Advertisement

Mantle cell lymphoma involving the oral and maxillofacial region: a study of 20 cases

Published:September 06, 2022DOI:https://doi.org/10.1016/j.oooo.2022.08.018

      Objective

      To investigate the clinicopathologic features of mantle cell lymphoma (MCL) involving the oral and maxillofacial region.

      Methods

      The MCL cases were retrieved from the pathosis database of 6 pathology laboratories. Original hematoxylin and eosin slides and immunohistochemical reactions were reviewed for confirmation of the initial diagnosis. Clinical data of the cases were obtained from the patients’ pathosis and/or medical charts.

      Results

      Twenty cases were included in the study, showing a male predominance and a mean age of 66 years. The oral cavity (12 cases) and the oropharynx (5 cases) were the most commonly involved subsites. Most cases presented as asymptomatic swellings, with 2 cases showing bilateral involvement of the palate. The classic histologic variant predominated (12/20 cases). All cases expressed CD20 with nuclear cyclin D1 positivity. SOX11 was seen in 9/13 cases, CD5 in 6/16 cases, Bcl2 in 16/19 cases, CD10 in 2/20 cases, and Bcl6 in 4/16 cases. Ki67 showed a mean proliferation index of 40.6%. The Epstein-Barr virus (EBV) was negative in all cases investigated. Follow-up data was available for 7 patients, with 5 currently alive and 2 deceased.

