A Rare Case of Severe Lactic Acidosis in a Patient With Mantle Cell Lymphoma

Abstract

Lactic acidosis is an extremely rare paraneoplastic manifestation of hematological malignancies, and often carries an extremely poor prognosis. Mantle cell lymphoma is an aggressive and rare form of non-Hodgkin lymphoma. To the best of our knowledge, it is extremely rare to have severe lactic acidosis in patients with mantle cell lymphoma. In this article, we are reporting a rare case of mantle cell lymphoma diagnosed with typical cluster differentiation (CD markers) in bone marrow examination with persistent lactic acidosis refractory to intravenous hydration that responded well to chemotherapy. Malignant lactic acidosis is a medical emergency that needs rapid evaluation and identification that shows improved prognosis after the introduction of chemotherapy.

Relapsed mantle cell lymphoma presenting with lactic acidosis and hypoglycemia: A case report

“…12 Mantle cell lymphoma presenting with concurrent lactic acidosis is only described four times in the literature. [13][14][15][16] A 2009 review of lactic acidosis in lymphoma patients detailed 29 cases, of which only 7 patients went into partial or full remission. 3 It is important to note, however, that of these 29 patients, most had features of systemic inflammatory response, and it is therefore difficult to define the exact etiology of the lactic acidosis.…”

“…Lactic acidosis is an under‐recognized presentation of lymphoma; however, it is well recognized that lactic acidosis is a very poor prognostic marker in cancer patients, with a reported mortality of 80% 12 . Mantle cell lymphoma presenting with concurrent lactic acidosis is only described four times in the literature 13‐16 . A 2009 review of lactic acidosis in lymphoma patients detailed 29 cases, of which only 7 patients went into partial or full remission 3 .…”

Type B Lactic Acidosis in a Patient with Mantle Cell Lymphoma

“…There are very few reported cases of MCL associated with type B lactic acidosis [ 14 , 33 – 36 ]. We have described a case of successfully treated type B lactic acidosis in a patient with MCL.…”

“…Mantle cell lymphoma (MCL) is a rare and aggressive form of B-cell non-Hodgkin's lymphoma. It is rarely associated with type B lactic acidosis via the Warburg effect [ 14 ]. Here, we present a case of successfully treated type B lactic acidosis in a patient with recently diagnosed MCL.…”

Paraneoplastic syndrome in malignant lymphoma: A case report

“…The growth and proliferation of lymphoma and distant metastases can cause haematological and biochemical changes in the body as well as disturbances in the water-electrolyte balance. Hypercalcaemia and lactic acidosis associated with haematological malignancies can be seen in aggressive lymphomas [ 3 ]. Reports of diffuse large B-cell lymphoma with hypercalcaemia and lactic acidosis as the first manifestation are rare.…”