| A rare
case of multiple lymphomatous polyposis with widespread involvement of
the gastrointestinal tract.
Arch
Pathol Lab Med. 2003 Aug;127(8):1028-30.
Multiple
lymphomatous polyposis (MLP) is an uncommon type of primary
non-Hodgkin gastrointestinal (GI) B-cell lymphoma characterized by the
presence of multiple polyps along the GI tract. Malignant cells of MLP
have mantle cell characteristics and thus are considered to be the
counterpart of the mantle cell lymphoma (MCL) in the GI tract. Since
1961, no more than 70 well-documented cases have been published. We
report the case of 53-year-old man diagnosed as having MLP. The
patient presented with diffuse abdominal pain, chronic lower GI
bleeding, peripheral lymphadenopathy, and weight loss. The
lymphomatous polyps extended from the esophagus to the rectum, with
bone marrow infiltration. Immunohistologic findings were
characteristic of MCL. The patient was treated with a combined
cyclophosphamide, vincristine, and prednisone chemotherapy regimen,
resulting in a partial response.
Diffuse lymphomatous
polyposis of the gastrointestinal tract. A case report with
immunohistochemical studies.Gastroenterology.
1985 May;88(5 Pt 1):1267-70.
A case of
diffuse lymphomatous polyposis of the gastrointestinal tract is
reported. The patient presented with abdominal pain and weight loss
and x-rays revealed multiple polyps involving the entire
gastrointestinal tract. Biopsies confirmed the diagnosis of
lymphomatous polyposis. The patient also had involvement of the bone
marrow and supraclavicular lymph node. Immunologically this lymphoma
was characterized as a monoclonal proliferation of B lymphocytes
bearing immunoglobulin M, type kappa. Diffuse lymphomatous polyposis
of the gastrointestinal tract appears to be a generalized malignancy
of
uncommitted B cells of Peyer's patches. The migratory properties of
these cells may account for the tendency to dissemination of
lymphomatous polyposis. Diffuse lymphomatous polyposis of the
gastrointestinal tract is a distinct entity, separate from the diffuse
gastrointestinal lymphoma known as Mediterranean-type lymphoma. |
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Pathology of the Intestinal Polyp (Multiple
Lymphomatous Polyposis)
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Lymphomatous polyposis of the gastrointestinal tract, including
mantle cell lymphoma, follicular lymphoma and mucosa-associated
lymphoid tissue lymphoma.Histopathology.
2005 Nov;47(5):467-78.
AIMS:
Lymphomatous polyposis (LP) is considered to represent mantle cell
lymphoma (MCL) of the gastrointestinal (GI) tract. However, a few
reports have suggested that some are follicular lymphoma (FL) or
mucosa-associated lymphoid tissue (MALT) lymphomas. In this study,
we analysed 35 patients and clarified the clinicopathological
features of LP. METHODS AND RESULTS: Paraffin-embedded tissue
samples were stained immunohistochemically and analysed by
tissue-fluorescence in situ hybridization (T-FISH) for IGH/CCND1 (cyclin
D1) and IGH/BCL2. The average age of the patients was 58.3 years.
Over half of the cases showed gastric, duodenal, small intestinal,
ileocaecal and sigmoid colonic lesions (15, 19, 15, 16 and 16 cases,
respectively). Phenotypically, cases were classified into three
types of MCL (cyclin D1+ CD5+ CD10-) (n=12), FL (cyclin D1- CD5-
CD10+) (n=14) and MALT (cyclin D1- CD5- CD10-) (n=9). T-FISH
identified 11 of the 11 examined cases with MCLs to have IGH/CCND1,
while seven of 10 cases with FL had IGH/BCL2, and none of the MALT
cases were positive for IGH/CCND1 or IGH/BCL2. At the study
endpoint, five of 12 patients with MCL were dead, two of 14 with FL
and one of nine with MALT were dead of other disease. Event-free
survival analysis showed significantly poorest outcome in MCL,
followed by FL, while MALT was associated with a favourable outcome
(P=0.0040). CONCLUSIONS: Our study emphasizes the importance of
differentiating MCL, FL and MALT of LP in evaluating prognosis and
hence the most suitable therapeutic regimen. |
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July 2009
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