Composite Mantle Cell Lymphoma and Gray Zone Lymphoma in Two Different Anatomical Locations

Abstract

Mantle cell lymphoma has been rarely found in composite form together with Hodgkin or non-Hodgkin lymphomas. A 69-year-old male patient presented with lumbal pain, cervical and axillary lymphadenopathy. Magnetic resonance imaging showed a tumor on T3/T4 extending to epidural region. Neurosurgical tumor excision was performed and the specimen along with a left axillary lymph node was sent for histologic examination, which showed infiltration of both specimens with neoplastic population, having morphologic and immunophenotypic characteristics of mantle cell lymphoma. Larger cells with morphological and immunohistochemical features of Hodgkin and Reed-Sternberg cells were also apparent, distributed diffusely among neoplastic mantle cells. Polymerase chain reaction analysis revealed IGH monoclonality. On fluorescent in situ hybridization investigation, translocation t(11;14) was detected. The interesting of this case rests in the presence of double neoplastic population in two different anatomical locations. The question raising in similar cases is whether this coexistence is coincidental or it is due to a clonal relationship. B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma can be found in any site.




J Med Cases. 2014;5(4):241-244
doi: http://dx.doi.org/10.14740/jmc1718w