A Case of Multiple Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma of the Colon Identified as Simple Mucosal Discoloration

Abstract

Most colonic multiple mucosa-associated lymphoid tissue (MALT) lymphomas are confirmed with a histologic and immunohistochemical staining of the mucosal biopsy specimen obtained during colonoscopic examinations. Endoscopically, colonic MALT lymphomas frequently appear as protruding and/or ulcerative lesions, and there are not so many reports of colonic MALT lymphoma as compared to the frequent reports of MALT lymphoma of stomach. We report a unique case of colonic MALT lymphoma presenting as a simple reddish discoloration of mucosa; this presentation has never been describe before. Our patient was a 47-yr-old male who suffered from tenesmus and mucoid stool. A colonoscopy was accomplished, followed by a histologic examination and we diagnosed a colonic MALT lymphoma. Staging of the disease was done because this was necessary for choosing the modality of treatments. The patient was then treated with polychemotherapy in conjunction with radiation therapy.

A Case of Mucosa-Associated Lymphoid Tissue Lymphoma of the Sigmoid Colon Presenting as a Semipedunculated Polyp

“…MALT lymphoma of the stomach is known to be associated with Helicobacter pylori infection,11 whereas nongastric MALT lymphomas have been associated with Borrelia burgdorferi , Chlamydia psittaci , hepatitis C virus, Campylobacter jejuni , and autoimmune disease 12…”

“…These cases manifested as polypoid lesions, neoplastic lesions, and protruding lesions in the form of submucosal tumors,4,5,6,7,8,10 but only rarely in the form of luminal stenosis caused by thickening of the large intestine wall or a color change of the mucosa 9,11. Both neoplastic and polypoid lesions are sessile and accompanied by ulcers or nodularities in the mucosal lesion 5,6,7,8,10.…”

“…Most of the colonic MALT lymphomas present as a nonpedunculated protruding polypoid mass and/or ulceration. Cases of primary colonic MALT lymphoma reported in Korea have presented as multiple submucosal tumors (one case),4 a nonpedunculated protruding polypoid mass (four cases),5,6,7,8 obstructive lesions of the colon caused by mucosal edema or a tumor (two cases),9,10 or mucosal discoloration (one case) 11. Here, we report the case of a colonic MALT lymphoma presenting as a semipedunculated polyp that was removed by endoscopic mucosal resection (EMR).…”

Primary Rectal Mucosa-Associated Lymphoid Tissue Lymphoma: Report of a Case with Extensive FISH Study

“…In that review of a total of 34 cases, the median age is 62 years with equal sex ratio and a predominance of polypoid tumors. Ulcerative lesion is far less common, while multiple mucosal lesions with simple reddish discoloration as reported by Lee et al are extraordinary [14].…”

Colonic MALToma: a case report and review of the literature

“…MALTomas can affect many tissues but the gastrointestinal tract is the commonest site affected by the disease of which gastric MALTomas are the most common 2 – 4. In contrast, colonic MALToma is very rare and only a handful of cases have been reported over the years 3 , 4…”