Spontaneous Regression Of Mantle Cell Lymphoma: A Report Of Four Cases
Ye, H., Desai, A., Gong, T., Zeng, D., Nomie, K., Chen, W., Wang, W., Romaguera, J., & Wang, M. L. (2018). Spontaneous regression of mantle cell lymphoma: a report of four cases. Cancer communications (London, England), 38(1), 30. https://doi.org/10.1186/s40880-018-0306-z
View Original Source →Abstract
BACKGROUND: Spontaneous regression has been reported in some indolent forms of lymphoma. Mantle cell lymphoma (MCL) is an aggressive lymphoid neoplasm and has a poor prognosis. However, approximately 30% of MCL patients can exhibit indolent clinical behavior. To date, complete spontaneous regression of MCL has not been reported. CASE PRESENTATION: We describe four cases of spontaneous regression of MCL. At the time of presentation, these patients were asymptomatic, with lymph node enlargement and mild to moderate fluorodeoxyglucose (FDG) uptake on FDG-positron emission tomography combined with computed tomography. One of the possible mechanisms of spontaneous regression of the tumor could be due to the host immune response through humoral and cellular immunity, which may have a role in the clearance of tumor cells. CONCLUSIONS: In this report, we support the use of a "wait and watch" strategy for MCL patients with no risk factors and indolent behavior. This strategy helps spare patients from further potentially harmful chemotherapy. In addition, we describe the phenomenon of spontaneous regression in MCL patients who are asymptomatic and have low-volume disease.
Case Details
Disease Location
Lymph nodes
Personal Characteristics
44-year-old woman
Clinical Characteristics
Left groin pain for 3–4 weeks. CT scans of the abdomen and pelvis, which revealed bilateral inguinal as well as pelvic lymphadenopathy. Ultrasound of the inguinal lymph nodes demonstrated multiple enlarged hypoechoic lymph nodes, the largest measuring 2.7×1.3 cm on the left side and 3.3×2.4 cm on the right side. A left inguinal lymph node ultrasound-guided needle core biopsy showed mcl. PET/CT showed mild to moderate fdg uptake in multiple nodal areas, including the inguinal, left external iliac chain, and bilateral axillary lymph nodes. There was involvement of the bone marrow with 5% of total bone marrow cellularity.
Remission Characteristics
1 year later, a PET/CT showed a decrease in tumor size and uptake of fdg-avid disease
Treatment & Mechanisms
Proposed Remission Mechanisms
Host immune response through humoral and cellular immunity may play a central role
Clinical Treatment
Biopsy
Non-Clinical Treatment
None reported