Korean J Gastroenterol.  2013 Dec;62(6):365-369. 10.4166/kjg.2013.62.6.365.

A Case of Ileal Mucosa-associated Lymphoid Tissue Lymphoma Accompanied by Luminal Stricture and Arterial Spurting

Affiliations
  • 1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. L85210@korea.ac.kr
  • 2Department of Surgery, Korea University College of Medicine, Seoul, Korea.

Abstract

Primary small intestinal lymphoma is relatively uncommon. Small bowel tumors are difficult to diagnose, because they are usually asymptomatic in the initial phase, and they are not easily detected by traditional methods of investigating the small intestine. This case shows a successfully detected and treated gastrointestinal bleeding from rare ileal mucosa-associated lymphoid tissue lymphoma, using double balloon endoscopy.

Keyword

Mucosa-associated lymphoid tissue lymphoma; Gastrointestinal bleeding; Small intestine; Double balloon endoscopy

MeSH Terms

Aged
Arteries
Capsule Endoscopy
Constriction, Pathologic
Gastrointestinal Hemorrhage
Humans
Ileal Neoplasms/*diagnosis/pathology
Intestinal Mucosa/pathology
Lymphoid Tissue/*pathology
Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology
Male

Figure

  • Fig. 1. Video capsule endoscopy, showing fresh blood in the middle ileum.

  • Fig. 2. (A, B) Double balloon endoscopy shows active ulcer with luminal stricture. Arterial spurting was noted at the ulcer base. (C) Argon plasma coagulation with ephinephrine-normal saline mixture injection was used to achieve hemostasis.

  • Fig. 3. Histopathologic findings of mucosa-associated lymphoid tissue lymphoma. (A) The tumor measured 1.5×1.3 cm across. (B, C) Microscopic examination shows the poorly defined follicular areas that are composed of monocytoid B cells that feature enlarged nuclei (H&E, ×100), and infiltration and distortion of epithelial structures by aggregates of neoplastic lymphoid cells (H&E, ×400).(D) Immunohistochemistry shows strong positive activity for CD 20 (×400).


Reference

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