Spontaneous tumor lysis syndrome in hyperaggressive mantle cell lymphoma

[摘要] An otherwise well 61-year-old male presented to his primary carepractitioner with drenching sweats, weight loss, massive splenomegaly(30 cm as measured by computed tomography [CT], Figure 1A) and alymphocytosis (white blood cell [WBC] at diagnosis 150 × 109/L). Theperipheral smear was notable for the presence of pleomorphic abnormal lymphocytes, with clumped chromatin, high nuclear:cytoplasmratio and irregular nuclei (Figure 1B). Peripheral blood flow cytometry revealed a kappa light chain restricted population of mature B-cellswhich co-expressed CD20 and CD5 (Figure 1C). CD23 and CD10were negative. Fluorescent in situ hybridization revealed a CCND1/IGHrearrangement, consistent with a diagnosis of advanced stage mantlecell lymphoma (MCL). Approximately 3 weeks after diagnosis, he wasadmitted electively for chemotherapy.