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Yachida T, Matsuda T, Sakamoto T, Nakajima T, Kakugawa Y, Maeshima AM, Taniguchi H, Kushima R, Tobinai K, Kobara H, Masugata H, Masaki T, Saito Y. Endoscopic features of colorectal lymphoma according to histological type. JGH OPEN 2022; 6:257-262. [PMID: 35475204 PMCID: PMC9021707 DOI: 10.1002/jgh3.12738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/28/2022] [Accepted: 03/24/2022] [Indexed: 11/09/2022]
Abstract
Background and Aim This study aimed to investigate the relationship between the histological type of colorectal lymphoma and its endoscopic features. Methods We retrospectively analyzed patients with primary colorectal lymphoma who were diagnosed using colonoscopy and biopsy specimens at the National Cancer Center Hospital, Tokyo, Japan. The lesions were macroscopically classified into the following types via colonoscopy: polypoid, ulcerative, multiple lymphomatous polyposis, diffuse, and mixed. Results A total of 117 lesions were identified in 90 patients enrolled in this study. Of these, 59 (50%) were located in the ileocecal region, 23 (20%) in the rectum, 9 (8%) in the transverse colon, 8 (7%) in the sigmoid colon, 7 (6%) in the descending colon, and 4 (3%) in the ascending colon. Moreover, the most common histological subtypes were diffuse large B‐cell lymphoma (DLBCL) in 39 patients (43%) and mantle cell lymphoma (MCL) in 23 patients (26%), followed by follicular lymphoma (FL; 17%), mucosa‐associated lymphoid tissue (MALT) lymphoma (9%), peripheral T‐cell lymphoma‐NOS (2%), monomorphic epitheliotropic intestinal T‐cell lymphoma (MEITL; 2%), and Burkitt lymphoma (1%). More than half of the DLBCL (52%), MCL (52%), and MALT (56%) lymphomas were macroscopically classified as polypoid types. In contrast, FL lesions showed various macroscopic types. The majority of DLBCL (62%) and FL (78%) lesions were distributed in the ileocecal region. MCL lesions tended to be widely spread in various sites of the large intestine. Conclusions Colorectal lymphomas showed macroscopically distinctive features depending on the histological type. Understanding the macroscopic classification of the lesions by colonoscopy and its distribution may be helpful in diagnosing the type of lymphoma and determining the malignant grade based on the histological types.
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Affiliation(s)
- Tatsuo Yachida
- Endoscopy Division National Cancer Center Hospital Chuo City Tokyo Japan
- Department of Gastroenterology and Neurology, Faculty of Medicine Kagawa University Kita‐gun Kagawa Japan
- Department of General Internal Medicine, Faculty of Medicine Kagawa University Kita‐gun Kagawa Japan
| | - Takahisa Matsuda
- Endoscopy Division National Cancer Center Hospital Chuo City Tokyo Japan
| | - Taku Sakamoto
- Endoscopy Division National Cancer Center Hospital Chuo City Tokyo Japan
| | - Takeshi Nakajima
- Endoscopy Division National Cancer Center Hospital Chuo City Tokyo Japan
| | - Yasuo Kakugawa
- Endoscopy Division National Cancer Center Hospital Chuo City Tokyo Japan
| | | | - Hirokazu Taniguchi
- Department of Pathology National Cancer Center Hospital Chuo City Tokyo Japan
- Pathology and Clinical Laboratory Division JR Tokyo General Hospital Shibuya City Tokyo Japan
| | - Ryoji Kushima
- Department of Pathology National Cancer Center Hospital Chuo City Tokyo Japan
- Department of Clinical Laboratory Medicine and Diagnostic Pathology Shiga University of Medical Science Otsu Shiga Japan
| | - Kensei Tobinai
- Department of Hematology National Cancer Center Hospital Chuo City Tokyo Japan
| | - Hideki Kobara
- Department of Gastroenterology and Neurology, Faculty of Medicine Kagawa University Kita‐gun Kagawa Japan
| | - Hisashi Masugata
- Department of General Internal Medicine, Faculty of Medicine Kagawa University Kita‐gun Kagawa Japan
| | - Tsutomu Masaki
- Department of Gastroenterology and Neurology, Faculty of Medicine Kagawa University Kita‐gun Kagawa Japan
| | - Yutaka Saito
- Endoscopy Division National Cancer Center Hospital Chuo City Tokyo Japan
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2
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Kuo YC, Yu LY, Wang HY, Chen MJ, Wu MS, Liu CJ, Lin YC, Shih SC, Hu KC. Effects of Helicobacter pylori infection in gastrointestinal tract malignant diseases: From the oral cavity to rectum. World J Gastrointest Oncol 2022; 14:55-74. [PMID: 35116103 PMCID: PMC8790410 DOI: 10.4251/wjgo.v14.i1.55] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/03/2021] [Accepted: 12/10/2021] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) has infected approximately fifty percent of humans for a long period of time. However, improvements in the public health environment have led to a decreased chance of H. pylori infection. However, a high infection rate is noted in populations with a high incidence rate of gastric cancer (GC). The worldwide fraction of GC attributable to H. pylori is greater than 85%, and a high H. pylori prevalence is noted in gastric mucosa-associated lymphoid tissue lymphoma patients. These results indicate that the majority of GC cases can be prevented if H. pylori infection is eliminated. Because H. pylori exhibits oral-oral or fecal-oral transmission, the relationship between this microorganism and other digestive tract malignant diseases has also attracted attention. This review article provides an overview of H. pylori and the condition of the whole gastrointestinal tract environment to further understand the correlation between the pathogen and the host, thus allowing improved realization of disease presentation.
