Colonic mucosa-associated lymphoid tissue lymphoma identified by chromoendoscopy

Abstract

Colonic mucosa-associated lymphoid tissue (MALT) lymphomas are a rare occurrence

and the definitive treatment has not been established. Solitary or multiple,

elevated or polypoid lesions are the usual appearances of MALT lymphoma in the

large intestine and sometimes the surface may reveal abnormal vascularity.

Herein, we report a case of MALT lymphoma and review the relevant literature.

Upon colonoscopy, a suspected pathologic lesion was observed in the proximal

transverse colon. The lesion could be distinguished more prominently after using

narrow-band imaging mode and indigo carmine-dye spraying chromoendoscopy.

Histopathologic examination of this biopsy specimen revealed lymphoepithelial

lesions with diffuse proliferation of atypical lymphoid cells effacing the

glandular architecture and centrocyte-like cells infiltrating the lamina propria.

Immunohistochemical analyses showed that tumor cells were positive for CD20 and

Bcl-2e, and negative for CD10, CD23, and Bcl-6. According to Ann-Arbor staging

system, the patient had stage IIE. A partial colectomy with dissection of the

paracolic lymph nodes was performed. Until now, there is no recurrence of

lymphoma at follow-up.