Leukemic phase of mantle cell lymphoma - Two case reports and review of the literature

Two cases of mantle cell lymphoma are presented. Both patients were women, aged 68 and 56 years, who presented with lymph node enlargement. Each case was initially interpreted as a follicular small cleaved cell lymphoma. Both patients later presented with splenomegaly and recurrent lymphadenopathy. Morphologic and immunologic studies on a parotid swelling in one case and a splenectomy specimen in the other indicated a diagnosis of mantle cell lymphoma. Both women subsequently presented in leukemic phase associated with a poor prognosis, and both patients succumbed soon after. The characteristics, differential diagnosis, and leukemic phase of mantle cell lymphoma are discussed. The importance of appropriate immunohistochemical and flow cytometry analysis in distinguishing mantle cell lymphoma from morphologically similar follicular center cell lymphomas is demonstrated.