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Chen D, Zhong DF, Yang Y, Chen SS, Liu D. Colonic mucosa-associated lymphoid tissue lymphoma: A case report. Front Surg 2023; 10:1178394. [PMID: 37181595 PMCID: PMC10169616 DOI: 10.3389/fsurg.2023.1178394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/22/2023] [Indexed: 05/16/2023] Open
Abstract
Background Mucosa-associated lymphoid tissue (MALT) lymphoma is a group of extranodal lymphomas that originate from B cells. Primary colonic MALT lymphoma is a rare disease, and there is no consensus on its endoscopic features and standard therapies. It is essential to raise awareness of colonic MALT lymphoma and choose the appropriate treatment. Case presentation In this case report, we describe a 0-IIb-type lesion that was found by electronic staining endoscopy and magnifying endoscopy. The patient underwent a definitive diagnostic ESD for diagnosis. The patient was evaluated for lymphoma after diagnostic ESD according to the Lugano 2014 evaluation criteria, which are divided into imaging remission on the basis of CT and/or magnetic resonance imaging (MRI) evaluation and metabolic remission on the basis of PET-CT evaluation. Based on the PET-CT results suggesting increased glucose metabolism in the sigmoid colon, the patient underwent additional surgical treatment. According to the pathological results of the surgery, we found that ESD could treat such lesions, which may provide a new option for colorectal MALT lymphoma. Conclusion The low incidence of colorectal MALT lymphoma, especially for 0-IIb lesions, which are difficult to detect, requires the use of electronic staining endoscopy to improve the detection rate. The combination with magnification endoscopy can improve the understanding of colorectal MALT lymphoma, which ultimately requires pathological support for diagnosis. According to our experience with the present patient case, ESD seems to be a feasible and economical choice for the treatment of massive colorectal MALT lymphoma. However, the combined application of ESD and another therapy scheme needs further clinical investigation.
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Affiliation(s)
- Dan Chen
- Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua, China
| | - Ding-Fu Zhong
- Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua, China
| | - Yi Yang
- Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua, China
| | - Si-Shuang Chen
- Department of Pathology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua, China
| | - Dong Liu
- Department of Hepatobiliary and Pancreatic Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua, China
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Iwamuro M, Takahashi T, Tanaka T, Toji T, Hiraoka S, Kawano S, Kawahara Y, Okada H. Appendiceal Orifice Inflammation in Ulcerative Colitis Mimicking Mucosa-Associated Lymphoid Tissue Lymphoma in the Cecum. Case Rep Gastrointest Med 2020; 2020:8893604. [PMID: 33083067 DOI: 10.1155/2020/8893604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [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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3
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Hollie N, Asakrah S. MALT lymphoma of the colon: a clinicopathological review. J Clin Pathol 2020; 73:378-383. [PMID: 32034054 DOI: 10.1136/jclinpath-2019-206377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 02/06/2023]
Abstract
Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) occurs in approximately 9% of non-Hodgkin B cell lymphoma. However, it occurs only rarely within the colon. The presentation is often asymptomatic, and can have multiple endoscopic appearances, including a single or multinodular polypoid lesion. Furthermore, small biopsies can make histological evaluation challenging. The 2016 WHO classification update includes many molecular features of entities and expands the differential diagnosis of lymphoid lesions of the colon. In addition to immunohistochemistry, molecular methods may be tempting to use for small difficult cases. Furthermore, treatment approaches are varied for this entity, and not well studied. Therefore, an updated review on MALT lymphoma of the colon is needed.
