Linden Michael, Gopal Ajay, Edlefsen Kerstin
Department of Laboratory Medicine and Pathology, University of Minnesota, MMC 806, Minneapolis, MN 55455, USA.
Case Rep Hematol. 2012;2012:868151. doi: 10.1155/2012/868151. Epub 2012 Mar 29.
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.
一名71岁男性被诊断为侵袭性套细胞淋巴瘤，并开始接受六个周期的R-CHOP化疗。在开始第一个化疗周期大约两周后，他主诉右下腹剧痛，腹部CT扫描显示阑尾肿大并有局限性穿孔迹象。该男子因急性阑尾炎接受了开放性阑尾切除术并康复。阑尾切除标本被送去做常规病理分析。组织学证据显示存在穿孔，伴有纤维蛋白附着于浆膜表面的炎性浸润；黏膜表面有散在的小淋巴样聚集物。尽管通过常规组织学检查，黏膜下层和固有层的淋巴样聚集物不太明显，但免疫组化显示淋巴细胞主要是Cyclin D1过表达的B细胞。据我们所知，这是首例报道的急性阑尾炎合并套细胞淋巴瘤累及阑尾的病例。
