CLL vs Mantle Cell Lymphoma

[Observer]

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According to what I've been reading Chronic Lymphocytic Leukemia and Mantle Cell Lymphoma can be confused. Does anyone here know about the differences? What about a patient who is initially diagnosed with CLL, but 3 years later has a drastic turn for the worse, has a splenectomy with the surprise finding of a diffuse malignant lymphoma, high grade large cell immunoblastic type, arising in a background of mantle zone lymphoma.

This was attributed to being histologic conversion of low-grade lymphoma to high-grade lymphoproliferative process (immunoblastic lymphoma) compatible with richter's syndrome.

The final diagnosis after the death of said patient, who was, incidentally, a 52 year old white male, was 1)Recurrent malignant lymphoma 2) Histologic conversion of mantle cell lymphoma 3) long standing mantle cell lymphoma for the past 3-4 years.

From this information, did the patient ever actually have CLL or did they all along have MCL, or is this unclear or indeterminant?

 

[Matte Kudesai]

According to what I've been reading Chronic Lymphocytic Leukemia and Mantle Cell Lymphoma can be confused. Does anyone here know about the differences? What about a patient who is initially diagnosed with CLL, but 3 years later has a drastic turn for the worse, has a splenectomy with the surprise finding of a diffuse malignant lymphoma, high grade large cell immunoblastic type, arising in a background of mantle zone lymphoma.

This was attributed to being histologic conversion of low-grade lymphoma to high-grade lymphoproliferative process (immunoblastic lymphoma) compatible with richter's syndrome.

The final diagnosis after the death of said patient, who was, incidentally, a 52 year old white male, was 1)Recurrent malignant lymphoma 2) Histologic conversion of mantle cell lymphoma 3) long standing mantle cell lymphoma for the past 3-4 years.

From this information, did the patient ever actually have CLL or did they all along have MCL, or is this unclear or indeterminant?

Any cytogenetic info initially?

 

[Observer]

Any cytogenetic info initially?

Where would I find this information? I don't have the original pathology report yet from when the original diagnosis of CLL was made. I should be getting a copy of that today.

The patient had a biopsy of a lymph node 3 1/2 years before his dramatic downward turn. At that time he was thought to have had CLL. His discharge summary from his final hospitalization did not list CLL as a diagnosis. This patient died 10 years ago. He was exposed to radioactive materials through his work at a Dept of Energy (DOE) site. CLL is considered a non-compensable illness, whereas lymphomas are, hence the importance of differentiating what his true diagnosis was.

 

[PathJet]

i am confused as to why you are asking this 10 years later? and how you would know about the legal ramifications of the different diagnoses?

are you a pathologist in training?

the reason is the explanation can get quite detailed and these diagnoses can be based on a variety of diagnostic modalities which you did not post

it is difficult to jump to conclusions about a patient's disease when the bottom line is presented only

CLL and mantle cell can have very similar appearances under the microscope (we call this morphology) there is also a significant overlap in the results of additional special studies

as far as the natural history of each disease not related to this particular patient since only essentially hearsay is posted at this point you can look this up on your favorite generic medical web page

if you are a physician -you can join the new popular online physician groups where you need to verify your medical license status and ask for advice on that online group

 

[djmd]

Where would I find this information? I don't have the original pathology report yet from when the original diagnosis of CLL was made. I should be getting a copy of that today.

The patient had a biopsy of a lymph node 3 1/2 years before his dramatic downward turn. At that time he was thought to have had CLL. His discharge summary from his final hospitalization did not list CLL as a diagnosis. This patient died 10 years ago. He was exposed to radioactive materials through his work at a Dept of Energy (DOE) site. CLL is considered a non-compensable illness, whereas lymphomas are, hence the importance of differentiating what his true diagnosis was.

This is exactly why I didn't comment when I saw this thread, I just knew something like this back story was there...

 

[deschutes]

Not the appropriate venue for this discussion. Thread closed.