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Umyarova E, Adapa S, Naramala S, Gayam V, Aeddula NR, Konala VM. A Rare Manifestation of a Rare Disease: Mantle Cell Lymphoma Presenting With Aseptic Meningitis. J Investig Med High Impact Case Rep 2019; 7:2324709619858643. [PMID: 31234647 PMCID: PMC6593924 DOI: 10.1177/2324709619858643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Mantle cell lymphoma (MCL) is a rare form of non-Hodgkin lymphoma characterized by clonal proliferation of follicular mantle zone B lymphocytes. It is caused by abnormal chromosomal translocation t(11;14) resulting in aberrant expression of cyclin D1. This leads to activation of anti-apoptotic pathways and abnormal proliferation of MCL cells. Patients can present with an indolent course or a fulminant disease with short overall survival. The disease frequently involves extranodal organs, but rarely manifests with neurological symptoms. We report a rare case of aberrant CD5-negative MCL presenting with aseptic meningitis.
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Affiliation(s)
| | | | | | - Vijay Gayam
- 4 Interfaith Medical Center, Brooklyn, NY, USA
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Baheti AD, Tirumani SH, Sewatkar R, Sachin SS, Shinagare AB, Ramaiya NH. MDCT of extranodal mantle cell lymphoma: a single institute experience. ABDOMINAL IMAGING 2015; 40:1693-1699. [PMID: 25724714 DOI: 10.1007/s00261-015-0389-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To study the pattern of extranodal and particularly gastrointestinal (GI) involvement of mantle cell lymphoma (MCL) on MDCT MATERIALS AND METHODS: In this IRB-approved, HIPAA compliant retrospective study, MDCT features of 78 patients (62 males and 16 females, mean age 57 years) with MCL including 28 patients at presentation were reviewed. Clinical and histopathological (blastoid vs. non-blastoid) data were noted from medical records. RESULTS Extranodal involvement was present in overall 51/78 patients on CT (65%), 18/28 (64%) patients at presentation. Spleen (21/78-27%) and bowel (19/78-24%) were the most common sites of extranodal involvement by MCL on imaging, followed by lungs (10/78-13%) and skin/subcutaneous tissue (9/78-12%). Bowel involvement was either in the form of endophytic polypoidal lesions (n = 11, mean size 3.1 cm), as focal mild bowel wall thickening (n = 5, mean thickness 1.4 cm), or as combination of the two (n = 3). Blastoid histology was present in 14/78 (24%) patients and was statistically associated with skin/subcutaneous involvement (p < 0.05; Fisher's exact t test). Median follow-up was 72 months during which 21 patients died with median survival of 48 months (26 months for blastoid histology vs. 47 months for non-blastoid histology). There was no statistical correlation between sites of involvement and survival. CONCLUSIONS MCL has a predilection for extranodal disease, predominantly involving the spleen, bowel, lungs, and subcutaneous tissue. GI involvement on CT is in the form of endoluminal polypoidal lesions and mild bowel wall thickening. Skin/subcutaneous involvement was statistically more common with blastoid histology in our study.
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Affiliation(s)
- Akshay D Baheti
- Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA,
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Kang BW, Sohn SK, Moon JH, Chae YS, Kim JG, Lee SJ, Kim WS, Lee JJ, Lee SR, Park KU, Lee HS, Lee WS, Won JH, Park MR, Kwak JY, Kim MK, Kim HJ, Oh SY, Kang HJ, Suh C. Clinical features and treatment outcomes in patients with mantle cell lymphoma in Korea: Study by the Consortium for Improving Survival of Lymphoma. Blood Res 2014; 49:15-21. [PMID: 24724062 PMCID: PMC3974951 DOI: 10.5045/br.2014.49.1.15] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/05/2013] [Accepted: 02/19/2014] [Indexed: 12/11/2022] Open
Abstract
Background We investigated the clinical features and treatment outcomes of patients with mantle cell lymphoma (MCL) in Korea. Methods We retrospectively analyzed the clinical characteristics and prognosis of 131 patients diagnosed with MCL between January 2004 and December 2009 at 15 medical centers in Korea; all patients received at least 1 chemotherapeutic regimen for MCL. Results The median age for the patients was 63 years (range, 26-78 years), and 77.9% were men. A total of 105 patients (80.1%) had stage III or IV MCL at diagnosis. Fifty-two patients (39.7%) were categorized with high- or high-intermediate risk MCL according to the International Prognostic Index (IPI). Eighteen patients (13.7%) were in the high-risk group according to the simplified MCL-IPI (MIPI). The overall incidence of extranodal involvement was 69.5%. The overall incidence of bone marrow and gastrointestinal involvements at diagnosis was 41.2% and 35.1%, respectively. Cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab were used frequently as the first-line treatment (41.2%). With a median follow-up duration of 20.0 months (range, 0.2-77.0 months), the overall survival (OS) at 2 years was 64.7%, while the event-free survival (EFS) was 39.7%. Multivariate analysis showed that the simplified MIPI was significantly associated with OS. However, the use of a rituximab-containing regimen was not associated with OS and EFS. Conclusion Similar to results from Western countries, the current study found that simplified MIPI was an important prognostic factor in Korean patients with MCL.
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Affiliation(s)
- Byung Woog Kang
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Sang Kyun Sohn
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Joon Ho Moon
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yee Soo Chae
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jong Gwang Kim
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Soo Jung Lee
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Won Seog Kim
- Department of Hematology/Oncology, Internal Medicine, Samsung Medical Center, Seoul, Korea
| | - Je-Jung Lee
- Department of Hematology/Oncology, Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Se Ryeon Lee
- Department of Hematology/Oncology, Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Keon Uk Park
- Department of Hematology/Oncology, Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Ho Sup Lee
- Department of Hematology/Oncology, Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Won Sik Lee
- Department of Hematology/Oncology, Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Jong-Ho Won
- Department of Hematology/Oncology, Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Moo-Rim Park
- Department of Hematology/Oncology, Internal Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Jae-Yong Kwak
- Department of Hematology/Oncology, Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea
| | - Min Kyoung Kim
- Department of Hematology/Oncology, Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Hyo Jung Kim
- Department of Hematology/Oncology, Internal Medicine, Hallym University Scared Heart Hospital, Anyang, Korea
| | - Sung Yong Oh
- Department of Hematology/Oncology, Internal Medicine, Dong-A University Hospital, Busan, Korea
| | - Hye Jin Kang
- Department of Hematology/Oncology, Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Cheolwon Suh
- Department of Hematology/Oncology, Internal Medicine, Asan Medical Center, Seoul, Korea
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