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Affiliation(s)
- Norris Hollie
- Pathology, Beth Israel Lahey Health, Boston, Massachusetts, USA
| | - Saja Asakrah
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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5
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Zanelli M, Tioli C, Mengoli MC, De Marco L, Valli R, Zizzo M, Ascani S. Marginal-zone lymphoma: A rare presentation with multiple intestinal polyps. Clin Res Hepatol Gastroenterol 2019; 43:117-9. [PMID: 30166251 DOI: 10.1016/j.clinre.2018.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 08/01/2018] [Indexed: 02/04/2023]
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Nakamura Y, Matsuda K, Yokoyama S, Tamura K, Mitani Y, Iwamoto H, Mizumoto Y, Murakami D, Fujimoto M, Yamaue H. Mass-forming mucosa-associated lymphoid tissue lymphoma of the cecum treated by laparoscopy-assisted bowel resection. Int Cancer Conf J 2019; 8:66-70. [PMID: 31149550 DOI: 10.1007/s13691-018-00355-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 12/18/2018] [Indexed: 01/30/2023] Open
Abstract
Colonic mucosa-associated lymphoid tissue (MALT) lymphoma is very rare, especially those which form a mass. Although the characteristics and treatment methods of gastric MALT lymphomas are well established, those of colonic MALT lymphomas have been insufficiently described. Here, we report a case of mass-forming cecal MALT lymphoma that was successfully treated by laparoscopy-assisted bowel resection. A 60-year-old woman with right lower abdominal pain and a palpable tumor was referred to our hospital. Colonoscopy showed a smooth elevated submucosal tumor-like lesion in the cecum. Histological and immunochemical findings were consistent with MALT lymphoma. Serum tumor marker levels were within normal range. Enhanced abdominal computed tomography showed a large tumor 55 mm in diameter in the cecum and edema of a few paracolic lymph nodes. The tumor was diagnosed as cecal MALT lymphoma classified as stage II1 by Lugano classification, and laparoscopy-assisted ileocecal resection was performed. The postoperative course was uneventful and the patient underwent eradication therapy for Helicobacter pylori. A year after the operation she has had no recurrence. In patients with mass-forming colonic MALT lymphoma without dissemination, surgical resection may be a feasible treatment.
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Affiliation(s)
- Yuki Nakamura
- 1Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510 Japan
| | - Kenji Matsuda
- 1Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510 Japan
| | - Shozo Yokoyama
- 1Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510 Japan
| | - Koichi Tamura
- 1Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510 Japan
| | - Yasuyuki Mitani
- 1Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510 Japan
| | - Hiromitsu Iwamoto
- 1Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510 Japan
| | - Yuki Mizumoto
- 1Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510 Japan
| | - Daisuke Murakami
- 1Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510 Japan
| | - Masakazu Fujimoto
- 2Department of Human Pathology, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroki Yamaue
- 1Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510 Japan
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Ahmed M. Simultaneous Occurrence of Colonic Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma (MALToma) and Lung Cancer. Case Rep Gastrointest Med 2018; 2018:3607101. [PMID: 30631608 DOI: 10.1155/2018/3607101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/24/2018] [Accepted: 11/11/2018] [Indexed: 01/19/2023] Open
Abstract
Colonic MALToma accounts for 2.5% of all MALTomas. MALToma can be associated with certain chronic infections, autoimmune disorders, Waldenstrom's macroglobulinemia, and old age. Synchronous MALTomas can occur in multiple organs. Simultaneous occurrence of colonic MALToma and colon cancer has been reported. A case of colonic MALToma and lung cancer is described here.
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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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Nezhat CH, Dun EC, Wieser F, Zapata M. A rare case of primary extranodal marginal zone B-cell lymphoma of the ovary, fallopian tube, and appendix in the setting of endometriosis. Am J Obstet Gynecol 2013; 208:e12-4. [PMID: 23108066 DOI: 10.1016/j.ajog.2012.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 09/16/2012] [Accepted: 10/02/2012] [Indexed: 11/30/2022]
Abstract
Extranodal marginal zone B-cell lymphomas are uncommon. Most occur in the gastrointestinal tract. Marginal zone B-cell lymphomas of the female genital tract are rare, and few cases exist of marginal zone B-cell lymphomas of the uterus, cervix, and fallopian tubes. We report the first marginal zone B-cell lymphoma of the ovary, fallopian tube, and appendix arising in endometriosis.
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Affiliation(s)
- Ceana H Nezhat
- Atlanta Center for Minimally Invasive Surgery and Reproductive Medicine, Northside Hospital, Atlanta, GA, USA
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Amouri A, Chtourou L, Mnif L, Mdhaffar M, Abid M, Ayedi L, Daoud J, Elloumi M, Boudawara T, Tahri N. [MALT lymphoma of the rectum: a case report treated by radiotherapy]. Cancer Radiother 2008; 13:61-4. [PMID: 19101191 DOI: 10.1016/j.canrad.2008.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Revised: 09/11/2008] [Accepted: 11/04/2008] [Indexed: 01/30/2023]
Abstract
The mucosa-associated lymphoid tissue (MALT) lymphoma is a distinct clinical pathologic entity that develops in diverse anatomic locations such as the stomach, salivary gland, thyroid, lung, skin and breast. However, colorectal involvement is extremely rare. To our knowledge, only ten cases of primary rectal MALT lymphoma have been reported in the literature. We report a 46-year-old woman with rectal MALT lymphoma, which regressed after radiotherapy. The patient had rectal bleeding. Colonoscopy showed a pseudonodular and ulcerated big fold in the rectum. Microscopic and immunohistologic studies of the biopsy specimen showed typical features of low grade MALT lymphoma. Upper endoscopy showed chronic gastritis with lymphoid follicles but without any infiltration of lymphoma cells. Helicobacter pylori infection was confirmed by histology. No extra-intestinal involvement was found on the staging evaluation, which included computed tomography (CT) of the abdomen, chest, pelvis and a bone marrow biopsy. We attempted to eradicate H. pylori with a 7-day course of omeprazole, amoxycillin, and metronidazole. Eradication was proved successful by endoscopy. Repeated colonoscopy 4 months after the end of treatment showed that the rectal tumor had not regressed. Biopsy specimens confirmed the persistent infiltration of lymphoma cells. The patient was considered to be a non-responder to eradication therapy and was indicated for radiotherapy. He underwent a total of 34 Gy. Complete regression was confirmed by colonoscopic and histologic examination at 2 months after the end of treatment. He was followed up closely with colonoscopy, but no relapse of these lesions was detected after 12 months.
