The patient had noted an increase in inguinal, axillary, and cervical lymph nodes, weakness, and fatigue for 7 years, but had not sought medical attention or examination. From late 2025, he experienced a worsening of his condition, a 21 kg weight loss, increased weakness, sweating, subfebrile temperature, and enlargement of all groups of lymph nodes. From February 2026, he developed bone pain and lower back pain. His hemogram showed leukocytes up to 160x109/L, erythrocytes 3.3, hemoglobin 85g/L, platelets 184x109/L, ESR 27, and lymphocytosis up to 92%. He was hospitalized due to lymphostasis. The myelogram showed lymphocytes 91%, myelocytes 0.5%, monocytes 1%, band neutrophils 0.5%, and segmented neutrophils 6.75%. In the smear, atypical altered lymphocytes of medium and small size were observed, with round, oval nuclei, lobulated shape, and irregular cytoplasmic contours. Lymphocytes containing one large nucleolus (prolymphocytes?) were frequently seen – as shown in the photos. Immunophenotyping revealed a monoclonal population of B-lymphocytes with the phenotype CD19k+CD5+CD23-CD20+CD79b+CD200-, corresponding to mature B-cell lymphoproliferative disorder, accounting for 82.4% of nucleated cells. The changes are most likely consistent with mantle cell lymphoma.
🙏 The publication was kindly provided by Ekaterina Nozdrina, Omsk.
