Acute Appendicitis in a Man Undergoing Therapy for Mantle Cell Lymphoma

Abstract

<jats:p>A 71-year-old man was diagnosed with an aggressive mantle cell lymphoma and was started on six cycles of R-CHOP chemotherapy. Approximately two weeks after starting his first cycle of chemotherapy, he complained of severe right lower quadrant abdominal pain, and an abdominal CT scan demonstrated an enlarged appendix with evidence of contained perforation. The man underwent open appendectomy for acute appendicitis and recovered. The appendectomy specimen was submitted for routine pathological analysis. There was histologic evidence of perforation in association with an inflammatory infiltrate with fibrin adhered to the serosal surface; scattered small lymphoid aggregates were present on the mucosal surface. Although the lymphoid aggregates in the submucosa and lamina propria were rather unremarkable by routine histologic examination, immunohistochemistry revealed the lymphocytes to be predominantly Cyclin D1-overexpressing B cells. To our knowledge, this is the first reported case of acute appendicitis in association with appendiceal involvement by mantle cell lymphoma.</jats:p>

Mantle Cell Lymphoma Presenting as Acute Abdominal Syndrome: A Rare Case Report and Literature Review

“…Most appendiceal lymphomas are non-Hodgkin's lymphoma, and the most common histologic type is large B-cell lymphoma, followed by Burkitt lymphoma [9]. Although gastrointestinal lymphoma is the most common form of extranodal lymphoma, patients with mantle cell lymphoma of the appendix are rare, and only a few cases can be found in the literature (Table 2) [10][11][12][13][14][15]. Compared with other B-cell lymphomas, MCLs have poorer long-term survival and earlier relapse even with appropriate therapy.…”

Mantle cell lymphoma presenting as acute appendicitis

“…Being that the number of lymphoma related appendicitis is so few that mostly case reports are found in literature. 1,8,9 How lymphoma causes appendicitis is not known definitively. Case reports show evidences that intravascular tumor invasion leading to ischemia of appendix and subsequently appendicitis or obstruction of appendiceal lumen leading to appendicitis.…”

“…There is only one reported case in the literature of mantle cell lymphoma associated with appendicitis. 8 We are reporting a case of a patient with mantle cell lymphoma before a chemotherapy treatment presenting with acute appendicitis.…”