P-040 Diffuse Large Cell B Lymphoma Type Activated B Cell (Mantle Lymphoma) as a Differential Diagnosis of Inguinal Hernia. A Rare Finding

Abstract

Introduction Mantle cell lymphoma is a rare type of B-cell non-Hodgkin lymphoma. It represents 7% of lymphomas in Europe, with an incidence of between 4 and 8 cases/year per million-hab. More frequent in men with a 4:1 ratio and middle-age. We present a diagnosed clinical case of MCL with an infrequent presentation. Material & Methods A 70-year-old male affected by left inguinal tumor after physical exertion 6 months before the consultation. Abdominal ultrasound and CT scan describe an extra testicular 3cm lesion with irregular edges without extension to other structures with possible signs of malignancy. Surgery is performed with the lesion bloc excision including left test and elements of the spermatic cord. Results The analysis of Pathological Anatomy shows us as a result a diffuse large cell B Lymphoma type Polymorphic Mantle Cell Lymphoma. The postoperative extension study (PET) shows no residual tumor or medullary involvement, suggestive of stage I. Discussion MCL is a rare type of lymphoma, characterized by translocation (11;14) (q13; q32) leading to overexpression of cyclin D1. Most common presentation of MCL is B symptoms (up to 40%) fever, night sweats. Others include asthenia, nighttime pruritus, adenopathies, and hepatic or splenic enlargement. Finally, CML can present with extranodal disease, digestive system, respiratory system, nervous system, endocrine or salivary glands. It is a highly aggressive type of lymphoma that is usually diagnosed in advanced stages (90% cases), with poor prognosis with a life expectancy of 4 years despite optimal treatment. Current treatment consists of a combination of chemotherapy and immunotherapy.