[Isolated primary gastric localization of a mantle cell lymphoma].
Primary mantle cell lymphoma of the digestive tract is uncommon; it rarely involves the stomach and generally manifests as a lymphomatous polyposis. Isolated gastric localization is exceedingly rare. We present a case of a 57-year-old man who presented with a six-month history of atypical epigastric pain. Endoscopy revealed a large ulceration of the gastric mucosa. Histological examination of the biopsied specimens concluded to a marginal zone B-cell lymphoma (MALT-type) of low-grade. Patient underwent two courses of anti-Helicobacter pylori therapy followed by chemotherapy, without endoscopic amelioration. Histological control showed the persistence of a nodular lymphomatous proliferation that respects glands. It was made of monotonous small cells reactive with CD5 and cyclin D1. The diagnosis of gastric mantle cell lymphoma was made. No other digestive or nodal localization was found. Patient underwent intensive chemotherapy anti-CD20; he was free of disease three years after diagnosis. Primary mantle cell lymphoma of the stomach is an uncommon neoplasm. Diagnosis is often difficult and requires the use of CD5 to exclude a MALT-cell lymphoma, which is much more frequent in this location.
Bel Haj Salah
Mériam
M
Service d'anatomie et de cytologie pathologiques, hôpital M. Tahar Mâamouri, Nabeul, Tunisie. meriambhs@yahoo.fr
Ben Brahim
Ehsen
E
Zidi
Yosra S H
YS
Tangour
Monia
M
Kilani
Houda
H
Abdelmoula
Selma
S
Chatti-Dey
Samia
S
D018951:Antigens, CD20 / Q000032:analysis; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018956:CD5 Antigens / Q000032:analysis; D002453:Cell Cycle; D005500:Follow-Up Studies; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000473:pathology*; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology*
D018951:Antigens, CD20; D000970:Antineoplastic Agents; D018956:CD5 Antigens