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Case  - Discussion

Hematopathology Case

Circulating Mantle Cell Lymphoma Cells

Note: This patient had a history of MCL. Circulating MCL cells are usually medium in size with variable cell size and nuclear morphology. The chromatin is moderately condensed. Nucleolus is usually inconspicuous but can be vasible. MCL cells, particularly the blastoid variant, may closely resemble circulating myeloblasts. However, myeloblasts are larger and have less variation in size, more delicate chromatin, and prominent nucleolus in almost all cells. MCL may mimic CLL; however, CLL cells are typically smaller and monotonous, have denser chromatin, inconspicuous nucleoli (except prolymphocytes), and mixed prolymphocytes, which are almost always present.

 

Key cytologic features of MCL cells in the peripheral blood:

o  Cell size: mixed, small to medium

o  Nucleus: prominent irregularity and variation

o  Chromatin: moderately condensed or reticular

o  Nucleolus: present in subset of cells

o  Cytoplasm: scant