#00063673

A 61-year-old male presented with spontaneous spleen rupture, wide spread lymphadenopathy. Hb 126 g/L, WBC 52 x10^9/L (neutrophil 6.2 x 10^9/L lymphocyte 45.3 x 10^9/L), Platelet 100 x 10^9/L. Blood film showed lymphocytosis, pleiomorphic lymphocytes.  Blood flow cytometry showed 53% CD5+CD23+CD79b+FMC7+Kappa restricted B lymphocytes.  FISH detected an IgH-CCND1 translocation in 56% of cells analyzed. Bone marrow trephine showed 60% small to medium to large atypical lymphocytes. They were strongly positive for Cyclin D1 and largely negative for SOX-11. Diagnosis of mantle cell lymphoma was made.