Presentation
4 month history of weight loss. New nausea and vomiting. Positive fecal occult blood test.
Patient Data
Bilateral thoracic paravertebral masses, measuring up to 86 x 40 x 85 mm on the right, and 41 x 14 x 65 mm on the left.
Gastric antral mucosal biopsy
All three specimens (A,B and C) are similar, showing ulcerated mucosa extensively infiltrated by small malignant cells with basophilic nuclei and high N/C ratios. The malignant cells are strongly positive with CD20 and negative for neuroendocrine markers (CD56,synaptophysin and TTF1); confirming the diagnosis of B cell lymphoma. Further immunohistochemical stains show that this is a mantle cell lymphoma.
Case Discussion
Typical features of mantle cell lymphoma, including advanced stage disease at diagnosis, and GI tract involvement.
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