Mantle cell lymphoma of the gastrointestinal tract presenting with multiple intussusceptions--case report and review of literature.

BACKGROUND: Mantle cell lymphoma (MCL) is an aggressive type of B-cell non-Hodgkin's lymphoma that originates from small to medium sized lymphocytes located in the mantle zone of the lymph node. Extra nodal involvement is present in the majority of cases, with a peculiar tendency to invade the gastro-intestinal tract in the form of multiple lymphomatous polyposis. MCL can be accurately diagnosed with the use of the highly specific marker Cyclin D1. Few cases of mantle cell lymphoma presenting with intussuception have been reported. Here we present a rare case of multiple intussusceptions caused by mantle cell lymphoma and review the literature of this disease. CASE PRESENTATION: A 68-year-old male presented with pain, tenderness in the right lower abdomen, associated with nausea and non-bilious vomiting. CT scan of abdomen revealed ileo-colic intussusception. Laparoscopy confirmed multiple intussusceptions involving ileo-colic and ileo-ileal segments of gastrointestinal tract. A laparoscopically assisted right hemicolectomy and extended ileal resection was performed. Postoperative recovery was uneventful. The histology and immuno-histochemistry of the excised small and large bowel revealed mantle cell lymphoma with multiple lymphomatous polyposis and positivity to Cyclin D1 marker. The patient was successfully treated with Rituximab-CHOP chemotherapy and remains in complete remission at one-year follow-up. CONCLUSION: This is a rare case of intestinal lymphomatous polyposis due to mantle cell lymphoma presenting with multiple small bowel intussusceptions. Our case highlights laparoscopic-assisted bowel resection as a potential and feasible option in the multi-disciplinary treatment of mantle cell lymphoma.

Primary clear cell ductal adenocarcinoma of the pancreas: a case report and clinicopathologic literature review.

We present a very rare, interesting case of a carcinoma of the pancreas with predominantly abundant clear cell morphology. According to the WHO classification, primary clear cell carcinoma of the pancreas is classified as a rare "miscellaneous" carcinoma. The tumor was observed in the distal body and tail of the pancreas of a 74-year-old woman. The histopathology of tumor cells showed well-defined cell membranes, clear cytoplasm, and prominent cell boundaries. Immunohistochemical (IHC) staining showed positive reactions to antibodies against vimentin, cytokeratin 7 (CK-7), mucicarmine (MUC-1), periodic acid-Schiff (PAS), periodic acid-Schiff with diastase (PASD), carcinoembryonic antigen (CEA), and Carbohydrate Antigen 19-9 (CA 19-9). On the other hand, IHC staining was negative for alpha-fetoprotein (AFP), cytokeratin 20 (CK-20), HMB45, chromogranin, and synaptophysin. The patient was subsequently diagnosed with a primary solid-type pancreatic clear cell carcinoma with hepatic metastasis. Herein, we report this rare case and include a review of the current literature of this tumor.

An unusual location of a papillary fibroelastoma.

Papillary fibroelastomas are benign, avascular tumors and 90 % of them are attached to the cardiac valves. We present an unusual case, where papillary fibroelastoma was found attached to the interventricular septum, flopping in and out of the left ventricular outflow tract.

Case report and literature review: acute pneumonitis and alveolar hemorrhage after subcutaneous injection of liquid silicone.

Lay (non-medical) injection of silicone may lead to serious clinical consequences. Most reports of illicit cosmetic procedures have dealt with failed, lay attempts at breast augmentation. Although these procedures have resulted in severe pneumonitis and alveolar hemorrhage, reports of similar complication after lay attempts at buttock augmentation have been sparse. We describe one of these rare cases and review the literature on clinicopathologic sequelae of lay attempts at cosmetic procedures using commercially available silicone preparations.