Composite Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia/Small Cell Lymphoma with 17p Deletion: A Case Study

Hanan Armanious, MD, PhD, Jean Deschênes, MD, Wei-Feng Dong, MD, PhD, Iyare Izevbaye, MD, PhD


Here we describe a case of a composite mantle cell lymphoma (MCL) and chronic lymphocytic leukemia/small cell lymphocytic lymphoma (CLL/SLL) with 17p deletion in the MCL. The patient presented with 3 years of progressive lymphocytosis. Cervical lymph node biopsy showed morphologic features of nodular MCL and internodular CLL/SLL, two populations of CD5+ cells by flow cytometry, a t(11;14) translocation with a deletion in chromosome 11 by FISH, and biclonal IGH gene rearrangement. In the peripheral blood, flow cytometry showed a single population of CD5+ cells; FISH showed a t(11;14) translocation. Peripheral blood IGH gene rearrangement confirmed a single B cell monoclonal population identical to one of the two lymph node clones.  Peripheral blood karyotyping detected 17p deletion, attributed to the MCL, the sole B cell clonal population in the peripheral blood. The diagnosis was concurrent MCL and CLL/SLL in the lymph node with peripheral MCL harboring a 17p deletion.

[N A J Med Sci. 2017;10(1):13-19.   DOI:  10.7156/najms.2017.1001013]


mantle cell lymphoma; CLL/SLL; Fluorescence in situ hybridization

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Jaffe ES, Banks PM, Nathwani B, Said J, Swerdlow SH. Recommendations for the reporting of lymphoid neoplasms: a report from the Association of Directors of Anatomic and Surgical Pathology. Mod Pathol. 2004;17:131-135.

Campo E, Raffeld M, Jaffe ES. Mantle-cell lymphoma. Semin Hematol. 1999;36:115-127.

Hallek, M. Chronic lymphocytic leukemia: 2015 update on diagnosis, risk stratification, and treatment. Am. J. Hematol. 2015;90:446-460.

Fabbri G, Dalla-Favera R. Nat Rev Cancer. The molecular pathogenesis of chronic lymphocytic leukaemia. 2016;6:145-162.

Hoeller S, Zhou Y, Kanagal-Shammanna R, et al. Composite mantle cell lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma: a clinicopathologic and molecular study. Hum Pathol. 2013;44:110-121.

Caraway NP. Strategies to diagnose lymphoproliferative disorders by fine-needle aspiration by using ancillary studies. Cancer. 2005;105:432-442.

Caraway NP, Gu J, Lin P, Romaguera JE, Glassman A, Katz R. The utility of interphase fluorescence in situ hybridization for the detection of the translocation t(11;14)(q13;q32) in the diagnosis of mantle cell lymphoma on fine-needle aspiration specimens. Cancer. 2005;105:110-118.

Onciu M, Schlette E, Medeiros LJ, Abruzzo LV, Keating M, Lai R. Cytogenetic findings in mantle cell lymphoma cases with high level of peripheral blood involvement have a distinct pattern of abnormalities. Am J Clin Pathol. 2001;16:886-892.

Halldórsdóttir AM, Lundin A, Murray F, et al. Impact of TP53 mutation and 17p deletion in mantle cell lymphoma. Leukemia. 2011;25:1904-1908.

Hallek M. Chronic lymphocytic leukemia: 2013 update on diagnosis, risk stratification and treatment. Am J Hematol. 2013;88:803-816.


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