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A 58-year-old man presen ts with fatigue and weigh t loss over the past 1 month. On physical exam. he has enlarged lymph nodes and splenomegaly. Hemoglobin is 9.3 g/dl. leukocyte count is 1 78.000/,LLL. and platelet count is 85.000/,LLL. Flow cytometry of the peripheral blood reveals expression of CDS . CD 1 9 . and CD 20. and lack of CD23. Cyclin D 1 is positive. The peripheral blood smear is shown below.
What is the most common clinical presentation of mantle cell lymphoma (MCL)?
- Asymptomatic with abnormal blood counts
- Advanced disease with lymphadenopathy
- CNS involvement with meningismus
- Fever, drenching night sweats, and weight loss
Medicine
B. Most patients with MCL lymphoma present at an advanced stage, with lymphadenopa-thy but without B symptoms. Extradodal involvement makes up about 20% to 25% of cases, including the intestine (often as multiple lymphomatous polyposis) and Waldeyer's ring. CNS involvement is rare (Blood. 1 997;89:2067-2078).
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