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Affiliation(s)
- A Amouri
- Service d'hépatogastroentérologie, hôpital Hédi-Chaker, 3029 Sfax, Tunisie.
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Abstract
We herein present a case of a 75-year-old female with mucosa-associated lymphoid tissue (MALT) lymphoma of the transverse colon with the stage IE (Ann Arbor classification). Colonoscopy revealed the tumor’s appearance as a IIa plus IIc-like early colon cancer as defined according to the macroscopic classification of the Japanese Research Society for Cancer of Colon, Rectum and Anus, measuring less than 2 cm in diameter. Histologically, the tumor was diagnosed as MALT lymphoma because of the presence of lymphoepithelial lesions consisting of diffuse proliferation of atypical lymphocytes and glandular destruction. The majority of these lymphocytes immunohistochemically stained for the B-lymphocyte marker. The patient first underwent H pylori eradication therapy with Lansap®. However, the tumor size gradually increased over the next 4 mo and the patient eventually underwent surgical resection. The operative procedure included a partial colectomy with dissection of the paracolic lymph nodes. The tumor measured 45 mm x 30 mm in diameter and histological examination showed that the lymphoma cells had infiltrated the muscle layer of the colon without nodal involvement. The patient has had no recurrence postoperatively without any chemotherapy.
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MESH Headings
- Aged
- Anti-Bacterial Agents/therapeutic use
- Colon, Transverse/microbiology
- Colon, Transverse/pathology
- Colon, Transverse/surgery
- Colonic Neoplasms/microbiology
- Colonic Neoplasms/pathology
- Colonic Neoplasms/surgery
- Disease Progression
- Drug Resistance, Microbial
- Female
- Helicobacter Infections/complications
- Helicobacter Infections/drug therapy
- Helicobacter pylori
- Humans
- Lymphoma, B-Cell, Marginal Zone/microbiology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/surgery
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Affiliation(s)
- Shigetoshi Matsuo
- Department of Surgery, Nagasaki Prefectural Shimabara Hospital, 7895 Shimokawajiri, Shimabara, Nagasaki 855-0861, Japan.
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13
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Affiliation(s)
- Shouichi Tanaka
- Department of Gastroenterology, Iwakuni National Hospital, Iwakuni, Japan
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Lehman NL, Horoupian DS, Warnke RA, Sundram UN, Peterson K, Harsh GR. Dural marginal zone lymphoma with massive amyloid deposition: rare low-grade primary central nervous system B-cell lymphoma. Case report. J Neurosurg 2002; 96:368-72. [PMID: 11838814 DOI: 10.3171/jns.2002.96.2.0368] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors report the case of a 63-year-old woman who presented with a primary dural extranodal marginal zone lymphoma (MZL) associated with massive kappa light chain amyloidosis of the meninges. Extranodal MZL is a low-grade B-cell lymphoma that may show variable degrees of plasmacytic differentiation. Like solitary plasmacytoma of soft tissue, which can also be associated with amyloid, extranodal MZL generally responds well to local therapy and has a good prognosis. It is important to distinguish these entities from high-grade primary central nervous system (CNS) B-cell lymphomas and more aggressive and/or widespread, potentially amyloidogenic conditions such as multiple myeloma, lympho-plasmacytoid lymphoma, and chronic lymphocytic leukemia/small lymphocytic lymphoma. To the authors' knowledge this is the first reported case of dural MZL associated with massive meningeal amyloid deposition. Extranodal MZL is a rare low-grade primary CNS B-cell lymphoma that may be associated with amyloidosis. It should be considered in the differential diagnosis of CNS lymphoproliferative lesions and CNS amyloidosis.
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Affiliation(s)
- Norman L Lehman
- Department of Pathology, Stanford University Medical Center, California 94305-5324, USA
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