by leukemic mantle cells<ref name=":0" /><ref name=":4">{{Cite journal|last=Espinet|first=Blanca|last2=Solé|first2=Francesc|last3=Pedro|first3=Carme|last4=Garcia|first4=Mar|last5=Bellosillo|first5=Beatriz|last6=Salido|first6=Marta|last7=Florensa|first7=Lourdes|last8=Camacho|first8=Francisca I.|last9=Baró|first9=Teresa|date=2005-11|title=Clonal proliferation of cyclin D1-positive mantle lymphocytes in an asymptomatic patient: an early-stage event in the development or an indolent form of a mantle cell lymphoma?|url=https://pubmed.ncbi.nlm.nih.gov/16260278|journal=Human Pathology|volume=36|issue=11|pages=1232–1237|doi=10.1016/j.humpath.2005.08.021|issn=0046-8177|pmid=16260278}}</ref> | ||
|Active surveillance | |Active surveillance | ||
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|N=1 | |N=1 | ||
|Female aged 71 y with overt MCL, clinical stage 4A, in 2013; retrospective review of previous lymph nodes excised with invasive ductal breast carcinoma in 2003 (ten y prior to the overt MCL) showed in situ mantle cell neoplasm<ref name=":3" /> | |Female aged 71 y with overt MCL, clinical stage 4A, in 2013; retrospective review of previous lymph nodes excised with invasive ductal breast carcinoma in 2003 (ten y prior to the overt MCL) showed in situ mantle cell neoplasm<ref name=":3">{{Cite journal|last=Teixeira Mendes|first=Larissa Sena|last2=Wotherspoon|first2=Andrew|date=2016-02|title=The relationship between overt and in-situ lymphoma: a retrospective study of follicular and mantle cell lymphoma cases|url=https://pubmed.ncbi.nlm.nih.gov/26052648|journal=Histopathology|volume=68|issue=3|pages=461–463|doi=10.1111/his.12753|issn=1365-2559|pmid=26052648}}</ref> | ||
|Overt MCL 10 y after in situ neoplasm; Dead 1 year after the diagnosis of overt MCL (or 11 y after diagnosis of in situ mantle cell neoplasm) | |Overt MCL 10 y after in situ neoplasm; Dead 1 year after the diagnosis of overt MCL (or 11 y after diagnosis of in situ mantle cell neoplasm) | ||
|No | |No | ||
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|N=1 | |N=1 | ||
|Male aged 68 y, retrospective diagnosis of in situ mantle cell neoplasm in mesenteric lymph nodes resected with colorectal carcinoma; case identified in a systematic study as an incidental finding<ref name=":2" /> | |Male aged 68 y, retrospective diagnosis of in situ mantle cell neoplasm in mesenteric lymph nodes resected with colorectal carcinoma; case identified in a systematic study as an incidental finding<ref name=":2">{{Cite journal|last=Bermudez|first=Glenda|last2=González de Villambrosía|first2=Sonia|last3=Martínez-López|first3=Azahara|last4=Batlle|first4=Ana|last5=Revert-Arce|first5=José B.|last6=Cereceda Company|first6=Laura|last7=Ortega Bezanilla|first7=César|last8=Piris|first8=Miguel A.|last9=Montes-Moreno|first9=Santiago|date=2016-07|title=Incidental and Isolated Follicular Lymphoma In Situ and Mantle Cell Lymphoma In Situ Lack Clinical Significance|url=https://pubmed.ncbi.nlm.nih.gov/26945339|journal=The American Journal of Surgical Pathology|volume=40|issue=7|pages=943–949|doi=10.1097/PAS.0000000000000628|issn=1532-0979|pmid=26945339}}</ref> | ||
|Dead at 1.33 y (16 months), no lymphoma | |Dead at 1.33 y (16 months), no lymphoma | ||
|No | |No | ||
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This disease is <u>defined/characterized</u> as detailed below: | This disease is <u>defined/characterized</u> as detailed below: | ||
* The Latin phrase “in situ” means “in the natural or original position or place”, as per the Merriam-Webster dictionary. In normal benign lymphoid tissues, the mantle zones of lymphoid follicles are formed by naïve mature B-cells after maturation from precursor B-cells in the bone marrow. In situ mantle cell neoplasm is a pre-malignant neoplasm composed of mantle cells “in their natural position” that harbor, in addition, the t(11;14) balanced translocation characteristic of mantle cell lymphoma with the overexpression of cyclin D1 protein. | *The Latin phrase “in situ” means “in the natural or original position or place”, as per the Merriam-Webster dictionary. In normal benign lymphoid tissues, the mantle zones of lymphoid follicles are formed by naïve mature B-cells after maturation from precursor B-cells in the bone marrow. In situ mantle cell neoplasm is a pre-malignant neoplasm composed of mantle cells “in their natural position” that harbor, in addition, the t(11;14) balanced translocation characteristic of mantle cell lymphoma with the overexpression of cyclin D1 protein. | ||
