Master Mantle Cell Lymphoma with Picmonic for Medicine

Mantle cell lymphoma is a relatively rare lymphoid neoplasm that makes up about 2.5% of non hodgkin’s lymphomas in the United States. These cancers typically present in older adults, usually in the fifth to sixth decades of life and demonstrate a male predominance. As the name suggests, the tumor cells resemble normal mantle zone B cells that surround germinal center in lymph nodes. At the time of diagnosis, the majority of patients have generalized lymphadenopathy and 20 to 40% demonstrate peripheral blood involvement. Mantle cell lymphomas characteristically express high levels of cyclin D1 caused by an (11;14) translocation which involves the IgH locus on chromosome 14 and the cyclin D1 locus on chromosome 11. The resulting up-regulation of cyclin D1 promotes progression from G1 to the S phase during the cell cycle. Most tumors also express B cell markers including CD19 and CD20. It is also usually CD5+ positive, which helps to distinguish these cells from other B cell neoplasms like CLL. Mantle cell lymphomas have poor prognosis with median survival only 3-4 years. The lymphoma usually cannot be cured with conventional chemotherapy and most patients eventually succumb to organ dysfunction due to tumor infiltration.