Journal of

Case Reports and Images in Pathology

 
     
Case Report
 
Synchronous presentation of mantle cell lymphoma and plasma cell dyscrasia: A case report
Galani K.S.1, Gadage V.S.2, Deshmukh Mahesh3, Menon S.4, Gujral S.5
1Consultant Pathologist, SRL Diagnostics.
2Conultant Pathologist, Sahyadri hospital.
3Consultant Pathologist, RST Cancer Hospital.
4Assistant Pathologist, Tata Memorial Hospital.
5Professor, Tata Memorial Hospital.

Article ID: 100009Z11GS2016
doi:10.5348/Z11-2016-9-CR-5

Address correspondence to:
Dr. Komal Galani
Consultant Pathologist, SRL Ltd, Safalya
3 rd floor, Near KRIMS Hospital
Ramdaspeth, Nagpur
India-440010

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How to cite this article:
Galani KS, Gadage VS, Mahesh D, Menon S, Gujral S. Synchronous presentation of mantle cell lymphoma and plasma cell dyscrasia: A case report. J Case Rep Images Pathol 2016;2:20–24.


Abstract
Introduction: The coexistence of non-Hodgkin lymphomas (NHL) with plasmacytoma or multiple myeloma (MM) at same anatomical location is reported only as a few case reports.
Case Report: We report a case of 63-year-old male who presented with nasal obstruction and bilateral cervical and right axillary lymphadenopathy of three months duration. Biopsy from nasal mass revealed diffuse infiltration by atypical lymphoid cells which expressed LCA, CD20, CD5 and cyclin D1 on immunohistochemistry. A diagnosis of extranodal mantle cell lymphoma was rendered. A staging bone marrow aspirate revealed an increase in atypical lymphoid cells and morphologically atypical plasma cells, consisting 15% and 20% of the nucleated non-erythroid cells respectively. The bone marrow biopsy showed small paratrabecular and interstitial nodular aggregates of atypical lymphoid cells which were highlighted by CD20, CD5 and cyclin D1. In addition, CD138 highlighted an interstitial increase in plasma cells which also demonstrated an aberrant expression of CD56 and cyclin D1. This proved the coexistence of mantle cell lymphoma and plasma cell dyscrasia, which is worth reporting.
Conclusion: This study clearly demonstrates the unique existence of mantle cell lymphoma (MCL) with plasma cell dyscrasia based on careful morphologic evaluation and a panel of immunostains. A molecular approach to analyze the clonal relationship between the two populations is needed to exclude a composite lymphoma and allow for appropriate treatment.

Keywords: Cyclin D1, Mantle cell lymphoma, Plasma cell dyscrasia, Synchronous


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Author Contributions
Komal S. Galani – Acquisition of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Vijaya S. Gadage – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Mahesh K. Deshmukh – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Santosh Menon – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Sumeet Gujral – Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Komal S. Galani et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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