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Clinical and morphological features of mantle cell lymphoma as a cause of ascites

https://doi.org/10.21886/2219-8075-2025-16-4-47-54

Abstract

The article describes a rare clinical case of hydroperitoneum in a patient with mantle cell lymphoma. This observation illustrates the diagnostic difficulties in identifying the cause of ascites of unclear etiology and emphasizes the important role of cytological analysis of ascitic fluid.

Mantle cell lymphoma is an aggressive mature B-cell lymphoma characterized by the proliferation of abnormal lymphoid cells with typical indolent nuclear circuits. Although extranodal involvement is not uncommon for a given vila lymphoma, the isolated occurrence of ascites as the first manifestation of the disease presents a unique and complex diagnostic situation.

The purpose of this clinical example was to demonstrate the importance of including oncological and hematological diseases in the differential diagnostic search for ascites, especially when standard methods (for example, imaging diagnostic methods, biochemical tests) do not reveal an obvious cause.

The work analyzes in detail the clinical case of a patient with hydroperitoneum, where a comprehensive diagnostic approach was applied, including ultrasound examination, laboratory tests and, most importantly, cytological and immunophenotypic examination of peritoneal fluid.

Cytological analysis of ascitic fluid revealed the presence of atypical lymphoid cells, which made it possible to establish the diagnosis of mantle cell lymphoma with peritoneal damage. This diagnostic method has become key for determining the tactics of patient management and the timely start of specific polychemotherapy.

 Early detection of specific cells in ascitic fluid allows for an accurate diagnosis, determination of the stage of the disease and immediate initiation of appropriate treatment, ultimately improving the prognosis for the patient.

About the Authors

A. A. Serdyuk
Kuban State Medical University; Krasnodar Regional Clinical Emergency Hospital
Russian Federation

Anna A. Serdyuk, Cand. Sci. (Med.), Assistant Professor at the Department of Hospital Therapy; Therapist

Krasnodar


Competing Interests:

Authors declares no conflict of interest



A. V. Larionova
Krasnodar Regional Clinical Emergency Hospital
Russian Federation

Anna A. Serdyuk, Cand. Sci. (Med.), Assistant Professor at the Department of Hospital Therapy

Krasnodar


Competing Interests:

Authors declares no conflict of interest



D. A. Rabadanov
Kuban State Medical University; Krasnodar Regional Clinical Emergency Hospital
Russian Federation

Daniil A. Rabadanov, Assistant Professor at the Department of Hospital Therapy; Therapist

Krasnodar


Competing Interests:

Authors declares no conflict of interest



O. Y. Chukhrai
Clinical Oncology Dispensary No. 1
Russian Federation

Olga Yu. Chukhray, Head of the Pathology Department

Krasnodar


Competing Interests:

Authors declares no conflict of interest



T. V. Chitanava
Clinical Oncology Dispensary No. 1
Russian Federation

Tamara V. Chitanava, Cand. Sci. (Med.), Hematologist

Krasnodar


Competing Interests:

Authors declares no conflict of interest



References

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2. Romaguera JE, Medeiros LJ, Hagemeister FB, Fayad LE, Rodriguez MA, et al. Frequency of gastrointestinal involvement and its clinical significance in mantle cell lymphoma. Cancer. 2003;97(3):586-591. Erratum in: Cancer. 2003;97(12):3131. PMID: 12548600. https://doi.org/10.1002/cncr.11096.

3. Ferrer A, Salaverria I, Bosch F, Villamor N, Rozman M, et al. Leukemic involvement is a common feature in mantle cell lymphoma. Cancer. 2007;109(12):2473-2480. https://doi.org/10.1002/cncr.22715

4. Keklik M, Yildirim A, Keklik E, Ertan S, Deniz K, et al. Pericardial, pleural and peritoneal involvement in a patient with primary gastric mantle cell lymphoma. Scott Med J. 2015;60(2):e21-4. https://doi.org/10.1177/0036933015570528

5. Yonal I, Ciftcibasi A, Gokturk S, Yenerel MN, Akyuz F, et al. Massive ascites as the initial manifestation of mantle cell lymphoma: a challenge for the gastroenterologist. Case Rep Gastroenterol. 2012;6(3):803-809. https://doi.org/10.1159/000346290

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Review

For citations:


Serdyuk A.A., Larionova A.V., Rabadanov D.A., Chukhrai O.Y., Chitanava T.V. Clinical and morphological features of mantle cell lymphoma as a cause of ascites. Medical Herald of the South of Russia. 2025;16(4):47-54. (In Russ.) https://doi.org/10.21886/2219-8075-2025-16-4-47-54

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ISSN 2219-8075 (Print)
ISSN 2618-7876 (Online)