A case of
mucosa-associated lymphoid tissue lymphoma forming multiple
lymphomatous polyposis in the small intestine.World
J Gastro enterol. 2007 Mar 7;13(9):1453-7.
A 50-year old
woman suffering from diabetes had a CT scan that revealed a diffuse
thickening of small intestinal wall and swollen paraaortic lymph
nodes. An esophagogastroduodenoscopy (EGD) confirmed multiple polypoid
lesions in the duodenum and small intestine, and conventional
histological testing revealed non-specific inflammatory changes.
Further examinations including the immunohistochemical profiles of the
biopsied specimens led us to diagnose the lesion as a marginal zone
B-cell lymphoma of mucosa-associated lymphoid tissue type, forming
multiple lymphomatous polyposis sequentially spreading from duodenal
bulb to terminal ileum. According to Lugano's classification, its
staging was clinically diagnosed as stage II. Two courses of a
standard CHOP (cyclophosphamide, doxorubicin hydrochloride,
vincristine sulfate, and predonisolone) regimen with rituximab reduced
the lesion and the patient had a almost complete response. A 5-year
follow-up EGD and histological examinations detected no recurrence of
the disease.
Gastrointestinal lymphomatous polyposis--clinical, endoscopical and
evolution features. A case report.Rom
J Gastroenterol. 2005 Sep;14(3): 273-8.
Primary
gastrointestinal non-Hodgkin lymphoma accounts for 13-18% of all
malignant tumours of small bowel and only 1 % of large bowel tumours
(1). Multiple lymphomatous polyposis is a rare entity, characterized
by the presence of multiple lymphomatous polyps along the gut (2).
Majority of cases with gastrointestinal primary lymphoma are
classified histologically as "mantle cell" lymphomas. A 59 year old
patient was admitted to our clinic for fatigue and rectal bleeding.
Endoscopic examination of the colon revealed an infiltrative-exulcerative
lesion of the terminal ileon, a polypoid mass on ileocecal valve and
multiple polyps over the entire colon and rectum. Gastroscopy revealed
polyps into the duodenal bulb. Histopathological and
immunohistochemical studies on biopsy specimens from colon and
duodenum confirmed gastrointestinal non-Hodgkin lymphoma, probably
"mantle cell" lymphoma. Because she was in an advanced stage she
received only cytostatic treatment. A clinical, endoscopical and
histopathological follow up at 3, 6 and 12 months was performed. |
