Lymphomatous polyp of mantle cell type in the duodenum complicated by gastric cancer: a case of trisomy 3 and t(11;14)(q13;q32).
We experienced a rare case of a lymphomatous polyp of mantle cell type forming a polypoid mass lesion in the duodenum bulbous together with advanced gastric cancer. A total gastrectomy was performed, and the specimen revealed atypical small- to medium-sized lymphoid cells with indented nuclei, which infiltrated the Peyer's patch and formed a nodular mass in the lamina propria and submucosa of the duodenum. The lymphoma cells also infiltrated the lymphoid follicle of the gastric mucosa, spleen, and regional lymph node with a typical mantle zone pattern. Flow cytometric analysis of the single cells of the lymph node and immunohistochemistry of a paraffin-embedded specimen revealed that the lymphoma cells expressed surface CD5, CD19, CD20, and nuclear cyclin D1. Chromosomal analysis of this single cell suspension revealed that these lymphoma cells have trisomy 3 in conjunction with t(11;14)(q13;q32), which is frequently seen in mucosa-associated lymphoid tissue lymphomas (MALToma) in the stomach and is also reported in mantle cell lymphoma as a secondary genetic alteration. Our report suggests that trisomy 3 may be a common chromosomal abnormality in lymphomatous polyps of mantle cell type.
Tsuchiyama
J
J
First Department of Internal Medicine, Niigata University School of Medicine, Asahimachi 1-754, 951, Japan. j-tutti@nifty.com
Yoshino
T
T
Imajo
K
K
Kondou
E
E
Hamada
E
E
Tomiyama
Y
Y
Toba
K
K
Furukawa
T
T
Fuse
I
I
Aizawa
Y
Y
Harada
M
M
Tsubota
T
T
D000230:Adenocarcinoma / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D002880:Chromosomes, Human, Pair 11; D002883:Chromosomes, Human, Pair 14; D002893:Chromosomes, Human, Pair 3; D002999:Clone Cells / Q000276:immunology / Q000473:pathology; D020732:Cytogenetic Analysis; D004379:Duodenal Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D006801:Humans; D016130:Immunophenotyping; D007417:Intestinal Polyps / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D014178:Translocation, Genetic; D014314:Trisomy