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Case 209 - Discussion

Hematopathology Case


Circulating Mantle Cell Lymphoma Cells

  • Circulating mantle cells lymphoma (MCL) cells may be present in the peripheral blood, and occasionally can reach a substantially high number;
  • The morphology of circulating MCL cells depends on the morphologic subtype of tumor cells. For the most common small cell variant of MCL, the circulating tumors closely resemble CLL cells. However, compared to the CLL cells, MCL cells are slightly larger with more variable cell sizes and more nuclear irregularities. Some MCL cells are small with round nuclei and condensed chromatin, whereas others are medium sized with slightly dispersed chromatin, more cytoplasm, or a distinct small nucleolus.
  • For the blastoid or pleomorphic variant, the tumor cells are medium or large in size. The chromatin is usually open, resembling blasts. However, the nucleolus is usually small or inconspicuous, even in cells with pleomorphic morphology.