胆管狭窄を呈したマントル細胞リンパ腫の１例

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  • A CASE OF MANTLE CELL LYMPHOMA PRESENTING WITH STENOSIS OF BILE DUCT

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Mantle cell lymphoma (MCL) accounts for 3-10% of all non-Hodgkin's lymphomas. It is mature Bcell lymphoma often affecting organs outside the lymphatic system, besides lymph nodes. We recently encountered a case of MCL, in which a bile duct tumor was first detected during evaluation for hepatic dysfunction. The definitive diagnosis of MCL was made on the basis of postoperative pathological examination after preoperative cytology and biopsy conducted several times failed to yield the diagnosis.<br> The patient was an 80-year-old man, who consulted a nearby clinic for progressive anorexia. Laboratory examination revealed hepatic dysfunction, and he was referred to our hospital. Abdominal CT scan visualized a mass compressing the inferior vena cava around the pancreatic head and upper bile duct, as well as narrowing of the bile duct. Bile cytology and bile duct biopsy revealed no evidence of malignancy. Percutaneous biopsy under ultrasound guidance also failed to yield the definitive diagnosis. Intraoperative pathological examination of frozen sections also revealed no evidence of malignancy. Therefore, hepaticojejunostomy was performed to treat the bile duct stenosis. The tumor was postoperatively diagnosed as MCL. One course of THP-COP therapy combined with Rituximab resulted in a decrease of the tumor size.

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