Mantle cell lymphoma of the gastrointestinal tract presenting with multiple intussusceptions – case report and review of literature

Abstract

Background: Mantle cell lymphoma (MCL) is an aggressive type of B-cell non-Hodgkin's lymphoma that originates from small to medium sized lymphocytes located in the mantle zone of the lymph node. Extra nodal involvement is present in the majority of cases, with a peculiar tendency to invade the gastro-intestinal tract in the form of multiple lymphomatous polyposis. MCL can be accurately diagnosed with the use of the highly specific marker Cyclin D1. Few cases of mantle cell lymphoma presenting with intussuception have been reported. Here we present a rare case of multiple intussusceptions caused by mantle cell lymphoma and review the literature of this disease.

Approach to cases with multiple invagination

“…Multiple sequential invagination has only been documented in newborns once [3]. In some literature, in the cases that are accompanied by more than one invagination, additional pathologies such as Peutz–Jeghers syndrome, adenomatous polyp, metastatic melanoma, metastatic lung cancer, malign pleural mesothelioma, and lymphoma are generally shown as leading points [1,2,4]. In our first patient, no anatomical leading point was encountered.…”

Multiple lymphomatous polyposis of the gastrointestinal tract: Report of three cases and literature review

“…The mean interval between the onset of symptom and diagnosis is 5 months (range 0–9 months) . More than half of the patients have infiltration of the bone marrow at the time of diagnosis, as well as involvements of the liver, spleen and mesenteric and peripheral lymph nodes.…”

“…It is worth mentioning that cytogenetic characteristic of MLP as mantle cell lymphoma is the presence of t(11;14)(q13;q32) which results in the overexpression of cyclin‐D1 protein . The cytogenetic characteristic of MLP as follicular lymphoma is the presence of t(14;18) which is related to BCL‐2 antiapoptosis . Cytogenetic molecular biology studies are rarely mandatory in routine diagnosis but can be useful if it is difficult to diagnose MLP.…”

“…16 The cytogenetic characteristic of MLP as follicular lymphoma is the presence of t (14;18) which is related to BCL-2 antiapoptosis. 13 Cytogenetic molecular biology studies are rarely mandatory in routine diagnosis but can be useful if it is difficult to diagnose MLP.…”

Intussusception in adults: what radiologists should know

“…Coronal T2-weighted MR image demonstrates an ileoileal intussusception (c). Melanoma with metastases was diagnosed after surgery endoscopic or radiological evaluation alone and histological examination is required for the diagnosis [54]. Intussusception is a very rare mode of presentation of intestinal NHL.…”