Mantle Cell Lymphoma Mimicking as Irreducible Inguinal Hernia – A Rare Case Report
Life Sciences -General surgery
DOI:
https://doi.org/10.22376/ijlpr.2023.13.4.L130-L136Keywords:
Mantle cell lymphoma, irreducible inguinal hernia, hodgkin’s lymphoma, non-hodgkin’s lymphoma, immunohistochemistry.Abstract
Lymphomas are malignant neoplasms originating from bone marrow and lymphatic structures resulting in the proliferation of lymphocytes. It is divided into Hodgkin’s and Non-Hodgkin’s lymphoma. Among Non-Hodgkin’s lymphoma, diffuse large B cell type is the most common, and the follicular variant is next. Mantle cell lymphoma (MCL) is one of the least common varieties of Non-Hodgkin’s lymphoma. It is a case of mantle cell lymphoma presented as an irreducible inguinal hernia. This case report aims to tell us that when it comes to inguinal hernias, most of them do not concentrate on general examination. In this case, it's clear that even if a patient present with an inguinal hernia, it is mandatory to rule out other common clinical findings to prevent misdiagnosis. Even though previous similar cases described were of lymphomas identified in the hernia sac along with the hernia component, it is the first report of mantle cell lymphoma, which presented as an inguinal swelling mimicking an irreducible inguinal hernia. This 72-year male patient, a farmer by occupation, complained of swelling and pain over the right groin. On examination, we found multiple enlarged inguinal lymph nodes raised the suspicion of lymphoma. We proceeded with a CT abdomen and chest, followed by surgery, and mantle cell lymphoma was diagnosed after immunohistochemistry results. The patient was referred for chemotherapy, and a long-term follow-up was done. The patient was doing good. Furthermore, it highlights the significance of the role played by surgeons in screening by sending only macroscopically unusual specimens for microscopic analysis. Here, we present a case of primary non-lymphoma Hodgkin's of the sigmoid colon that manifested as an inguinal hernia that was completely irreducible.
References
Lenz G, Dreyling M, Hiddemann W. Mantle cell lymphoma: established therapeutic options and future directions. Ann Hematol. 2004;83(2):71-7. doi: 10.1007/s00277-003-0774-2, PMID 14669040.
Sen F, Medeiros LJ, Lu D, Jones D, Lai R, Katz R, et al. Mantle cell lymphoma involving skin: cutaneous lesions may be the disease's first manifestation, and tumors often have blastoid cytologic features. Am J Surg Pathol. 2002;26(10):1312-8. doi: 10.1097/00000478-200210000-00008, Medline. PMID 12360046, Google Scholar.
Avcı T, Yabanoğlu H, Arer İM, Koçer NE, Çalışkan K, Börcek P et al. Primary small intestinal non-Hodgkin lymphoma diagnosed after emergency surgery. Ulus Travma Acil Cerrahi Derg. 2017;23(2):128-33. doi 10.5505/tjtes.2016.02359, PMID 28467579.
Nicholson CP, Donohue JH, Thompson GB, Lewis JE. A study of metastatic cancer found during inguinal hernia repair. Cancer. 1992;69(12):3008-11. doi: 10.1002/1097-0142(19920615)69:12<3008::aid-cncr2820691224>3.0.co;2-8, PMID 1591694.
Yoell JH. Surprises in hernial sacs; diagnosis of tumors by microscopic examination. Calif Med. 1959;91(3):146-8. PMID 13846556.
Chen KT. Metastatic carcinoma in inguinal hernia sac. J Surg Oncol. 1984;25(4):248-9. doi 10.1002/jso.2930250405, PMID 6717021.
Møller MB. Non-Hodgkin’s lymphoma of the spermatic cord. Acta Haematol. 1994;91(2):70-2. doi: 10.1159/000204256, PMID 8023646.
Kinet S, Kuppens EFP, Maes H, Van Cleven S, De Paepe P, Van Droogenbroeck J. Diffuse large B-cell lymphoma presenting as an inguinal hernia - a case report. Acta Chir Belg. 2022:1-4. doi: 10.1080/00015458.2022.2122320, PMID 36069512.
