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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
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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
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Journal Article
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
2025
Overview
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.
Publisher
Springer Nature Singapore,Springer Nature B.V
Subject
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
/ Biopsy
/ Bone Marrow Neoplasms - pathology
/ Bone Marrow Neoplasms - therapy
/ Colon
/ Colonic Neoplasms - pathology
/ Edema
/ Hematopoietic Stem Cell Transplantation
/ Humans
/ Lymphoma
/ Lymphoma, Large B-Cell, Diffuse - diagnosis
/ Lymphoma, Large B-Cell, Diffuse - pathology
/ Lymphoma, Large B-Cell, Diffuse - therapy
/ Lymphoma, Mantle-Cell - diagnosis
/ Lymphoma, Mantle-Cell - pathology
/ Lymphoma, Mantle-Cell - therapy
/ Male
/ Medicine
/ Oncology
/ Rectal Neoplasms - pathology
/ Rectum