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Affiliation(s)
- Yang-Che Kuo
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Lo-Yip Yu
- Department of Internal Medicine, Healthy Evaluation Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Horng-Yuan Wang
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Ming-Jen Chen
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 10051, Taiwan
| | - Chun-Jen Liu
- Department of Internal Medicine, Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan
| | - Ying-Chun Lin
- Department of Anesthesia, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Shou-Chuan Shih
- Division of Gastroenterology, Department of Internal Medicine, Health Evaluate Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Kuang-Chun Hu
- Department of Internal Medicine, Healthy Evaluation Center, Mackay Memorial Hospital, MacKay Junior College of Medicine, Nursing, and Management, Taipei 10038, Taiwan
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3
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Macedo Silva V, Freitas M, Boal Carvalho P, Dias de Castro F, Cotter J. Multifocal Colonic Ulcerations: An Unusual Presentation of Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2021; 29:187-191. [DOI: 10.1159/000515466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/01/2021] [Indexed: 11/19/2022]
Abstract
<b><i>Introduction:</i></b> Mucosa-associated lymphoid tissue (MALT) lymphoma is relatively uncommon and accounts for only 5% of all non-Hodgkin lymphomas. The most common site of extranodal involvement is the gastrointestinal (GI) tract, with most cases affecting the stomach (up to 75% of all GI MALT lymphomas). Colonic disease occurs in only 2.5% of cases, most commonly manifesting as a single polypoid lesion on endoscopic evaluation. <b><i>Case Presentation:</i></b> We present the case of a 61-year-old woman whose colonoscopy (after a positive fecal occult blood test as part of colorectal cancer screening) revealed superficially ulcerated pseudo-polypoid lesions in the ascending proximal colon and hepatic flexure; microscopical and immunohistochemical analysis of the tissue sample was compatible with MALT lymphoma. Staging computed tomography showed concomitant nodular pulmonary lesions, the largest being located in the superior left lobe and 34 mm in size. Due to the disseminated state of the disease, systemic treatment with bendamustine and rituximab was initiated. Up to the time of submitting this paper, the patient was still asymptomatic and under chemotherapy treatment. <b><i>Conclusion:</i></b> With this case report, we aim to demonstrate the diversity of presentation of MALT lymphoma as well as its less typical locations; gastroenterologists should have an awareness of these and a low suspicion threshold.
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Appendiceal Orifice Inflammation in Ulcerative Colitis Mimicking Mucosa-Associated Lymphoid Tissue Lymphoma in the Cecum. Case Rep Gastrointest Med 2020; 2020:8893604. [PMID: 33083067 PMCID: PMC7563037 DOI: 10.1155/2020/8893604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/18/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022] Open
Abstract
A 55-year-old Japanese woman, who had been diagnosed with ulcerative colitis at 18 years of age, underwent screening endoscopy examinations. Esophagogastroduodenoscopy revealed an extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of the stomach. Colonoscopy showed a slightly elevated reddish lesion with dilated microvessels but no erosions or ulcers. Although MALT lymphoma in the cecum was endoscopically suspected, flow cytometry and pathological analyses led to the diagnosis of appendiceal orifice inflammation in ulcerative colitis. This case highlights the diversity of the endoscopic appearance of appendiceal orifice inflammation in ulcerative colitis.
