Joanna, generally MCL is hard and unpredictable disease. There is natural attraction to GIT, therefore, we regularly perform GFS and CFS. The problem is that disease is stage IV in most cases. Bone marrow and blood must be examined by flow for CD5+19+20+23- cells and PCR shall be perfomed for Cyclin D1. If no cells are found and stage is limited to rectum, you have extranodal disease anyway. There is not time to watch. Must me treated right away with combination chmotherapy (CHOP etc.) combined with rituximab. Chances are better then in disseminated disease.
As Dr Klabusay said, MCL is very often multifocal. If you look hard enough you will find occult diseases elsewhere in particular in the marrow, lymph glands and GIT. There are different protocols available (RCHOP, RCHOP-Velcade). Do you have any information about its proliferation index?
It depends on the involvement of bone marrow. If bone marrow is involved outcome is not up to the limit. In this case combination chemotherapy along with monoclonal antibody(MAB) is the treatment of choice.
Negative bone marrow,negative PET scan,negative LDH,all other labs normal.Disease limited to the rectal mucosa and mucosa of ileocecal area.Pt asymptomatic 1 year since initial diagnosis.Pt opts not to treat but wait and watch,and follow up in 1 year for further testing.Any thoughts?