Gastrointestinal involvement by mantle cell lymphoma identified by biopsy performed during endoscopy

Abstract

Rationale:Primary gastrointestinal mantle cell lymphoma is rare, and histopathological examination and specific immunohistochemical staining are still the gold standard for diagnosis. Therefore, it is necessary to find a new way to improve positive biopsy rates.Patient concerns:A 58-year-old man was admitted to our hospital with epigastric pain, abdominal distension, nausea, and melena. Endoscopy identified submucosal neoplasms and diffuse gastrointestinal tract involvement including the esophagus.Diagnoses:A false-negative diagnosis was first determined by ordinary endoscopy. However, a large tissue biopsy was subsequently performed using endoscopic mucosal resection based on endoscopic ultrasonography (EUS). Pathological examination of the biopsy specimens taken from the lesions of the duodenum and rectum revealed diffuse lymphocytic proliferation and obscure nodular and small cleaved cells with irregularly shaped nuclei. Immunohistochemistry showed that the cells were positive for CyclinD1, BCL-2, CD20, CD21, and CD5; however, they were negative for CD3, CD6, CD10, and CD43.Interventions:The patient refused to receive further treatment.Outcomes:Mantle cell lymphoma was conclusively diagnosed.Conclusions:EUS has an important role in the diagnosis and management of gastrointestinal submucosal tumors. Performing a pathological biopsy including EUS may be useful for identifying the unknown nature of tumors of the digestive tract.

Clinicopathological Features, Treatment Strategy, and Prognosis of Primary Non-Hodgkin’s Lymphoma of the Duodenum: A SEER Database Analysis

“…From our study, the treatment of PDLs was also in line with the current treatment trend, but interestingly, the proportion of PDLs treated by surgery was lower than that of the stomach (9.64%) and the small intestine (35.13%), among which it was significantly lower than that of the small intestine. e reason may be that the duodenal lesion is mostly found in the descending segment [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23], which has a complex anatomical structure and a small possibility of local resection, unlike the small intestine which can be directly resected, so conservative treatment is more preferred. Once a larger operation is performed, it is bound to cause complications and affect the quality of life.…”

“…As primary duodenum lymphomas (PDLs) are exceedingly rare, the current researches about PDLs are based on anecdotal reports [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. In the present study, we retrospectively reviewed the clinical and pathological manifestations of lymphomas of duodenum lymphoma for cases based on the largest sample size so far to identify prognostic factors and to clarify the value of treatment modalities in the management of these malignancies.…”

Image-Guided Percutaneous Biopsy and Drainage of the Abdomen

“…Most biopsies of the gastrointestinal system are performed by endoscopic techniques, which allow direct visualization of tumors. 57,58 While commonly performed, endoscopic biopsies are often limited to FNA, due to limitations in equipment size that preclude the use of cutting needles. 59 When FNA is insufficient to provide a diagnosis, imageguided percutaneous core biopsy may have a role.…”

Complete Endoscopic and Histopathological Remission of Mantle Cell Lymphoma of the Gastrointestinal Tract

“…Primary gastrointestinal (GI) MCL is very rare, accounting for only 1%-4% of GI lymphomas [2]. Macroscopic GI involvement in MCL is rare (15%-30% of patients) and there are sparse reports of MCL detected by endoscopy [3-4]. We describe an unusual presentation of MCL presenting as a duodenal mass and then also occurring in the ileocecal region, achieving complete endoscopic and histological remission after chemoimmunotherapy.…”