* An in situ mantle cell neoplasm may precede, co-exist with, or may occur after the development of an overt mantle cell lymphoma. This pre-malignant neoplasm is more often identified in patients newly diagnosed with an overt mantle cell lymphoma in whom a retrospective examination of a prior reactive-appearing lymph node or lymphoid tissue biopsy shows the presence of in situ mantle cell neoplasm. In situ mantle cell neoplasm is only rarely diagnosed in lymph nodes diagnosed as benign or reactive lymphoid hyperplasia after biopsy for enlargement or other symptomatic causes. The diagnostic criteria for in situ mantle cell neoplasm are currently based primarily on histopathologic examination (description in the morphologic features section). The pathologic diagnosis of in situ mantle cell neoplasm requires distinguishing from two major disease entities: (1) reactive lymphoid hyperplasia, and (2) mantle cell lymphoma with a mantle zone pattern. Of note, in situ mantle cell neoplasm may co-exist with any overt mature B-cell lymphoma, including as a component of a composite lymphoma. | *An in situ mantle cell neoplasm may precede, co-exist with, or may occur after the development of an overt mantle cell lymphoma. This pre-malignant neoplasm is more often identified in patients newly diagnosed with an overt mantle cell lymphoma in whom a retrospective examination of a prior reactive-appearing lymph node or lymphoid tissue biopsy shows the presence of in situ mantle cell neoplasm. In situ mantle cell neoplasm is only rarely diagnosed in lymph nodes diagnosed as benign or reactive lymphoid hyperplasia after biopsy for enlargement or other symptomatic causes. The diagnostic criteria for in situ mantle cell neoplasm are currently based primarily on histopathologic examination (description in the morphologic features section). The pathologic diagnosis of in situ mantle cell neoplasm requires distinguishing from two major disease entities: (1) reactive lymphoid hyperplasia, and (2) mantle cell lymphoma with a mantle zone pattern. Of note, in situ mantle cell neoplasm may co-exist with any overt mature B-cell lymphoma, including as a component of a composite lymphoma. | ||
*Synonyms/terminology - In situ mantle cell neoplasia, term used in the revised 4<sup>th</sup> edition World Health Organization classification<ref>Swerdlow SH, et al., (2017). Mantle cell lymphoma, in World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues, Revised 4th edition. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Arber DA, Hasserjian RP, Le Beau MM, Orazi A, and Siebert R, Editors. IARC Press: Lyon, France, p290.</ref> and in the International Consensus Classification of mature lymphoid neoplasms<ref>{{Cite journal|last=Campo|first=Elias|last2=Jaffe|first2=Elaine S.|last3=Cook|first3=James R.|last4=Quintanilla-Martinez|first4=Leticia|last5=Swerdlow|first5=Steven H.|last6=Anderson|first6=Kenneth C.|last7=Brousset|first7=Pierre|last8=Cerroni|first8=Lorenzo|last9=de Leval|first9=Laurence|date=2022-06-02|title=The International Consensus Classification of Mature Lymphoid Neoplasms: A Report from the Clinical Advisory Committee|url=https://pubmed.ncbi.nlm.nih.gov/35653592|journal=Blood|pages=blood.2022015851|doi=10.1182/blood.2022015851|issn=1528-0020|pmid=35653592}}</ref>; in situ mantle cell lymphoma (historical); mantle cell lymphoma in situ (historical); mantle cell lymphoma (MCL)-like B-cells of undetermined significance<ref>{{Cite journal|last=Fend|first=Falko|last2=Cabecadas|first2=José|last3=Gaulard|first3=Philippe|last4=Jaffe|first4=Elaine S.|last5=Kluin|first5=Philip|last6=Kuzu|first6=Isinsu|last7=Peterson|first7=Loann|last8=Wotherspoon|first8=Andrew|last9=Sundström|first9=Christer|date=2012-09|title=Early lesions in lymphoid neoplasia: Conclusions based on the Workshop of the XV. Meeting of the European Association of Hematopathology and the Society of Hematopathology, in Uppsala, Sweden|url=https://pubmed.ncbi.nlm.nih.gov/24307917|journal=Journal of Hematopathology|volume=5|issue=3|doi=10.1007/s12308-012-0148-6|issn=1868-9256|pmc=3845020|pmid=24307917}}</ref> (historical) | |||
