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Case Reports in Hematology
Volume 2015 (2015), Article ID 146598, 6 pages
http://dx.doi.org/10.1155/2015/146598
Case Report

De Novo CD5 Negative Blastic Mantle Cell Lymphoma Presented with Massive Bone Marrow Necrosis without Adenopathy or Organomegaly

1Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh 11159, Saudi Arabia
2Department of Hematology and Blood Bank, Theodor Bilharz Research Institute, Giza, Egypt
3Department of Oncology, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh 11159, Saudi Arabia
4Department of Basic Science, Princess Nourah Bint Abdulrahman University, College of Medicine, Riyadh, Saudi Arabia
5Department of Adult Clinical Hematology and Stem Cell Therapy, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh 11159, Saudi Arabia

Received 14 April 2015; Revised 12 July 2015; Accepted 26 July 2015

Academic Editor: John Frater

Copyright © 2015 Ghaleb Elyamany et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The recent World Health Organization (WHO) classification defines mantle cell lymphoma (MCL) as a distinct entity characterized by a unique immunophenotype and a molecular hallmark of chromosomal translocation t(11;14)(q13;q32). We report an unusual case of an advanced stage of CD5 negative MCL with a blastoid variant with a massive bone marrow (BM) necrosis as an initial presenting feature, with no adenopathy or hepatosplenomegaly. The pathologic features showed blastoid variant of MCL and flow cytometry showed that the tumor cells were CD5−, CD19+, CD20+, FMC-7+, CD23−, and lambda light chain restricted. Chromosomal analysis, using karyotype and fluorescent in situ hybridization (FISH), demonstrated karyotypic abnormalities in addition to the t(11;14). Our case study may be reported as a unique case of CD5− blastic MCL with unusual presentation and findings which made the diagnosis of MCL difficult.