PRIMARY MANTLE CELL LYMPHOMA OF GASTROINTESTINAL TRACT- A CASE REPORT

Mantle cell lymphoma (MCL) represents a relatively rare type of mature B cell neoplasm, which arrises from the CD5+ cells of the mantle zone of lymph follicles. It often has the extranodal or leukemic presentation. It is characterized by the relative insensitivity to applied chemotherapy and high relapse rate after treatment. Median survival is about 3-4 years, and highly aggressive protocols may shift the median up to 5 years. Our patient was a typical example of the natural biological course of MCL. A male patient, 57 years old, was admitted to the Clinic for Oncology CC Nis, after he was diagnozed with primary mantle cell lymphoma of the digestive tract in the form of multiple lymphomatouos polyposis (MLP) of the colon and small intestine. After the colonoscopic biopsies, he was diagnosed with MCL. This case was regarded as advanced stage of lymphoma, with low MIPI index. He received 8 cycles of immunochemotherapy CHOP+Rituximab with excellent clinical response determined as complete remission (CR). After disease-free interval of two years, a relapse occurred in the stomach, which was histopathologically verified. MCL is still a disease with poor prognosis. Therapeutic approach, given the poor prognosis and resistance to conventional immunochemiotherapy and even high dose therapy followed by the autologuos stem cell transplantation, still remains insufficiently defined. Newer therapeutic agents which are found in a large number of clinical trials provide relatively encouraging results.