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5
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Successful Endoscopic Resection of Mucosa-Associated Lymphoid Tissue Lymphoma of the Colon. ACG Case Rep J 2019; 6:e00228. [PMID: 31832456 PMCID: PMC6855546 DOI: 10.14309/crj.0000000000000228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 08/28/2019] [Indexed: 12/17/2022] Open
Abstract
Mucosa-associated lymphoid tissue lymphomas are the most common form of primary malignant gastrointestinal lymphoma. Although typically found in the stomach, extragastric locations have been described, in rare cases, the colon. The optimal management of these neoplasms remains uncertain and limited largely to small retrospective series or case reports. We report a patient with a colonic mucosa-associated lymphoid tissue lymphoma identified during a routine screening colonoscopy which was removed endoscopically without any adjuvant antimicrobial therapy, chemotherapy, or radiation therapy. She remained disease-free after the 1-year follow-up, providing support to potential endoscopic therapy in appropriately selected patients.
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Won JH, Kim SM, Kim JW, Park JH, Kim JY. 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 2019; 11:8577-8587. [PMID: 31572011 PMCID: PMC6759223 DOI: 10.2147/cmar.s214197] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/13/2019] [Indexed: 12/14/2022] Open
Abstract
Background Colorectal mucosa-associated lymphoid tissue (MALT) lymphoma (cMALToma) is rare and comprises only 2.5% of the MALT lymphomas. Its etiology and treatment have not been well established. The aim of this systematic literature review was to try to characterize cMALToma and analyze the risk factors for treatment failure with various therapeutic strategies. Methods We retrospectively reviewed 50 case reports from 1993 to 2017 through a PubMed search of English medical literature, describing cMALToma. We included 67 patients from previous case reports and we added 6 patients treated for cMALToma in our multicenter institutes. Risk factor analysis was done for treatment failure, defined as remission failure and recurrence. Results Of 73 patients diagnosed with cMALToma, tumors were located in 54 patients (74.0%) in the rectum, in 10 patients (13.6%) in the right colon, in 3 patients (4.1%) in the transverse colon, and in 6 patients (8.2%) in the sigmoid colon. In first-line treatment, patients achieved complete remission (CR) with surgery (18/19 cases), local resection (18/19 cases), chemotherapy (12/13 cases), radiation therapy (4/5 cases), antibiotics therapy including Helicobacter pylori eradication (12/15 cases), and no treatment (1/2 cases). Among these, eight cases (10.9%) needed second-line treatment, and there was overall remission failure in 3 cases (4.1%). Of the remaining 70 patients with CR, the tumor recurred in 5 patients (6.8%). The multivariable analysis showed that male sex, multiple tumors, and first-line treatment failure were significantly related to treatment failure (p=0.03, p=0.05, p=0.03, respectively). Conclusion CR of primary cMALToma was achieved using various therapeutic strategies. First-line treatment failure and multiple tumors were associated with treatment failure, although the numbers of cases that failed are too small to draw definitive conclusions.
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Affiliation(s)
- Jae Hee Won
- Department of Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
| | - Sung Min Kim
- Department of Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
| | - Jong Wan Kim
- Department of Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
| | - Jun Ho Park
- Department of Surgery, Kangdong Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
| | - Jeong Yeon Kim
- Department of Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
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7
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Abbas H, Niazi M, Makker J. Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma of the Colon: A Case Report and a Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:491-497. [PMID: 28469125 PMCID: PMC5424574 DOI: 10.12659/ajcr.902843] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patient: Female, 56 Final Diagnosis: Colonic MALT lymphoma Symptoms: Epigastric pain Medication: — Clinical Procedure: Colonoscopy and biopsy Specialty: Gastroenterology and Hepatology
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Affiliation(s)
- Hafsa Abbas
- Department of Medicine, Bronx Lebanon Hospital Center, Bronx, USA
| | - Masooma Niazi
- Department of Pathology, Bronx Lebanon Hospital Center, Bronx, USA
| | - Jasbir Makker
- Department of Medicine, Division of Gastroenterology, Bronx Lebanon Hospital Center, Bronx, USA
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8
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Kelley SR. Mucosa-associated lymphoid tissue (MALT) variant of primary rectal lymphoma: a review of the English literature. Int J Colorectal Dis 2017; 32:295-304. [PMID: 27995323 DOI: 10.1007/s00384-016-2734-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2016] [Indexed: 02/08/2023]
Abstract
PURPOSE Primary rectal lymphoma (PRL) is the third most common cause of rectal cancer following adenocarcinoma (90-95 %) and carcinoid (5 %). The most common variant of PRL is the mucosa-associated lymphoid tissue (MALT) type. To date, no study has been able to recommend an optimal treatment algorithm for this rare disease. The aim of our study was to review the English literature on primary rectal MALT lymphoma. METHODS A review of the English literature was conducted to identify articles describing the MALT variant of PRL. RESULTS Fifty-one cases were identified. A complete response was achieved in 12 of 19 cases treated with Helicobacter pylori eradication therapy, 5 of 6 with radiation, 2 of 4 cases with chemotherapy, 2 of 4 with endoscopic resection, 6 of 8 cases with surgical resection, and all 8 with combination therapies. Cases failing initial therapies were responsive to various second-line treatments. Two cases spontaneously regressed with observation alone. CONCLUSION Complete regression of primary rectal MALT lymphoma was achieved using various therapeutic strategies, although the numbers of different treatment modalities are too small to draw definitive conclusions.
