Two cases of mantle cell lymphoma with a unique CD8+ phenotype are reported. Both patients had disease that was resistant to therapy; one patient had the blastic variant of mantle cell lymphoma. Flow cytometric analysis of bone marrow and cerebrospinal fluid samples revealed a phenotype consistent with mantle cell lymphoma, with the additional finding of CD8 positivity in 40% or more of the tumor cells in both cases. This is the first description of such a finding, and CD8+ mantle cell lymphoma may represent a unique type of B-cell neoplasia. Our findings may be important in the prediction of therapeutic response or in the detection of residual disease after therapy.