Mucosa-associated lymphoid tissue (MALT) lymphoma manifesting as multiple lymphomatosis polyposis of the gastrointestinal tract

Citation
Np. Breslin et al., Mucosa-associated lymphoid tissue (MALT) lymphoma manifesting as multiple lymphomatosis polyposis of the gastrointestinal tract, AM J GASTRO, 94(9), 1999, pp. 2540-2545
Citations number
42
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
AMERICAN JOURNAL OF GASTROENTEROLOGY
ISSN journal
00029270 → ACNP
Volume
94
Issue
9
Year of publication
1999
Pages
2540 - 2545
Database
ISI
SICI code
0002-9270(199909)94:9<2540:MLT(LM>2.0.ZU;2-9
Abstract
There have been a number of previous case reports of lymphomas in the form of multiple mucosal polyps affecting variable lengths of colonic and intest inal mucosa. Invariably these have been classified histologically as mantle cell lymphomas. We report a case of this rare syndrome that illustrates ma ny of its typical features but which demonstrates significant histological and immunophenotypic differences. A 67-yr-old man was referred with a 3-mon th history of altered bowel habit and a barium enema suggestive of extensiv e ulcerative colitis. At colonoscopy, diffuse umbilicated mucosal polyps we re seen throughout the colon and a larger circumferential mass lesion at th e ileocecal valve. Biopsies demonstrated a diffuse B-cell lymphoma consiste nt with "multiple lymphomatous polyposis" of the colon. Flow cytometry reve aled CD25 positive/CD5 negative lymphoid cells confirming marginal B-cell l ymphoma of mucosa-associated lymphoid tissue (MALT) type. Upper gastrointes tinal investigations confirmed similar involvement of the stomach, duodenum , and small bowel. Helicobacter pylori was absent. Flow cytometry abnormali ties consistent with marrow involvement were present. These features led to a diagnosis of stage IV marginal zone B-cell lymphoma of MALT type, presen ting as multiple lymphomatous polyposis of the gastrointestinal tract. Thre e months of combination chemotherapy resulted in an excellent symptomatic a nd endoscopic response. (Am J Gastroenterol 1999;94:2540-2545, (C) 1999 by Am. Coll. of Gastroenterology).