      Conclusion

      Mantle cell lymphoma, albeit rare, may manifest in the oral and maxillofacial region. Its histologic heterogeneity demands a high degree of diagnostic skill from pathologists.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Vergote V
        • Janssens A
        • André M
        • et al.
        Results from the Belgian mantle cell lymphoma registry.
        Acta Clin Belg. 2017; 72: 172-178
        • Jain P
        • Wang M.
        Mantle cell lymphoma: 2019 update on the diagnosis, pathogenesis, prognostication, and management.
        Am J Hematol. 2019; 94: 710-725
        • Epperla N
        • Hamadani M
        • Fenske TS
        • Costa LJ.
        Incidence and survival trends in mantle cell lymphoma.
        Br J Haematol. 2018; 181: 703-706
        • Swerdlow SH
        • Campo E
        • Seto M
        • Müller-Hermelink HK
        • et al.
        Mantle cell lymphoma.
        in: Swerdlow SH Campo E Harris NL World Health Organization Classification of Tumours of Hematopoietic and Lymphoid Tissues, revised. 4th ed. IARC, Lyon, France2017: 285-290
        • Nabrinsky E
        • Danilov AV
        • Koller PB.
        High-risk mantle cell lymphoma in the era of novel agents.
        Curr Hematol Malig Rep. 2021; 16: 8-18
        • Lukach L
        • Lehman H
        • Livoff A
        • Nahlieli O
        • Michaeli E
        • Allon I.
        Mantle cell lymphoma of the oral cavity: an uncommon site for an uncommon lesion, two new cases and literature review.
        Oral Oncol. 2020; 103104578
        • Marques JAS
        • Ferreira F
        • Melo DP
        • Santos M
        • Vaz RP.
        Palatine tonsils primary presentation of blastoid variant of mantle cell lymphoma: case report.
        Head Neck Pathol. 2021; 15: 588-592
        • Valente VB
        • Castro TF
        • Takamiya AS
        • et al.
        Blastoid variant of mantle cell lymphoma in palatine tonsil.
        Oral Oncol. 2021; 122105552
        • Tashakori M
        • Kim DH
        • Kanagal-Shamanna R
        • et al.
        Mantle cell lymphoma involving tonsils: a clinicopathologic study of 83 cases.
        Human Pathol. 2021; 118: 60-68
        • Wagner VP
        • Rodrigues-Fernandes CI
        • Carvalho MVR
        • et al.
        Mantle cell lymphoma, malt lymphoma, small lymphocytic lymphoma and follicular lymphoma of the oral cavity: an update.
        J Oral Pathol Med. 2021; 50: 622-639
        • Ambinder AJ
        • Shenoy PJ
        • Nastoupil LJ
        • Flowers CR.
        Using primary site as a predictor of survival in mantle cell lymphoma.
        Cancer. 2013; 119: 1570-1577
        • Breen CT
        • Chao J
        • Mehra S
        • Kohli N.
        Extranodal head and neck mantle cell lymphoma: characteristics, treatment, and survival.
        Ann Otol Rhinol Laryngol. 2022; 131: 412-419
        • Issa DE
        • van de Schans SA
        • Chamuleau ME
        • et al.
        Trends in incidence, treatment and survival of aggressive B-cell lymphoma in the Netherlands 1989-2010.
        Haematologica. 2015; 100: 525-533
        • Smith A
        • Crouch S
        • Lax S
        • et al.
        Lymphoma incidence, survival and prevalence 2004-2014: sub-type analyses from the UK's Haematological Malignancy Research Network.
        Br J Cancer. 2015; 112: 1575-1584
        • Leux C
        • Maynadié M
        • Troussard X
        • et al.
        Mantle cell lymphoma epidemiology: a population-based study in France.
        Ann Hematol. 2014; 93: 1327-1333
        • Chang CC
        • Rowe JJ
        • Hawkins P
        • Sadeghi EM.
        Mantle cell lymphoma of the hard palate: a case report and review of the differential diagnosis based on the histomorphology and immunophenotyping pattern.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96: 316-320
        • Guggisberg K
        • Jordan RCK.
        Mantle cell lymphoma of the oral cavity: case series and comprehensive review of the literature.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109: 98-104
        • Kamel MG
        • El-Qushayri AE
        • Sayed AK
        • Huy NT.
        Using the primary site as a prognostic tool for nodal mantle cell lymphoma: a SEER-based study.
        J Comp Eff Res. 2020; 9: 861-876
        • Jain P
        • Wang M.
        Blastoid mantle cell lymphoma.
        Hematol Oncol Clin North Am. 2020; 34: 941-956
        • Rodrigues-Fernandes CI
        • Gonçalves Junior A
        • Soares CD
        • et al.
        Oral and oropharyngeal diffuse large B-cell lymphoma and high-grade B-cell lymphoma: a clinicopathologic and prognostic study of 69 cases.
        Oral Surg Oral Med Oral Pathol Oral Radiol. 2021; 131: 452-462
        • Loungani L
        • Mundhe R
        • Chinoy R.
        Aggressive cyclin D1 negative blastoid variant mantle cell lymphoma—a case report.
        Int J Surg Pathol. 2022; 30: 190-194
        • Pizzi M
        • Agostinelli C
        • Righi S
        • et al.
        Aberrant expression of CD10 and BCL6 in mantle cell lymphoma.
        Histopathology. 2017; 71: 769-777
        • Xu J
        • Medeiros LJ
        • Saksena A
        • et al.
        CD10-positive mantle cell lymphoma: clinicopathologic and prognostic study of 30 cases.
        Oncotarget. 2017; 9: 11441-11450
        • Fuseya H
        • Yoshida M
        • Oyama R
        • et al.
        Mantle cell lymphoma with dot-like nuclear staining for cyclin D1.
        Leuk Lymphoma. 2020; 61: 2016-2019
        • Zhou L
        • Xu H
        • Zhou J
        • Ouyang B
        • Wang C.
        A rare case of hairy cell leukemia with co-expression of CD5 and cyclin D1: a diagnostic pitfall.
        Mol Clin Oncol. 2020; 13: 74
        • Isaac KM
        • Portell CA
        • Williams ME.
        Leukemic variant of mantle cell lymphoma: clinical presentation and management.
        Curr Oncol Rep. 2021; 23: 102
        • Maddocks K.
        Update on mantle cell lymphoma.
        Blood. 2018; 132: 1647-1656
        • Karmali R
        • Switchenko JM
        • Goyal S
        • et al.
        Multi-center analysis of practice patterns and outcomes of younger and older patients with mantle cell lymphoma in the rituximab era.
        Am J Hematol. 2021; 96: 1374-1384
        • Lim SY
        • Horsman JM
        • Hancock BW.
        The mantle cell lymphoma international prognostic index: does it work in routine practice?.
        Oncol Lett. 2010; 1: 187-188
        • Hoster E
        • Rosenwald A
        • Berger F
        • et al.
        Prognostic value of Ki-67 index, cytology, and growth pattern in mantle-cell lymphoma: results from randomized trials of the European mantle cell lymphoma network.
        J Clin Oncol. 2016; 34: 1386-1394