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Affiliation(s)
- Scott R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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9
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Okamura T, Suga T, Iwaya Y, Ito T, Yokosawa S, Arakura N, Ota H, Tanaka E. Helicobacter pylori-Negative Primary Rectal MALT Lymphoma: Complete Remission after Radiotherapy. Case Rep Gastroenterol 2012; 6:319-27. [PMID: 22754493 PMCID: PMC3383297 DOI: 10.1159/000339461] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Rectal mucosa-associated lymphoid tissue (MALT) lymphoma is a rare condition. Although the majority of patients undergo surgical resection, a definitive treatment for rectal MALT lymphoma has not yet been established. In the present study, we report the outcome of radiotherapy in 3 patients with rectal MALT lymphoma. Our cohort ranged from 56 to 65 years of age. The male/female ratio was 1:2, and all patients were in stage I (Lugano classification) of the disease. Endoscopic findings revealed elevated lesions resembling submucosal tumors in 2 patients, and a sessile elevated lesion with a nodular surface in 1 patient. One of the 3 patients underwent magnifying endoscopy with crystal violet staining that demonstrated a type I pit pattern (Kudo's classification) lesion with a broad intervening area caused by the upthrust of the tumor from the submucosa. All patients tolerated radiotherapy at doses of 30 Gy without major complications and achieved complete remission. Follow-up ranged from 13 to 75 months (mean 51.0 months), revealing no recurrence of MALT lymphoma. As such, we propose radiotherapy to be a safe and effective means for treating rectal MALT lymphoma.
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Affiliation(s)
- Takuma Okamura
- Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
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10
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Ohara E, Kitadai Y, Onoyama M, Ohnishi M, Shinagawa K, Oka S, Yoshida S, Tanaka S, Sakamoto N, Yasui W, Shimamoto F, Chayama K. Regression of rectal MALT lymphoma after antibiotic treatment in a patient negative for Helicobacter pylori. Clin J Gastroenterol 2011; 5:59-63. [PMID: 26181877 DOI: 10.1007/s12328-011-0270-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 10/10/2011] [Indexed: 01/31/2023]
Abstract
A 53-year-old man was referred to our hospital with bloody stool. Barium enema study and colonoscopy revealed multiple small nodules on the anterior wall of the lower rectum. Biopsy specimens showed proliferation of atypical lymphoid cells forming the nodules. Mucosa-associated lymphoid tissue lymphoma was diagnosed on the basis of histologic and immunohistochemical examinations. No metastasis was detected in lymph nodes or distant organs, indicative of clinical stage I disease. Although the test results were negative for Helicobacter pylori, eradication therapy was performed. The lesion disappeared completely within 9 months after the triple antibiotic therapy. H. pylori eradication therapy may be a useful treatment option regardless of H. pylori status.
