The therapeutic use of isotonic bicarbonate solution is limited owing to paradoxical intracellular acidosis. Tris-hydroxymethyl aminomethane rapidly corrects intracellular acidosis, restoring hepatic lactate clearance through the Cori cycle.
Flow cytometric immunophenotyping demonstrated bright CD45 expression with low side scatter and positivity for CD19, CD20, CD38, CD5, CD79b, and FMC7 with negativity for CD34, CD23, CD200, and CD10, suggesting blastoid transformation of MCL rather than de novo ALL. This case highlights the critical role of flow cytometry in distinguishing blastoid MCL from acute leukemia, thereby preventing misdiagnosis and ensuring appropriate therapeutic decision-making.
The postoperative course was uneventful and the patient remained disease-free at 8-month follow-up after completing R-CHOP chemotherapy...Although rare, DLBCL should be considered as a differential diagnosis in unexplained SBO. Early recognition and a multidisciplinary management strategy improve prognosis.