Discordant lymphoma characterized by the coexistence of diffuse large B-cell lymphoma in the brain and mantle cell lymphoma in the colon, rectum, and bone marrow.

IF 3 3区医学 Q2 CLINICAL NEUROLOGY Brain Tumor Pathology Pub Date : 2025-04-01 Epub Date: 2025-03-18 DOI:10.1007/s10014-025-00499-y

Kyosuke Yamaguchi, Go Yamamoto, Otoya Watanabe, Kosei Kageyama, Daisuke Kaji, Yuki Taya, Aya Nishida, Kazuya Ishiwata, Shinsuke Takagi, Hisashi Yamamoto, Yuki Asano-Mori, Hironori Uruga, Shinji Ito, Yutaka Takazawa, Atsushi Wake, Naoyuki Uchida, Shuichi Taniguchi

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Abstract

We describe a rare case of discordant lymphoma characterized by the coexistence of diffuse large B-cell lymphoma (DLBCL) in the brain and mantle cell lymphoma (MCL) in the colon, rectum, and bone marrow. A 63-year-old male patient with consciousness impairment and gait disturbance was admitted to our institution. Head computed tomography scan and contrast-enhanced magnetic resonance imaging showed a mass in the right temporal lobe and rectal wall thickening. Brain biopsy revealed DLBCL, and bone marrow and rectum biopsy showed MCL. According to a polymerase chain reaction analysis of immunoglobulin heavy-chain gene rearrangements using brain and bone marrow specimens, the two lesions were clonally unrelated lymphomas. After five cycles of R-MPV (rituximab, methotrexate, procarbazine, vincristine) therapy and three cycles of R-ESHAP (rituximab, etoposide, cytarabine, cisplatin, methylprednisolone) therapy, the patient received autologous hematopoietic stem cell transplantation using R-MEAM (rituximab, ranimustine, etoposide, cytarabine, melphalan) regimen after bridging therapy with ibrutinib. In addition, he received whole-brain irradiation at a dose of 40 Gy in 20 fractions as consolidation therapy. He did not relapse within 3 years of transplantation. To the best of our knowledge, this is the first case report of DLBCL and MCL coexistence.

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不协调性淋巴瘤以脑弥漫性大b细胞淋巴瘤和结肠、直肠和骨髓套细胞淋巴瘤共存为特征。

我们报告一例罕见的不协调性淋巴瘤，其特征是脑弥漫大b细胞淋巴瘤（DLBCL）和结肠、直肠和骨髓套细胞淋巴瘤（MCL）共存。我院收治一位63岁男性患者，伴有意识障碍和步态障碍。头部计算机断层扫描和磁共振增强成像显示右侧颞叶肿块和直肠壁增厚。脑活检显示DLBCL，骨髓和直肠活检显示MCL。根据免疫球蛋白重链基因重排的聚合酶链反应分析，使用大脑和骨髓标本，这两个病变是克隆无关的淋巴瘤。患者接受5个周期的R-MPV（利妥昔单抗、甲氨蝶呤、丙卡嗪、长春新碱）治疗和3个周期的R-ESHAP（利妥昔单抗、依托泊苷、阿糖胞苷、顺铂、甲基强龙）治疗后，在伊鲁替尼桥接治疗后，采用R-MEAM（利妥昔单抗、雷莫司汀、依托泊苷、阿糖胞苷、melphalan）方案接受自体造血干细胞移植。此外，他接受了20次40gy剂量的全脑照射作为巩固治疗。移植后3年内无复发。据我们所知，这是首例DLBCL和MCL共存的病例报告。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain Tumor Pathology 医学-病理学

CiteScore

5.40

自引率

9.10%

发文量

审稿时长

>12 weeks

期刊介绍： Brain Tumor Pathology is the official journal of the Japan Society of Brain Tumor Pathology. This international journal documents the latest research and topical debate in all clinical and experimental fields relating to brain tumors, especially brain tumor pathology. The journal has been published since 1983 and has been recognized worldwide as a unique journal of high quality. The journal welcomes the submission of manuscripts from any country. Membership in the society is not a prerequisite for submission. The journal publishes original articles, case reports, rapid short communications, instructional lectures, review articles, letters to the editor, and topics.Review articles and Topics may be recommended at the annual meeting of the Japan Society of Brain Tumor Pathology. All contributions should be aimed at promoting international scientific collaboration.