Fast Five Quiz: Mantle Cell Lymphoma Workup

Ann S. LaCasce, MD, MMSc


February 08, 2023

Both histologic examination and immunophenotyping using immunohistochemistry (IHC) for cyclin D1 overexpression are required to diagnose MCL. FISH testing for t(11;14) can also be helpful. The EMSO guidelines state that as only the minority of these cases is correctly diagnosed on the basis of classical histology only, review by an expert hematopathologist is advised. In particular, additional IHC for detection of cyclin D1 overexpression is mandatory.

Histologic examination alone is usually inadequate, and generally cyclin D1 overexpression is mandatory for the diagnosis of MCL. In rare cyclin D1-negative cases, detection of SOX11 may be helpful to establish the diagnosis, per the same guidelines.

Immunophenotyping using both IHC and flow cytometry is also used to differentiate MCL from other small B-cell lymphomas. In addition to cyclin D1 overexpression, MCL cells are CD5+ and pan-B cell antigen positive; they typically do not express CD10 or CD23, per Abbasi and colleagues.

Learn more about MCL.

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