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Affiliation(s)
- E Ohara
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Y Kitadai
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - M Onoyama
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - M Ohnishi
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - K Shinagawa
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - S Oka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - S Yoshida
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - S Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - N Sakamoto
- Department of Molecular Pathology, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan
| | - W Yasui
- Department of Molecular Pathology, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan
| | - F Shimamoto
- Department of Health Science, Faculty of Human Culture and Society, Prefectural University of Hiroshima, Hiroshima, Japan
| | - K Chayama
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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11
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Marín García D, Cárdenas Lafuente F, Utrilla Ayala MDC, Galán Jurado MV, Jiménez Martín JJ, García Ordóñez MA. [Primary diffuse large B-cell lymphoma of the rectum simulating a rectal adenocarcinoma]. GASTROENTEROLOGIA Y HEPATOLOGIA 2009; 33:92-8. [PMID: 19875198 DOI: 10.1016/j.gastrohep.2009.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Revised: 08/02/2009] [Accepted: 09/01/2009] [Indexed: 11/20/2022]
Abstract
Colorectal lymphoma is an extremely infrequent entity, representing less than 0.5% of all primary colorectal neoplasms. Colorectal localization accounts for 15-20% of all gastrointestinal lymphomas, after the stomach and small intestine. Because the symptoms are non-specific, this disease is usually diagnosed in the advanced stages. Dawson's criteria are highly useful in the differential diagnosis between primary colorectal involvement and gastrointestinal tract involvement secondary to systemic lymphoma, which is important due to the distinct prognosis and treatment of these entities. We report the case of a B-cell non-Hodgkin's lymphoma that was difficult to diagnose and was treated with R-CHOP polychemotherapy. Outcome was poor.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/pathology
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Colonoscopy
- Cyclophosphamide/therapeutic use
- Diagnosis, Differential
- Doxorubicin/therapeutic use
- Humans
- Immunohistochemistry
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/surgery
- Male
- Meta-Analysis as Topic
- Middle Aged
- Neoplasm Staging
- Prednisone/therapeutic use
- Prognosis
- Radiography, Abdominal
- Rectal Neoplasms/diagnosis
- Rectal Neoplasms/drug therapy
- Rectal Neoplasms/mortality
- Rectal Neoplasms/pathology
- Rectal Neoplasms/surgery
- Rectum/pathology
- Tomography, X-Ray Computed
- Vincristine/therapeutic use
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Affiliation(s)
- David Marín García
- Unidad de Aparato Digestivo, Servicio de Medicina Interna, Hospital Comarcal Antequera, Antequera, Málaga, España.
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Ahlawat S, Kanber Y, Charabaty-Pishvaian A, Ozdemirli M, Cohen P, Benjamin S, Haddad N. Primary mucosa-associated lymphoid tissue (MALT) lymphoma occurring in the rectum: a case report and review of the literature. South Med J 2007; 99:1378-84. [PMID: 17233195 DOI: 10.1097/01.smj.0000215855.98512.9d] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The primary extranodal B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is a distinct clinical pathologic entity that develops in diverse anatomic locations such as the stomach, salivary gland, thyroid, lung, and breast; however, colorectal involvement is rare. To the best of our knowledge, only 30 cases of primary rectal MALT lymphoma have been published in the English language literature, mostly from Japan. A single case has been reported from the US before this report. The most common symptoms ranged from asymptomatic to occult or gross gastrointestinal bleeding. Simultaneous involvement of the cecum or colon was seen in 20% of the patients. Ninety percent of the patients were classified as low grade, Stage 1 at the time of diagnosis. Polypoid lesions were 10-fold more common than ulcerative lesions. Seven patients were reported to have H pylori in the stomach. The majority of the patients underwent surgical or endoscopic resection as a cure; however, controversy exists with regards to antibiotic treatment or observation alone because of unknown etiopathogenesis. Infection with microorganisms other than H pylori has been postulated in the development of rectal MALT lymphoma; however, this hypothesis remains unproven. The overall prognosis of rectal MALT lymphoma appears favorable; however, long-term follow-up data is lacking. Therefore, periodic clinical monitoring should be done in these patients.
