Mucosa-associated Lymphoid Tissue Lymphoma Of The Rectum That Regressed Spontaneously
Takenaka, R., Tomoda, J., Sakata, T., Ichiba, T., Motoi, M., Mizuno, M., & Tsuji, T. (2000). Mucosa-associated lymphoid tissue lymphoma of the rectum that regressed spontaneously. Journal of gastroenterology and hepatology, 15(3), 331–335. https://doi.org/10.1046/j.1440-1746.2000.02086.x
View Original Source →Abstract
We report a case of mucosa-associated lymphoid tissue (MALT) lymphoma of the rectum that regressed spontaneously. A 76-year-old man visited our hospital because of positive faecal occult blood testing. Colonoscopic examination revealed a slightly yellowish protruded lesion with a grooved depression in the lower rectum and two flat elevations in the upper rectum. Microscopic and immunohistological studies led to a diagnosis of MALT lymphoma. As the patient exhibited severe renal dysfunction and angina pectoris, the lesions were left untreated. Three months later, the protruded lesion became flat and the other lesions became unclear. He was followed up closely with endoscopy, but no relapse of these lesions was detected 19 months after the diagnosis.
Case Details
Disease Location
Rectum
Personal Characteristics
76 -year-old male march 1997 at age 29 had lung tuberculosis at age 44 had diabete mellitus at age 46, chronic glomerulonphritis and at age 73 angina pectoris his father died of rectal cancer and his mother died from uterine carcinoma
Clinical Characteristics
Had a positive fecal occult blood test physical exam showed no abnormalities except his palpebral conjunctiva was slightly anemic hemoglobin was 11.0g/dl, hematocrit was 33.7%, blood urea nitrogen was 37mg/dl, creatinine was 2.8mg/dl and 24-h creatinine clearance was 24.4ml/min barium enema showed an ulcerative polypoid lesion in the lower rectum colonoscopy disclosed a slightly yellowish protruded lesion with a grooved depression, measuring 2cm in diameter in the lower rectum. Also two flat, slightly yellowish elevations in the upper rectum biopsy specimens from all the lesions demonstrated dense diffuse lymphatic infiltration nuclear features resembled those of small cleaved cells of the geminal center and were referred to as centrocyte-like cells the showed lymphoepithelial lesions characterized by infiltration of lymphoma cells around the epithelium immunohistochemistry showed lymphoma cells were positive for kappa light chain and negative for lambda light chain, this demonstrated that these cells represented monoclonal neoplasms. Chest, abdominal and pelvic CT, gallium scintigraphy, upper gastrointestinal endoscopy and small bowl meal study detected no lesion in other areas primary rectal malt lymphoma was diagnosed rapid urease test and microscopic exam did not confirm h. Pylori infection and serum antibody was negative malt lymphoma was considered low-grade malignancy due to chronic renal dysfunction and angina pectoris and no treatment was administered
Remission Characteristics
Three months later, the protruded lesion became smaller and flat and the other flat lesions became more unclear biopsy specimens showed lymphatic infiltration but the monoclonality was not demonstrated in immunohistochemical staining he was followed-up closely with endoscopy but no relapse of the lesions was detected 19 months after the diagnosis
Treatment & Mechanisms
Proposed Remission Mechanisms
No major mechanism proposed for this case
Clinical Treatment
None reported
Non-Clinical Treatment
None reported