A Case of Primary Sigmoid Colon Mucosa-associated Lymphoid Tissue Lymphoma

Abstract

The gastrointestinal (GI) tract is the most frequently involved site of mucosa-associated lymphoid tissue (MALT) lymphoma. Stomach is the most common site of involvement among the GI tract. However, MALT lymphoma of the large intestine is rare. A diagnosis is established by pathological examination of the surgical or endoscopic specimens. A 72-year-old man with low abdominal pain was diagnosed as a sigmoid MALT lymphoma, which was noted as an obstructing mass in a colonoscopic examination. A left hemicolectomy was performed, and the patient has had no recurrence postoperatively without any chemotherapy.

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

“…Clinically, it is usually asymptomatic or present with nonspecific symptoms such as bloody diarrhea and/or abdominal pain. However, in some rare cases, intestinal obstruction or intussusception can appear 9,10,13,14. Systemic symptoms such as fever and weight loss are rare because most MALT lymphomas are well localized and slow growing 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. In terms of regions of occurrence, five cases have been reported in the rectum,4,5,6,7,11 five cases in the appendix or ileocecal valve,5,6,8,9,11 and two cases in the ascending colon 6,9.…”

“…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).…”

An unusual case of fever and a sigmoid mass

“…Studies have identified the most common disease location to be the caecum (60%), followed by right-colon (27%) and the sigmoid colon (13%) 3. It is reported that there is a male predominance, with a maximal incidence in the 50–70-year age group 1 4. There is a reported association with inflammatory bowel disease, although a direct causal link has yet to be established 5…”

Management of Asymptomatic Mucosa-Associated Lymphoid Tissue Lymphoma of the Colon Found Incidentally on Colonoscopy

“…Surgical cure for MALT has been reported after colonic resection. 5 Systemic therapy used for treatment of colonic MALT includes cyclophosphamide, doxorubicin, vincristine, prednisone; bortezomib; and rituximab-based regimens. [6][7][8] There is 1 report of successful monotherapy with rituximab, a monoclonal antibody with activity against CD20-positive cell types.…”