A rapid progression from classical mantle cell lymphoma to a blastoid variant.

This case report presents an 82-year-old male initially diagnosed with classical mantle cell lymphoma (MCL) that progressed to the aggressive blastoid variant. The patient was initially treated with oral chemotherapy (PEP-C), followed by ibrutinib, but experienced disease progression with central nervous system (CNS) involvement and blastoid morphology. Despite subsequent intensive treatment, including high-dose cytarabine (Cytarabine), rituximab, and intrathecal methotrexate (Methotrexate), the patient's disease continued to advance, resulting in death. This case underscores the aggressive nature of blastoid MCL, its poor prognosis despite current therapeutic strategies, and highlights the need for individualized treatment approaches and CNS prophylaxis.