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Affiliation(s)
- Sushil Ahlawat
- Division of Gastroenterology, Department of Pathology, Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC 20007, USA
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13
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Narváez JA, Domingo-Domènech E, Roca Y, Romagosa V, De Lama E, González-Barca E, Petit J, Fernández-Sevilla A. Radiological features of non-gastric mucosa-associated lymphoid tissue lymphomas. Curr Probl Diagn Radiol 2005; 33:212-25. [PMID: 15459631 DOI: 10.1067/j.cpradiol.2004.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- José Antonio Narváez
- Department of CT and MR Imaging, Institut de Diagnòstic per la Imatge,Hospital Duran i Reynals, Barcelona, Spain
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14
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Hirasaki S, Endo H, Nishina T, Masumoto T, Tanimizu M, Hyodo I, Tajiri H. Mucosa-associated lymphoid tissue lymphoma occurring in the transverse colon. Dig Endosc 2003. [DOI: 10.1046/j.1443-1661.2003.00250.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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15
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KOYAMA NOBUATSU, YAMASHITA NAOYUKI, SAKURAZAWA NOBUYUKI, WACHI EIKO. Endoscopic removal of primary B‐cell mucosa‐associated lymphoid tissue lymphoma of the cecum. Dig Endosc 2003. [DOI: 10.1046/j.1443-1661.2003.00232.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- NOBUATSU KOYAMA
- Departments of * Surgery and † Pathology, Jisankai Medical Foundation, Tsuboi Hospital, Fukushima, Japan
| | - NAOYUKI YAMASHITA
- Departments of * Surgery and † Pathology, Jisankai Medical Foundation, Tsuboi Hospital, Fukushima, Japan
| | - NOBUYUKI SAKURAZAWA
- Departments of * Surgery and † Pathology, Jisankai Medical Foundation, Tsuboi Hospital, Fukushima, Japan
| | - EIKO WACHI
- Departments of * Surgery and † Pathology, Jisankai Medical Foundation, Tsuboi Hospital, Fukushima, Japan
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OKADA HIROYUKI, MIZUNO MOTOWO, YOSHINO TADASHI, YOKOTA KENJI, OKAZAKI HIROAKI, OKANO NOBUAKI, NASU JUNICHIROU, MANNAMI TOMOHIKO, OGUMA KEIJI, AKAGI TADAATSU, TSUJI TAKAO, SHIRATORI YASUSHI. CONCURRENT GASTRIC AND COLONIC LOW‐GRADE MUCOSA‐ASSOCIATED LYMPHOID TISSUE LYMPHOMATA IN A PATIENT WITHOUT HELICOBACTER PYLORIINFECTION. Dig Endosc 2003. [DOI: 10.1046/j.1443-1661.2003.00108.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- HIROYUKI OKADA
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - MOTOWO MIZUNO
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - TADASHI YOSHINO
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - KENJI YOKOTA
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - HIROAKI OKAZAKI
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - NOBUAKI OKANO
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - JUNICHIROU NASU
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - TOMOHIKO MANNAMI
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - KEIJI OGUMA
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - TADAATSU AKAGI
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - TAKAO TSUJI
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - YASUSHI SHIRATORI
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
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Viana HL, Henrique RM, Ferreira ES, Correia AM, Silva RA, Dias LM, Viana RL. Endoscopic ultrasonography in multiple lymphomatous polyposis. J Clin Gastroenterol 2002; 34:150-4. [PMID: 11782610 DOI: 10.1097/00004836-200202000-00010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Two cases of multiple lymphomatous polyposis (MLP) are presented, involving different segments of the gastrointestinal tract. Both cases display the characteristic clinical and pathologic features of MLP. In addition, we were able to document, for the first time, the endoscopic ultrasonographic findings in this disease. This new ancillary diagnostic technique was found to be very helpful in the evaluation of the structural changes of the wall of the gastrointestinal tract and in the detection of affected lymph nodes.
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Affiliation(s)
- Helena Lomba Viana
- Department of Gastroenterology, The Portuguese Cancer Institute, Oporto, Portugal
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Yoshino T, Ichimura K, Mannami T, Takase S, Ohara N, Okada H, Akagi T. Multiple organ mucosa-associated lymphoid tissue lymphomas often involve the intestine. Cancer 2001; 91:346-53. [PMID: 11180081 DOI: 10.1002/1097-0142(20010115)91:2<346::aid-cncr1008>3.0.co;2-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Low grade mucosa-associated lymphoid tissue (MALT) lymphomas usually are confined to single extranodal organs. Although some case reports have been published, clinicopathologic characteristics of multiorgan MALT lymphomas remain unclear. METHODS The authors evaluated 7 MALT lymphoma cases involving multiorgans in the past 7 years. In this period, they experienced 304 cases of MALT lymphomas. They analyzed the clinicopathologic features of these cases, including examination of clonal comparison among the lesions. RESULTS The patients, 4 females and 3 males, were aged 55-68 years old (average, 60.1 years). Four cases showed multiple organ involvement at the initial diagnosis or after a short period. In the other three cases, primary foci were the stomach, thyroid gland, and ocular adnexa; after a rather long period (3 years or more), distant metastases were found. Although intestinal primary lymphomas are rather rare, six of the seven cases showed large intestinal involvement. Lymph node involvement was proven in only three cases. The patients were rather resistant to the various therapeutic approaches. Although six patients are alive, five are with disease. DNA analyses revealed that in five of the cases evaluated, identical clones were detected among the different affected organs. CONCLUSIONS Multiorgan MALT lymphomas are rather rare. Most cases probably derived from a single clone, and lymphoma cells may selectively move among MALTs via a homing system with preferential involvement of the colon. Because multiorgan MALT lymphomas rarely achieve complete remission by treatment with combination chemotherapy or irradiation, MALT lymphomatous lesions should be checked carefully, especially in the large intestine.
