We present a 66-year-old patient complaining for a 2-month history of odinodysphagia. The physical examination showed a hypertrophic palatal tonsil hardened by palpation, a neoplastic lesion in the cavum, and a level II-B palpable left laterocervical adenopathy. Cavum and amygda- la biopsy was performed with...
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Afectacion Muscular Y Subcutanea En Miembros Inferiores Por Linfoma De Celulas Del Manto: Hallazgos En Imagenes PET-TC
1. AnnalsofClinicalandMedical ISSN 2639-8109
CaseReports Clinical Image
Afectacion Muscular Y Subcutanea En Miembros Inferiores Por
LinfomaDeCelulasDelManto:HallazgosEnImagenesPET-TC
Daniel GJA, Carlos RF*, María LRJ, Mahsa R and Manuel LEJ
Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Spain
1. Clinical Image
We present a 66-year-old patient complaining for a 2-month history of odinodysphagia. The
physical examination showed a hypertrophic palatal tonsil hardened by palpation, a neoplastic
lesion in the cavum, and a level II-B palpable left laterocervical adenopathy. Cavum and amygda-
la biopsy was performed with histological results of Mantle Cell Lymphoma B, positive for DC21,
CD23, B markers (CD20, Pax5), bcl2, cyclin D1; weakly positive for CD43 and CD5 and negative
for CD10, PD-1, with a Ki67 of 20%.
18F-FDG PET-CT study was requested for initial staging, interim and after finishing chemothe-
rapy treatment (CHOP-Rituximab), which showed a complete metabolic response (Figure 1),
proceeding to a consolidation treatment by autologous hematopoietic cellstransplantation.
After 9 months, on physical examination, inguinal adenopathies were palpated. New 18F-FDG
PET-CT was performed, including lower limbs, since the patient reported pain in the lower limbs
(Figure 2), which was pathological with multiple cutaneous-subcutaneous and muscular lesions.
Skin biopsy of one of lesions described on PET-CT was obtained. The result was lymphoid neo-
plasm with positive cells for B markers (CD20, Pax5), bcl2, cyclin D1, weakly positive for CD5
and negative for CD10, CD138 and CD23, with a Ki67 of 80% that confirmed infiltration by
Mantle lymphoma. The patient is currently under treatment with GEMOX (Gemcitabine-Oxa-
liplatin).
Mantle cell lymphoma is a rare lymphoid neoplasm (5-7% of all lymphomas). It is characterized
by translocation t (11; 14) (q13; q32), positivity for CD5, CD19 / 20 and overexpression of cyclin
D1 [1]. Manifesting clinically with adenopathic involvement (75%) and less frequently extrano-
dal (peripheral blood, bone marrow and gastrointestinal) [2], being the involvement of muscle
and cutaneous tissue unusual [3].
This case illustrates the usefulness of PET-CT as a diagnostic tool for staging, response assess-
ment, relapse and biopsy guidance, as well as in the need of in clinically suspicion, direct or
expand the anatomical territory of exploration of the PET-CT study, which in a habitual protocol
would be limited to pelvicterritoryes.
*Corresponding Author (s): Ramos-Font Carlos, Servicio de Medicina Nuclear, Hospital Uni-
versitario Virgen de las Nieves, Avenida de las Fuerzas Armadas 2 18014, Granada, Spain, Citation: Carlos RF, Afectacion Muscular Y Subcutanea En Miembros Inferiores Por Linfoma De Celulas
Tele: +34-958020580, E-mail: carlos.ramos.font.sspa@juntadeandalucia
http://www.acmcasereport.com/
Del Manto: Hallazgos En Imagenes PET-TC. Annals of Clinical and Medical Case Reports. 2020; 3(4): 1-3.
Volume 3 Issue 4- 2020
Received Date: 08 Mar 2020
Accepted Date: 28 Mar 2020
Published Date: 31 Mar 2020