Case Report Pericardial, pleural and peritoneal involvement in a patient with primary gastric mantle cell lymphoma Muzaffer Keklik 1 , Afra Yildirim 2 , Ertugrul Keklik 3 , Sirac Ertan 4 , Kemal Deniz 5 , Fahir Ozturk 6 , Ibrahim Ileri 6 , Ilkcan Cerci 6 , Demet Camlica 7 , Mustafa Cetin 8 and Bulent Eser 8 Abstract Primary gastric mantle cell lymphoma is a rare form of gastointestinal tumour. Although peritoneal carcinomatosis accompanied by malignant ascites is relatively common, mantle cell lymphoma presenting with ascites is rare. Also, effusions involving pericardial and pleural cavities are uncommon during the course of lymphomas. We report the first case in which pericardial, pleural and peritoneal effusion of a primary gastric mantle cell lymphoma. Keywords Mantle cell lymphoma, serosal involvement Introduction Mantle cell lymphoma (MCL), a mature B-cell non- Hodgkin lymphoma (NHL), often shows aggressive behaviour. It is also characterised by the chromosomal translocation t(11;14)(q13;q32). Specific result of this translocation is an overexpression of the cyclin D1. Immunohistochemical CD5+, CD19+, CD20+, CD10À, CD23À, FMC-7+, bcl-2+ and cyclin D1+ are specific of MCL. 1 Common sites of involvement are lymph nodes, spleen, Waldeyer’s ring, bone marrow, blood and extranodal sites including the gastrointes- tinal tract. 2,3 Primary gastric MCL represents 2.5%– 7% of NHLs. 4 Involvement of the serosa may be the presenting feature in a wide and complex variety of lymphomas. 5 Although the frequency of pleural effu- sion is 20%–30% in lymphomas, the involvement of peritoneal and pericardial cavities is uncommon. 6 Treatment of MCL still remains a very controversial issue with very poor response rates. 7,8 In this report, we describe the case of a primary gastric MCL with pericardial, pleural and peritoneal involvement. Case A 55-year-old female presented to our clinic with abdominal fullness, dyspnea and dyspepsia lasting for three months. There was no disease in her personal and family history. Also there was no history of smoking, illicit drug use or alcohol consumption. Physical exam- ination revealed decreased breath sounds. Her abdo- men was protuberant with positive fluid thrill. Laboratory analyses showed anaemia (haemoglobin 10.5 g/dl), with elevated ESR (42 mm/h). White blood cell count (WBC) and platelet count were normal 1 Medical Doctor, Department of Hematology, Faculty of Medicine, Erciyes University, Turkey 2 Medical Doctor, Department of Radiology, Faculty of Medicine, Erciyes University, Turkey 3 Medical Doctor, Department of Physiology, Faculty of Medicine, Erciyes University, Turkey 4 Medical Doctor, Department of Pathology, Faculty of Medicine, Erciyes University, Turkey 5 Associate Professor, Department of Pathology, Faculty of Medicine, Erciyes University, Turkey 6 Medical Doctor, Department of Internal Medicine, Faculty of Medicine, Erciyes University, Turkey 7 Laboratory Technician, Flow Cytometry Unit, Faculty of Medicine, Erciyes University, Turkey 8 Professor, Department of Hematology, Faculty of Medicine, Erciyes University, Turkey Corresponding author: Muzaffer Keklik, Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey. Email: muzafferkeklik@yahoo.com Scottish Medical Journal 0(0) 1–4 ! The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0036933015570528 scm.sagepub.com Scott Med J OnlineFirst, published on January 29, 2015 as doi:10.1177/0036933015570528