Korean J Gastroenterol.  2020 Dec;76(6):327-330. 10.4166/kjg.2020.126.

Colonic Mucosa-associated Lymphoid Tissue Lymphoma Treated by Radiation Therapy: Report of a Case and Literature Review

• Lee MJ
• Myung E
• Oh HH
• Joo YE

• KMID: 2509710
• DOI: http://doi.org/10.4166/kjg.2020.126

Abstract

Mucosa-associated lymphoid tissue (MALT) lymphoma predominantly involves the gastrointestinal tract, with the stomach being the most commonly affected site. Colonic involvement is quite rare. Hence, the etiology, clinical characteristics, treatment, and outcome of colonic MALT lymphoma are not well established. This paper reports a case of MALT lymphoma of the transverse colon, presenting as a subepithelial tumor in a 50-year-old woman. The patient received 3,060 cGy in 17 fractions with external beam radiation therapy for three weeks. At 2 months after radiation therapy, a colonoscopy examination revealed complete resolution and a scar change of the lesion. The follow-up at 24 months revealed no evidence of tumor recurrence after radiation therapy.

Keyword

Mucosa-associated lymphoid tissue lymphoma; Radiotherapy

Figure

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  Fig. 1 Colonoscopy shows a 20 mm sized subepithelial tumor with hyperemic mucosa arising in the transverse colon.

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  Fig. 2 Microscopic findings. (A) Endoscopic biopsy specimens show a diffuse and dense infiltration of small-sized lymphocytes and a lymphoepithelial lesion in the colonic mucosa (H&E staining, ×400). (B) Immunohistochemical staining shows infiltrative small-sized lymphocytes with positive for B-cell marker CD20 (×400).

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  Fig. 3 Colonoscopy findings. (A) The target of radiation therapy is indicated by a hemoclip. (B) After radiation therapy, a follow-up colonoscopy revealed complete resolution and scar change in the lesion.

Reference

1. Tannoury J, Amiot A, Lemonnier F, et al. 2020; Colonic mucosa-associated lymphoid tissue lymphoma: a case series. Leuk Lymphoma. 61:582–587. DOI: 10.1080/10428194.2019.1686501. PMID: 31694428.

2. Won JH, Kim SM, Kim JW, Park JH, Kim JY. 2019; Clinical features, treatment and outcomes of colorectal mucosa-associated lymphoid tissue (MALT) lymphoma: literature reviews published in English between 1993 and 2017. Cancer Manag Res. 11:8577–8587. DOI: 10.2147/CMAR.S214197. PMID: 31572011. PMCID: PMC6759223.

3. Jeon MK, So H, Huh J, et al. 2018; Endoscopic features and clinical out-comes of colorectal mucosa-associated lymphoid tissue lymphoma. Gastrointest Endosc. 87:529–539. DOI: 10.1016/j.gie.2017.08.027. PMID: 28882576.

4. Violeta Filip P, Cuciureanu D, Sorina Diaconu L, Maria Vladareanu A, Silvia Pop C. 2018; MALT lymphoma: epidemiology, clinical diagnosis and treatment. J Med Life. 11:187–193. DOI: 10.25122/jml-2018-0035. PMID: 30364585. PMCID: PMC6197515.

5. Hatakeyama M. 2019; Malignant Helicobacter pylori-associated dis-eases: gastric cancer and MALT lymphoma. Adv Exp Med Biol. 1149:135–149. DOI: 10.1007/5584_2019_363. PMID: 31016622.

6. Salar A. 2019; Gastric MALT lymphoma and Helicobacter pylori. Med Clin (Barc). 152:65–71. DOI: 10.1016/j.medcli.2018.09.006. PMID: 30424932.

7. Matsuo S, Mizuta Y, Hayashi T, et al. 2006; Mucosa-associated lymphoid tissue lymphoma of the transverse colon: a case report. World J Gastroenterol. 12:5573–5576. DOI: 10.3748/wjg.v12.i34.5573. PMID: 17007004. PMCID: PMC4088249.

8. Matsumoto T, Iida M, Shimizu M. 1997; Regression of mucosa-associated lymphoid-tissue lymphoma of rectum after eradication of Helicobacter pylori. Lancet. 350:115–116. DOI: 10.1016/S0140-6736(05)61818-1.

9. Raderer M, Pfeffel F, Pohl G, Mannhalter C, Valencak J, Chott A. 2000; Regression of colonic low grade B cell lymphoma of the muco-sa associated lymphoid tissue type after eradication of Helicobacter pylori. Gut. 46:133–135. DOI: 10.1136/gut.46.1.133. PMID: 10601069. PMCID: PMC1727770.

10. Petrosky JA, Hallac A, Agbroko SO, et al. 2017; Management of asymp-tomatic mucosa-associated lymphoid tissue lymphoma of the colon found incidentally on colonoscopy. Clin Gastroenterol Hepatol. 15:1130–1132. DOI: 10.1016/j.cgh.2017.02.022. PMID: 28246052.

11. Foo M, Chao MW, Gibbs P, Guiney M, Jacobs R. 2008; Successful treatment of mucosa-associated lymphoid tissue lymphoma of the rectum with radiation therapy: report of a case. Dis Colon Rectum. 51:1719–1723. DOI: 10.1007/s10350-008-9379-0. PMID: 18633678.

12. Kelley SR. 2017; Mucosa-associated lymphoid tissue (MALT) variant of primary rectal lymphoma: a review of the English literature. Int J Colorectal Dis. 32:295–304. DOI: 10.1007/s00384-016-2734-z. PMID: 27995323.

13. Piotrowski R, Kramer R, Kamal A. 2008; Image of the month. Extranodal marginal zone B-cell (mucosa-associated lymphoid tissue) lymphoma of the colon presenting as an obstructing mass. Clin Gastroenterol Hepatol. 6:e18–e19. DOI: 10.1016/j.cgh.2007.12.033. PMID: 18308643.