Saha TK, Hakim HN, Banik SK, Haque MR, Chowdhury TN, Talukder MT. Non-Hodgkins Lymphoma In Herniated Sigmoid Colon Presenting as Irreducible Left-Sided Inguinal Hernia A Case Report And Review of Literature. J Dhaka Med Coll. 2015;24(1):73-5. doi: 10.3329/jdmc.v24i1.29568.
Tan A, Taylor G, Ahmed T. Perforated sigmoid colon carcinoma in an irreducible inguinoscrotal hernia. Ann R Coll Surg Engl. 2013;95(7):125-6. doi: 10.1308/003588413X13629960047911, PMID 24112486.
Zentar A, Tijani Y, Elkaoui H, Elghanmi J, Sair K, Taberkant M et al. Small bowel schwannoma revealed during an inguinal hernia: a case report. J Med Case Rep. 2014;8:287. doi: 10.1186/1752-1947-8-287, PMID 25159340.
Ninos A, Douridas G, Liapi G, Ajazi E, Iordanou C, Pierrakakis S et al. Schwannoma in the inguinal canal masquerading an inguinal hernia. Hernia. 2004;8(1):73-5. doi: 10.1007/s10029-003-0146-9, PMID 14505234.
Matsumoto G, Ise H, Inoue H, Ogawa H, Suzuki N, Matsuno S. Metastatic colon carcinoma found within an inguinal hernia sac: report of a case. Surg Today. 2000;30(1):74-7. doi: 10.1007/PL00010052, PMID 10648089.
Slater R, Amatya U, Shorthouse AJ. Colonic carcinoma presenting as strangulated inguinal hernia: report of two cases and literature review. Tech Coloproctol. 2008;12(3):255-8. doi: 10.1007/s10151-008-0388-0, PMID 18798013.
G.A. Nunes. P. Sequeira, and V. Fernandes, “Mantle cell lymphoma of the cecum,” Revista Española de Enfermedades Digestivas, vol. 111, 2019.
Smith BM, Reilly K, Baker E, Deeken A, Dan AG. A case report of mantle cell lymphoma presenting as intussusception colon mass. Int J Surg Case Rep. 2020;69:28-31. doi: 10.1016/j.ijscr.2020.03.022, PMID 32248013.
Herrera-Gonzalez S, Shamoon D, Shen Tingliang, Badin S, Bains Y. A unique case of mantle cell lymphoma masquerading as a cecal mass. Case Rep Gastrointest Med. 2021;2021:Article ID 5581043. doi: 10.1155/2021/5581043, PMID 34545312.
Chinen Y, Tsukamoto T, Maegawa-Matsui S, Matsumura-Kimoto Y, Takimoto-Shimomura T, Tanba K; et al. Tumor-specific transcript variants of cyclin D1 in mantle cell lymphoma and multiple myeloma with chromosome 11q13 abnormalities. Exp Hematol. 2020;84:45-53.e1. doi 10.1016/j.exphem.2020.02.004, PMID 32145384.
US Department of Health and Human Services, Center for Disease Control and Prevention, National Center for Health Statistics, author. Health, United States 2007 with Chartbook on trends in the health of Americans; 2007. p. 366-7. Google Scholar.
Vega F, Medeiros LJ, Abruzzo LV. Primary para testicular lymphoma: a report of 2 cases and literature review. Arch Pathol Lab Med. 2001;125(3):428-32. doi: 10.5858/2001-125-0428-PPL, PMID 11231498, Google Scholar.
Zighelboim J, Larson MV. Primary colonic lymphoma. Clinical presentation, histopathologic features, and outcome with combination chemotherapy. J Clin Gastroenterol. 1994;18(4):291-7. doi: 10.1097/00004836-199406000-00007, PMID 8071513.
Tondini C, Giardini R, Bozzetti F, Valagussa P, Santoro A, Bertulli R, et al. Combined modality treatment for primary gastrointestinal non-Hodgkin’s lymphoma: the Milan Cancer Institute experience. Ann Oncol. 1993;4(10):831-7. doi 10.1093/oxford journals. Announced.a058388, PMID 8117602.
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