Multiplelymphomatous Polyposis : A Rare Type of Primary Diffuse Gastrointestinal Non - Hodgkin's Lymphoma = الزوائد اللمفاوية المتعددة : نوع نادر من أنواع السرطانات الأولية و الشاملة الغير هوجكنية للغدد اللمفاوية للجهاز الهضمي

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Multiplelymphomatous polyposis (MLP) is a rare form of intestinal mantle cell lymphoma(MCL), few cases were reported in the literature especially female cases. A 58 years old female was thoroughly investigated for her recurrent attacks of bleeding per-rectum associated with anemia, weight loss, low grade fever and mild generalized abdominal pain. Gastroscopy and colonoscopy showed multiple variable sized polyps at the lower esophageal, gastric, duodenal, and colonic mucosa. Ultrasound, computerized tomography of abdomen and diagnostic laparoscopy were done and revealed multiple bilateral pelvic, para-aortic, mesenteric and cecal lymph node enlargement. Histopathology with immunochemical staining were compatible with diagnosis of mantle cell lymphoma with wide spread gastrointestinal involvement (multiple lymphomatous polyposis). On follow up the patient showed good response to remedies with Rituximab-Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone (R-CHOP). Involvement of nearly entire gastrointestinal tract by MLP is a rare variety of mantle cell lymphoma, the combination therapy of R-CHOP is encouraging and feasible 18 months after initiation of treatment and follows up.