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Affiliation(s)
- T Yoshino
- Department of Pathology, Okayama University Medical School, Okayama, Japan.
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Hasegawa N, Kato K, Yamada K, Morita K, Kuroiwa M, Ito H, Kamioka T, Matsuura T, Sato M, Ono K, Suzuki Y, Goto H. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) of the sigmoid colon. Gastrointest Endosc 2000; 52:802-4. [PMID: 11115928 DOI: 10.1067/mge.2000.110737] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- N Hasegawa
- Departments of Internal Medicine and Pathology, Tosei General Hospital, Nishioiwake, Seto, Aichi-Prefecture, Japan
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Abstract
Mucosa-associated lymphoid tissue (MALT) lymphoma has attracted attention because its concept has amalgamated the study of etiology and pathogenesis in an intriguing group of lymphomas. MALT lymphomas are a B-cell malignancy with characteristic lymphoepithelial lesions; cells are CD20-positive and CD5- and CD10-negative. The molecular changes observed include trisomy 3, t(11;18), and t(1;14) translocations. They commonly occur in the stomach, orbit, salivary glands, and thyroid. Localized disease is present in 60% to 70% of patients. Involvement of multiple extranodal sites has been observed at presentation or during the course of disease. Lymphocyte homing has been implicated in gastrointestinal MALT and may be involved in other MALT lymphomas. Local therapy, either through surgery or radiotherapy, is curative in a high proportion of patients. MALT lymphomas respond to chemotherapy, but there is no evidence that cure can be achieved, although prolonged survival is common. Long-term follow-up is essential for study of the outcomes in this disease.
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Affiliation(s)
- M Gospodarowicz
- Department of Radiation Oncology, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
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Nakamura S, Matsumoto T, Takeshita M, Kurahara K, Yao T, Tsuneyoshi M, Iida M, Fujishima M. A clinicopathologic study of primary small intestine lymphoma: prognostic significance of mucosa-associated lymphoid tissue-derived lymphoma. Cancer 2000; 88:286-94. [PMID: 10640959 DOI: 10.1002/(sici)1097-0142(20000115)88:2<286::aid-cncr7>3.0.co;2-z] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND It remains unclear whether the presence of mucosa-associated lymphoid tissue (MALT) lymphoma has prognostic implications for patients with primary small intestine lymphoma. METHODS The clinicopathologic features of 80 patients with primary small intestine lymphoma were examined retrospectively in relation to the presence of MALT lymphoma. Survival was compared univariately and multivariately among the groups divided by clinicopathologic findings. RESULTS Twenty-one cases (26%) were diagnosed as low grade B-cell lymphoma (15 marginal zone B-cell lymphoma of MALT type, 2 mantle cell lymphoma, and 4 follicle center lymphoma), 46 cases (58%) were diagnosed as high grade B-cell lymphoma (19 secondary large cell lymphoma with a low grade MALT component, 17 diffuse large cell lymphoma without MALT features, 7 Burkitt lymphoma, and 3 lymphoblastic lymphoma), and 13 cases (16%) were diagnosed as T-cell lymphoma. A significantly better survival was noted for patients without colorectal and/or gastric involvement, diffuse infiltration under macroscopy, high grade histology, and perforation. Those patients with MALT type tumors, less advanced stage of disease, B-cell phenotype, benign lymphoid follicular hyperplasia, and radical tumor resectability appeared to have a better survival rate. Based on Cox multivariate analysis, early stage disease and MALT-derived tumors were determined to be independent prognostic factors (P < 0.05). CONCLUSIONS The presence of MALT-derived lymphoma appears to have a favorable prognosis among patients with primary small intestinal lymphoma.
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Affiliation(s)
- S Nakamura
- Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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