MALT lymphoma of the rectum, presenting with rectal prolapsus: a case report

Abstract

Up to now, there have been only a few reported cases of Mucosa-associated lymphoid tissue (MALT) lymphomas arising in the rectum. Its clinical presentation is indistinguishable from that of rectal carcinoma but the treatment is apparently different. Symptoms of primary lymphomas involving the rectum include; anorexia, weight loss, change in bowel habits, obstruction, and bleeding. These symptoms are not disease specific and can be seen in many other gastrointestinal disorders. Patients with polypoid masses may present with obstruction symptoms. In this rare case, a female patient admitted to the emergency service with prolapsus of a rectal mass.The optimal treatment of rectal MALT lymphoma is not well defined yet, given the rarity of the disease. Surgical resection of the localized lesion and following adjuvant chemotherapy has proved to be an effective treatment option. However, a close and long-lasting follow-up is important.

Anti-Helicobacter Pylori Therapy in Primary MALT Lymphoma of Rectum

“…Due to its rarity, the possible therapeutic approaches to primary rectal MALT lymphoma have not been standardized. In our review of the literature from 1997 to the present, local surgery was used in 9 patients, all of them without evidence of disease after a median follow-up of 28 months (range, 7-120 months) 12,13 . Chemotherapy (the CHOP protocol) was used in 5 patients as follows: as the only treatment in 2 (both achieving a complete response with a follow-up of 34 and 79 months, respectively); after local surgery in 2 patients, while in the remaining patient a fludarabine-based protocol was preferred because of the concurrent diagnosis of chronic lymphoid leukemia (response and outcome not reported) 12,14 .…”

A Rare Case of Primary Extra-Nodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) in the Rectum

“…The role of H. pylori infection is significant in developing gastric MALT lymphomas, as the lymphoid tissue in gastric mucosa commonly arises due to chronic H. pylori infection [ 7 , 8 ]. The source and pathogenesis of MALT lymphomas of the rectum remains unclear.…”

“…The treatment options for MALT lymphomas of the rectum encompass H. pylori eradication, surgical resection, various chemotherapeutic medications, and endoscopic mucosal resection [ 8 ]. Some studies have documented regression of rectal MALT lymphoma after initiation of triple therapy against H. pylori , even in patients who tested negative for this infection [ 14 , 15 ].…”