Clin Endosc.  2014 Mar;47(2):192-196. 10.5946/ce.2014.47.2.192.

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

• Kim MH
• Jung JT
• Kim EJ
• Kim TW
• Kim SY
• Kwon JG
• Kim EY
• Sung WJ

• KMID: 2049009
• DOI: http://doi.org/10.5946/ce.2014.47.2.192

Abstract

Mucosa-associated lymphoid tissue (MALT) lymphomas are characterized by lymphoepithelial lesions pathologically. Colonic MALT lymphomas are relatively rarer than lymphomas of the stomach or small intestine. Endoscopically, colonic MALT lymphoma frequently appears as a nonpedunculated protruding polypoid mass and/or an ulceration in the cecum and/or rectum. We report a unique case of a colonic MALT lymphoma presenting as a semipedunculated polyp. A 54-year-old man was found to have a 2-cm semipedunculated polyp in the sigmoid colon during screening colonoscopy. The polyp was removed by endoscopic mucosal resection. Histologic examination of the resected polyp revealed diffuse epithelial infiltration by discrete aggregates of lymphoma cells. We diagnosed the tumor as low-grade B-cell MALT lymphoma by immunohistochemical staining.

Keyword

Mucosa-associated lymphoid tissue lymphoma; Sigmoid colon; Colonic polyps

MeSH Terms

B-Lymphocytes
Cecum
Colon
Colon, Sigmoid*
Colonic Polyps
Colonoscopy
Middle Aged
Intestine, Small
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell, Marginal Zone*
Mass Screening
Polyps*
Rectum
Stomach
Ulcer

Figure

• 

  Fig. 1 Colonoscopic findings. (A) Colonoscopy image showing a solitary semipedunculated polyp with nodular and erythematous mucosa originating from the sigmoid colon. (B) The polyp was resected with a snare after mucosal incision with a flex knife. (C) The resected polyp was 2 cm in size. (D) Follow-up sigmoidoscopy (2 months after resection) showed a postendoscopic mucosal resection scar.

• 

  Fig. 2 Histologic findings. (A) Lymphoma cells, with small to medium-sized nucleoli with pale cytoplasm, infiltrated the reactive follicles. The epithelium was invaded and destroyed by discrete aggregates of lymphoma cells (arrows) (H&E stain, ×200). (B) Immunohistochemical staining revealed lymphoma cells with a diffuse immunoreaction for CD20 (Immunostain for CD20, ×200). (C) Immunohistochemical staining revealed that lymphoma cells were not immunoreactive for cyclin D1 (Immunostain for cyclin D1, ×200).

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