The <u>epidemiology/prevalence</u> of this disease is detailed below: | [[File:Schematic_showing_two_main_routes_for_the_development_of_overt_mantle_cell_lymphoma_from_an_in_situ_mantle_cell_neoplasm.jpg|alt=|none|thumb]]The <u>epidemiology/prevalence</u> of this disease is detailed below: | ||
* The real prevalence of in situ mantle cell neoplasm is currently unknown. The published literature for in situ mantle cell neoplasm is limited primarily to case reports, including collectively studied cases,<ref name=":0" /> and retrospective studies of cases of reactive lymphoid hyperplasia,<ref name=":0" /><ref name=":1">{{Cite journal|last=Adam|first=Patrick|last2=Schiefer|first2=Ana-Iris|last3=Prill|first3=Sophie|last4=Henopp|first4=Tobias|last5=Quintanilla-Martínez|first5=Leticia|last6=Bösmüller|first6=Hans-Christian|last7=Chott|first7=Andreas|last8=Fend|first8=Falko|date=2012-12|title=Incidence of preclinical manifestations of mantle cell lymphoma and mantle cell lymphoma in situ in reactive lymphoid tissues|url=https://pubmed.ncbi.nlm.nih.gov/22790016|journal=Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc|volume=25|issue=12|pages=1629–1636|doi=10.1038/modpathol.2012.117|issn=1530-0285|pmid=22790016}}</ref> lymph nodes in specimens resected for cancer,<ref name=":2" /> and lymph nodes and other organized lymphoid tissues resected for any non-hematologic cause prior to the diagnosis of overt mantle cell lymphoma<ref name=":3" />. | |||
The <u>clinical features</u> of this disease are detailed below: | {| class="wikitable" | ||
|+Table 1. Cohorts of tissues studied to detect in situ mantle cell neoplasm | |||
!Study cohorts for detecting in situ mantle cell neoplasm | |||
!N patients studied | |||
!In situ mantle cell neoplasm, N cases detected in the study | |||
|- | |||
|Retrospective study of cyclin D1 immunohistochemical stains in 100 consecutive cases of lymphoid hyperplasia to detect in situ mantle cell neoplasm<ref name=":0" /> | |||
|100 | |||
|0 (zero) by cyclin D1 stain<ref name=":0" /> | |||
|- | |||
|100 cases of reactive hyperplasia in lymph nodes studied by conventional cytogenetics<ref name=":4" /> | |||
|100 | |||
|0 (zero) clonal chromosomal abnormalities by conventional cytogenetics<ref name=":4" /> | |||
|- | |||
|Retrospective study of cyclin D1 immunohistochemical stains in reactive lymph nodes in surgical resection specimens of 131 consecutive patients with no history of lymphoma during a 3-month period<ref name=":1" /> | |||
|131 | |||
|0 (zero) by cyclin D1 stain<ref name=":1" /> | |||
|- | |||
|Retrospective study of lymph nodes (<u>></u> 0.5 cm size) resected with cancer in 341 consecutive patients diagnosed with colorectal (n= 201) and breast carcinoma (n= 140) during 1998-2000<ref name=":2" /> | |||
|341 | |||
|2 (0.58%) by cyclin D1 stain<ref name=":2" /> | |||
|- | |||
|Retrospective study of previous resections of lymph nodes and organized lymphoid tissues due to non-hematologic indications for surgery in 126 patients with overt mantle cell lymphoma<ref name=":3" /> | |||
|126 | |||
|2 (1.58%) by cyclin D1 stain<ref name=":3" /> | |||
|- | |||
|Retrospective study of all morphologically reactive lymph nodes and benign-appearing extranodal lymphoid infiltrates predating lymphoma diagnosis in patients diagnosed with overt mantle cell lymphoma<ref name=":1" /> | |||
|37 | |||
|0 (zero) cases reported with typical in situ mantle cell neoplasm by cyclin D1 stain;<ref name=":1" /> | |||
in 6 cases, minimal infiltration by cyclin D1 positive neoplastic mantle cells was identified at extranodal sites<ref name=":1" /> | |||
|}The <u>clinical features</u> of this disease are detailed below: | |||
Signs and symptoms - | Signs and symptoms - | ||