ABSTRACT
Mantle cell lymphoma (MCL) is a recently redefined category of malignant lymphoma that has been indivisualized under different names, because of classifications, such as the Working Formulation, fail to recognize it. In the Working Formulation, MCL is classified as diffuse small cleaved cell lymphoma most frequently. Immunophenotyping has a tremendous value in diagnosis of MCL and adds the accuracy of diagnosis. It more commonly arises in peripheral lymph nodes, but in colon, usually presents as a diffuse infiltration, known as multiple lymphomatous polyposis and lymphomatous polyposis can be regarded as the intestinal form of MCL. We recently experienced a case of recurrent MCL presented with a peculiar feature of intestinal lymphomatous polyposis in a 57-year old male patient. He had been diagnosed diffuse small cleaved cell lymphoma of tonsil and treated by CHOP chemotherapy. He developed a recurrence in stomach, colon, liver, spleen and bone marrow after 16 months in complete remission. We could confirm the previously diagnosed lymphoma of tonsil as MCL by adding immunophenotyping with cyclin D1 and CD5. He received salvage chemotherapy and responded partially. We report a case of MCL relapse in the form of intestinal lymphomatous polyposis and literatures are reviewed.
Subject(s)
Humans , Male , Middle Aged , Bone Marrow , Classification , Colon , Cyclin D1 , Diagnosis , Drug Therapy , Immunophenotyping , Liver , Lymph Nodes , Lymphoma , Lymphoma, Mantle-Cell , Lymphoma, Non-Hodgkin , Palatine Tonsil , Recurrence , Spleen , StomachABSTRACT
The incidence of a primary central nervous system (CNS) lymphoma in western countries is about 1% of all the intracranial tumors and has increased 2.2% over the last decade. A similar pattern of increased frequency is observed in Korea. Although most CNS lymphomas in western countries are high grade tumors carrying poor prognosis, the clinicopathologic features of the Korean CNS lymphoma have not been well studied. We report clinicopathological features of 18 cases of histologically proven primary brain lymphoma. The mean age of the patients was 50 years and there was no sex difference. The clinical and radiological characteristics included multiple site of occurrence, infrequent extracranial spread, and frequent seeding via cerebrospinal fluid. No patients were immune-compromised host. Of 18 cases, 15 cases were of B-lineage and 2 cases were of T-lineage. According to REAL classification, there were 12 cases of diffuse large B cell lymphoma, two cases of B cell lymphomas of small lymphoid cell, and two cases of peripheral T cell lymphoma, unspecified. The remaining subtypes were not subclassified because of inadequate material. Pleomorphic cytologic features and necrosis of varying extent were frequent in the cases of diffuse large B-cell lymphoma. These results suggest that overall clinicopathologic features of primary malignant lymphomas of the central nervous system in Korea are similar to those of western countries.