ONCAlert | 2018 SGO Annual Meeting on Women’s Cancer
Wang Mcl Landscape Case Studies

Case Studies: The Evolving Landscape of Mantle Cell Lymphoma

Expert Michael L. Wang, MD, discusses the case of a 55-year-old male diagnosed with mantle cell lymphoma, including disease background, prognosis, and various therapy approaches.

The Evolving Landscape of Mantle Cell Lymphoma

March 2013

  • A 55-year-old male presents to his physician complaining of fatigue, unexplained weight loss, and neck swelling
  • PMH: unremarkable
  • Physical exam:
    • Bilateral cervical lymphadenopathy
  • Laboratory findings:
    • Leukocytes, 9.0 X 109/L
    • Hb, 9.8 g/dL
    • LDH, 520 U/L
    • Beta2-microglobulin; 6.4 mg/L
    • AST, 167 U/L; ALT 202 U/L
  • Excisional biopsy of the right cervical node:
    • Immunophenotyping: IgM+, CD5+, CD10-, CD19+, CD20+, CD22+, CD23-, cyclin D1+
    • Cytogenetics: t(11;14)(q13;q32)
  • CT imaging of the neck, chest, abdomen, pelvis: marked 18F-FDG uptake and enlargement of bilateral cervical lymph nodes (right, 4.6 cm; left, 3.1 cm) and mesenteric lymph node (9.2 cm)
  • Diagnosis: Mantle-cell lymphoma, Ann Arbor stage III
  • The patient was started on induction therapy with R-hyper-CVAD and achieved significant reduction in tumor burden
  • Consolidation with autologous stem cell transplant resulted in complete remission

March 2017

  • The patient reports having symptoms of fatigue and weight loss
  • PET/CT shows diffuse uptake of 18F-FDG in the right lung and mediastinal lymph nodes
  • The patient was started on therapy with ibrutinib
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