title: A rare presentation of in situ mantle cell lymphoma and follicular lymphoma: a case report and review of the literature.
abstract: A 65-year-old gentleman presented with left groin swelling over the course of two months. Physical exam revealed nontender left inguinal adenopathy, and computed tomography scans detected multiple lymph nodes in the mesenteric, aortocaval, and right common iliac regions. An excisional lymph node biopsy was performed. Pathologic evaluation demonstrated follicular center site which stained positive for PAX5, CD20, CD10, Bcl-2, Bcl-6, and mantle zone cells. These findings demonstrated CCND1 and CD5 positivity, suggesting composite lymphoma comprising follicular lymphoma (FL) with in situ mantle cell lymphoma (MCLIS). FL is known as indolent non-Hodgkin lymphoma; however, the clinical significance of a coexisting MCLIS continues to be elusive, and optimal management of these patients remains largely unknown. This case illustrates the diagnostic and therapeutic challenges of composite lymphomas. This paper also discusses advances in molecular pathogenesis and lymphoma genomics which offer novel insights into these rare diseases.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, University of Arizona Cancer Center, University of Arizona, USA.
authors.forename: Josephine
authors.identifier: 0000-0002-9191-9412
authors.initials: J
authors.lastname: Taverna
authors.affiliation: Department of Medicine, University of Arizona, USA.
authors.forename: Anju
authors.initials: A
authors.lastname: Nair
authors.affiliation: Department of Medicine, University of Arizona, USA.
authors.forename: Seongseok
authors.identifier: 0000-0001-7343-1635
authors.initials: S
authors.lastname: Yun
authors.affiliation: Department of Pathology, University of Arizona, USA.
authors.forename: Spencer
authors.initials: S
authors.lastname: Paulson
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, University of Arizona Cancer Center, University of Arizona, USA.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Schatz
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, University of Arizona Cancer Center, University of Arizona, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Persky
authors.affiliation: Department of Pathology, University of Arizona, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Fuchs
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, University of Arizona Cancer Center, University of Arizona, USA.
authors.forename: Soham
authors.initials: S
authors.lastname: Puvvada