Korean J Gastroenterol.  2012 Jul;60(1):56-60. 10.4166/kjg.2012.60.1.56.

A Case of Mantle Cell Lymphoma with Meningioma

• Kim ES
• Goh PG
• Kim YJ
• Lee SY
• Moon HS
• Sung JK
• Lee BS
• Jeong HY

• KMID: 1718468
• DOI: http://doi.org/10.4166/kjg.2012.60.1.56

Abstract

Mantle cell lymphoma (MCL) is an uncommon type of gastrointestinal lymphoma. MCL is a distinct subtype of B-cell non-Hodgkin lymphomas. The major subtype of MCL is characterized by the presence of multiple lymphomatous polyposis (MLP), in which multiple polyps are observed along the gastrointestinal tract. The malignant cells express pan B-cell marker and the T-cell marker cluster of differentiation 5. The chromosomal translocation t(11;14)(q13;q32) that causes cyclin D1 overexpression is commonly observed on the cytogenetic analysis of MCL. Survival improvement has recently been achieved for patient with MCL by the successful introduction of monoclonal antibodies and dose-intensified approaches for treatment, including autologous stem cell transplantation strategies. Some reports suggest that there is an increased incidence of second malignancies in patients with MCL or lymphoma. We report a case of MCL involving the colon; the patient was a 60-year-old man who complained of low abdominal discomfort during defecation. During the workup, a meningioma was unexpectedly discovered. On analysis, the tumor was found to be a t(11;14)-negative and non-MLP-type MCL.

Keyword

Lymphoma, Mantle cell; Lymphoma, Non-Hodgkin; Meningioma

MeSH Terms

Chromosomes, Human, Pair 11
Chromosomes, Human, Pair 14
Cyclin D1/metabolism
Humans
Lymphoma, Mantle-Cell/*diagnosis/genetics/metabolism
Magnetic Resonance Imaging
Male
Meningeal Neoplasms/complications/*diagnosis/pathology
Meningioma/complications/*diagnosis/pathology
Middle Aged
Positron-Emission Tomography
Translocation, Genetic

Figure

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  Fig. 1 Endoscopic findings. Inflammatory mucosal changes were noted in the entire large intestine, especially in the rectum. Polypectomy was performed in the rectal region.

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  Fig. 2 Microscopic findings (H&E). Neoplastic cells had infiltrated the lamina propria of the colon (A, ×40). Intraepithelial B lymphocytes were forming the lymphoepithelium. The tumor cells were small-to-medium sized (B, ×200).

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  Fig. 3 Immunohistochemical staining. Tumore cells were strongly positive for CD20 and exhibit CD5 coexpression (A, ×200). Weak staining was observed for cyclin D1 in the nuclei of the tumor cells (B, ×200).

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  Fig. 4 PET image showed multiple hypermetabolic lesions in lymph nodes in the entire body, splenomegaly, and colon of terminal ileum, cecum, and rectum.

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  Fig. 5 T2-weighted brain MRI scan showed an approximately 2.6×2.5×1.7 cm meningioma in the right cerebellar convexity.

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