CLINICAL VIGNETTEwas seen (Fig. 1F).Serum chromogranin A (CgA) was elevated at 285.49 g/L (reference range: 0-100 g/L).Due to abnormal peripheral blood counts and the overall clinical presentation, a peripheral blood smear and flow-cytometric immunophenotyping were performed, revealing a monoclonal B-cell population consistent with mantle cell lymphoma (MCL).Excisional cervical lymph node biopsy confirmed classical-variant MCL: CD20(+), CD19(+), BCL2(+), cyclin D1(+), CD5(+), CD23(-), CD10(-), BCL6(-), CD3(-), p53(-), with Ki-67 approximately 25%.Clinically, the disease was staged Ann Arbor IVB, and the Mantle Cell Lymphoma International Prognostic Index (MIPI) classified the patient as high-risk.Owing to worsening dyspnea and a right pleural effusion, therapeutic-diagnostic thoracentesis was performed; pleural fluid cytology showed numerous lymphoid lineage cells, supporting lymphoid neoplasia.The patient was subsequently transferred to the Department of Hemato-oncology and Bone Marrow Transplantation, where chemotherapy was initiated.He received one cycle of bendamustine-rituximab (BR).The patient's condition initially improved, with a reduction in peripheral edema and abdominal girth.However, his clinical status later deteriorated, and he died before the planned administration of the subsequent chemotherapy cycle.Reports of MCL co-occurring with NETs are rare and involve the lung, skin, and larynx, including pulmonary carcinoid 1, Merkel cell carcinoma 2, and laryngeal neuroendocrine carcinoma 3.Only two isolated reports describe synchronous MCL and pancreatic adenocarcinoma 4, 5.To our knowledge, this is the first published report of concurrent MCL and pancreatic NET.
Wasyluk et al. (Fri,) studied this question.