Clinical and morphologic characteristics of the borderline cases
. | Case 1 SLL/MZL . | Case 2 SLL/MZL . | Case 3 SLL/MZL . | Case 4 SLL/MZL . | Case 5 MZL/MCL . | Case 6 MZL/MCL . |
|---|---|---|---|---|---|---|
| Clinical features | ||||||
| Sites of involvement | Spleen | Spleen | Spleen | Spleen | Nodes | Nodes |
| Bone marrow | Bone marrow | Bone marrow | Bone marrow | spleen | spleen | |
| Blood | Blood | Bone marrow | Bone marrow | |||
| Lymphocytosis | 3 × 109/L | 12 × 109/L | 8 × 109/L | 80 × 109/L | 4 × 109/L | 3 × 109/L |
| LDH | Elevated | Elevated | Normal | Elevated | Normal | Elevated |
| B2 microglobulin, g/L | 3.1 | 6 | 1.9 | 3.2 | 4.3 | 3.1 |
| Monoclonal component | M Kappa-29.3 g/L | G Lamda-4 g/L | 0 | 0 | 0 | 0 |
| Follow-up, years | 2.26 | 148 days | 3.55 | 1.94 | 121 days | 2.83 |
| Status at last follow-up | Alive | Dead (Neuro) | Alive | Dead | Dead | Alive |
| Histology | Diffuse infiltration of red pulp by small lympho-plasmacytic cells | Diffuse infiltration of small plasmacytoid cells | Micronodular infiltration of small cells | Diffuse infiltration of red pulp by small round cells; nodular pattern in splenic hilar LN | Micronodular and diffuse infiltration of round cells and centrocytic cells | Diffuse infiltration of small round cells, numerous mitoses |
| Lymphocyte cytology | Lympho-plasmacytic cells, MZL type | Atypical CLL cells (clumped chromatin, plasmacytoid differentiation, smudge cells) | Clumped chromatin, no smudge cells | Clumped chromatin, some smudge cells | Heterogeneous in size (small to large), basophilic cytoplasm | Small cells with regular nucleus |
| Immunophenotype of B cells | CD5+ CD23− | CD5+ CD23− CD43+ wk | CD5+ CD23+ wk | CD5+ CD23− CD43− | CD5+ CD23− CD43− | CD5+ CD23− CD43+ |
| CD43+ wk | Slg+++, MC7+, CD22++ | |||||
| Slg+++ | ||||||
| FMC7+, CD22++ | ||||||
| Cytogenetics | +12 | Complex without recurrent abnormalities | +12 | Complex with +3q | Complex with t(11;14) | No t(11;14) but very rare mitoses |
| del13q | +18 | t(1;12) | ||||
| IgVH mutational status | Mutated | Mutated | Mutated | Mutated | Mutated | Not mutated |
| Cyclin D1 | Not applicable | Not applicable | Not applicable | Not applicable | ++ | ++ |
| Site of biopsy | Spleen | Spleen | Spleen | Spleen | Spleen | Node |
. | Case 1 SLL/MZL . | Case 2 SLL/MZL . | Case 3 SLL/MZL . | Case 4 SLL/MZL . | Case 5 MZL/MCL . | Case 6 MZL/MCL . |
|---|---|---|---|---|---|---|
| Clinical features | ||||||
| Sites of involvement | Spleen | Spleen | Spleen | Spleen | Nodes | Nodes |
| Bone marrow | Bone marrow | Bone marrow | Bone marrow | spleen | spleen | |
| Blood | Blood | Bone marrow | Bone marrow | |||
| Lymphocytosis | 3 × 109/L | 12 × 109/L | 8 × 109/L | 80 × 109/L | 4 × 109/L | 3 × 109/L |
| LDH | Elevated | Elevated | Normal | Elevated | Normal | Elevated |
| B2 microglobulin, g/L | 3.1 | 6 | 1.9 | 3.2 | 4.3 | 3.1 |
| Monoclonal component | M Kappa-29.3 g/L | G Lamda-4 g/L | 0 | 0 | 0 | 0 |
| Follow-up, years | 2.26 | 148 days | 3.55 | 1.94 | 121 days | 2.83 |
| Status at last follow-up | Alive | Dead (Neuro) | Alive | Dead | Dead | Alive |
| Histology | Diffuse infiltration of red pulp by small lympho-plasmacytic cells | Diffuse infiltration of small plasmacytoid cells | Micronodular infiltration of small cells | Diffuse infiltration of red pulp by small round cells; nodular pattern in splenic hilar LN | Micronodular and diffuse infiltration of round cells and centrocytic cells | Diffuse infiltration of small round cells, numerous mitoses |
| Lymphocyte cytology | Lympho-plasmacytic cells, MZL type | Atypical CLL cells (clumped chromatin, plasmacytoid differentiation, smudge cells) | Clumped chromatin, no smudge cells | Clumped chromatin, some smudge cells | Heterogeneous in size (small to large), basophilic cytoplasm | Small cells with regular nucleus |
| Immunophenotype of B cells | CD5+ CD23− | CD5+ CD23− CD43+ wk | CD5+ CD23+ wk | CD5+ CD23− CD43− | CD5+ CD23− CD43− | CD5+ CD23− CD43+ |
| CD43+ wk | Slg+++, MC7+, CD22++ | |||||
| Slg+++ | ||||||
| FMC7+, CD22++ | ||||||
| Cytogenetics | +12 | Complex without recurrent abnormalities | +12 | Complex with +3q | Complex with t(11;14) | No t(11;14) but very rare mitoses |
| del13q | +18 | t(1;12) | ||||
| IgVH mutational status | Mutated | Mutated | Mutated | Mutated | Mutated | Not mutated |
| Cyclin D1 | Not applicable | Not applicable | Not applicable | Not applicable | ++ | ++ |
| Site of biopsy | Spleen | Spleen | Spleen | Spleen | Spleen | Node |
+, ++, and +++ correspond to the expression level of the immunostaining.
LN indicates lymph node; LDH, lactodehydrogenase.