Benign lymphomas of the rectum and anal canal: A study of 100 cases

Cornes, J. S.; Wallace, Michael; Morson, B. C.

doi:10.1002/path.1700820216

Cited by 61 publications

(24 citation statements)

References 22 publications

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“…Distinguishing between malignant lymphoma and multiple polyps can be difficult [294][295][296]; lymphoma has developed in a few patients with apparent nodular lymphoid hyperplasia [297,298]. It is unclear whether the malignant lymphoma represents a progression from the lymphoid hyperplasia or a de novo development of lymphoma.…”

Section: Lymphoid Hyperplasiamentioning

confidence: 99%

Neoplastic and Nonneoplastic Polyps of the Colon and Rectum

Macrae

Young

2008

Textbook of Gastroenterology

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Epidemiology PrevalenceInformation on the prevalence of polyps comes from autopsy studies and from colonoscopic surveys, which are of a much smaller scale. Autopsy studies generally show a higher prevalence of polyps and adenomas than endoscopic studies. Prevalence rates vary considerably between gender (males more common), ethnic groups, and countries, and reflect the rates of colorectal cancer in those population groups (see Chapter 63). In the United States, autopsy studies suggest an overall polyp prevalence of up to 50% [6,7], but colonoscopic surveys suggest no more than 40% [8][9][10][11][12][13][14][15]. In autopsy studies, fixation of the colon and careful use of a magnifying glass allow detection of small polyps that are more readily missed during colonoscopy [16][17][18][19][20].More than 90% of polyps detected at colonoscopy are epithelial in origin, that is, adenomas or hyperplastic polyps, and 75% of these are adenomas [8][9][10][11][12][13]. In the case of diminutive epithelial polyps (less than 5 mm), about half are hyperplastic [14,15].Age is the major determinant of adenoma prevalence [6,7]. Size at detection also increases with age [20]. Colorectal adenomas are uncommon in patients younger than 30 years of age. Anatomical distributionStudies show that colorectal adenomas are more common in the distal colon and rectum, similar to the distribution of colorectal cancer (see Chapter 63). Distribution, however, relates to size. Small adenomas are more uniformly distributed throughout the entire colon, whereas large adenomas (greater than 1 cm) show a distal predominance [7,8,21,22].

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Section: Lymphoid Hyperplasiamentioning

confidence: 99%

Neoplastic and Nonneoplastic Polyps of the Colon and Rectum

Macrae

Young

2008

Textbook of Gastroenterology

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“…1 Notably, the frequency of the lymphoepithelial complex is unevenly distributed and increases from the right to the left colon, being most frequently found in the rectum. [1][2][3][4][5][6] These lesions are also known as lymphoid polyps, benign lymphoid polyps, localized lymphoid hyperplasia (LLH) and rectal tonsils. [2][3][4][5][6] However, when exuberant, the reactive lymphoid infiltrates can be difficult to distinguish from lymphoma on small biopsy specimens.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6] These lesions are also known as lymphoid polyps, benign lymphoid polyps, localized lymphoid hyperplasia (LLH) and rectal tonsils. [2][3][4][5][6] However, when exuberant, the reactive lymphoid infiltrates can be difficult to distinguish from lymphoma on small biopsy specimens. [2][3][4][5][6] Histologically, a dense lymphoid infiltrate is present in the lamina propria and submucosa.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4][5][6] However, when exuberant, the reactive lymphoid infiltrates can be difficult to distinguish from lymphoma on small biopsy specimens. [2][3][4][5][6] Histologically, a dense lymphoid infiltrate is present in the lamina propria and submucosa. This is usually characterized by follicles with well-formed germinal centers that vary in size, often being strikingly enlarged with a narrow surrounding mantle zone.…”

Section: Introductionmentioning

confidence: 99%

“…This is usually characterized by follicles with well-formed germinal centers that vary in size, often being strikingly enlarged with a narrow surrounding mantle zone. [2][3][4][5][6] However, LLH of the large intestine appears to show histological variations. They included LLH of the rectum associated with prominent marginal zone hyperplasia or LLH demonstrating progressive transformation of the germinal center (PTGC).…”

Section: Introductionmentioning

confidence: 99%

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Histological Variety of Localized Lymphoid Hyperplasia of the Large Intestine: Histopathological, Immunohistochemical and Genotypic Findings of 16 Cases

Kojima

Nakamura

Itoh

et al. 2009

J Clin Exp Hematopathol

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Previous reports emphasized that localized lymphoid hyperplasia (LLH) of the large intestine is usually histologically characterized by large lymphoid follicles with striking enlarged germinal centers, and a narrow surrounding mantle zone and marginal zone (MZ). To clarify the histological varieties of LLH of the large intestine, 16 such cases have been studied. The present study demonstrated histological diversity of the LLH of the large intestine including (i) reactive follicular hyperplasia (RFH) (n＝8), (ii) RFH with progressive transformation of the germinal center (PTGC) (n＝3), (iii) RFH with MZ hyperplasia (n ＝3) and (iv) RFH with PTGC and MZ hyperplasia (n＝2). Overall histomorphological findings of the present series appear quite different from previous descriptions of LLH of the large intestine. The present study showed histological variety of the LLH of the large intestine. Moreover, LLH of the large intestine should be differentiated from extranodal marginal zone B-cell lymphoma and nodular lymphocyte predominant Hodgkin lymphoma as well as follicular lymphoma. Immunohistological studies demonstrated the reactive nature of all 16 lesions. However, three cases showing RFH demonstrated immunoglobulin heavy chain gene rearrangement by polymerase chain reaction study in 12 cases examined. It remains unclear whether these three cases showing RFH could be a sign of the prelymphomatous stage (incipient follicular lymphoma) or representing merely an exaggeration of normal B-cell clonal response in the germinal centers.

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