Multiple Lymphomatous Polyposis Research Articles

Multiple lymphomatous polyposis of the colon originating from T-cells: a case report

Multiple lymphomatous polyposis is an unusual form of non-Hodgkin’s lymphoma characterised by myriad polyps throughout the alimentary tract. Most multiple lymphomatous polyposis cases are derived from B-cell, and there has been little information on multiple lymphomatous polyposis of T-cell origin. A 67-year-old Japanese man presented with lower abdominal pain and diarrhoea of 4-week duration. Colonoscopy revealed numerous small umbilicated polyps and several raised erosions in the colorectum. Biopsy specimens showed diffuse proliferation of lymphoma cells negative for B-cell markers but positive for T-cell markers. Polymerase chain reaction using extracted chromosomal deoxyribonucleic acid from paraffin-embedded samples identified T-cell receptor γ and δ gene recombination. The patient was treated with combined chemotherapy, leading to complete resolution of the lesions.

A rare case of multiple lymphomatous polyposis with widespread involvement of the gastrointestinal tract.

Multiple lymphomatous polyposis (MLP) is an uncommon type of primary non-Hodgkin gastrointestinal (GI) B-cell lymphoma characterized by the presence of multiple polyps along the GI tract. Malignant cells of MLP have mantle cell characteristics and thus are considered to be the counterpart of the mantle cell lymphoma (MCL) in the GI tract. Since 1961, no more than 70 well-documented cases have been published. We report the case of 53-year-old man diagnosed as having MLP. The patient presented with diffuse abdominal pain, chronic lower GI bleeding, peripheral lymphadenopathy, and weight loss. The lymphomatous polyps extended from the esophagus to the rectum, with bone marrow infiltration. Immunohistologic findings were characteristic of MCL. The patient was treated with a combined cyclophosphamide, vincristine, and prednisone chemotherapy regimen, resulting in a partial response.

Multiple lymphomatous polyposis

Multiple lymphomatous polyposis is a rare form of gastrointestinal lymphoma characterized by the presence of multiple polyps throughout the length of the digestive tract. We present a typical case diagnosed by using an intestinal barium follow-through and CT scan which revealed gastric, ileac and colonic involvement as well as retroperitoneal adenopathy. We discuss the radiological differential diagnosis.

Multiple lymphomatous polyposis of the GI tract: Report of a case and review

Multiple lymphomatous polyposis of the GI tract: Report of a case and review

Multiple lymphomatous polyposis of the GI tract: Report of a case and review

Multiple lymphomatous polyposis of the GI tract: Report of a case and review

The Evaluation of the Biological Behavior and Grade Among Cases with Mantle Cell Lymphoma

We have studied the expression of MIB-1 and prognosis in cyclin D1(CyD1) + and CyD1 m mantle cell lymphoma (MCL), and compared them to B-CLL/SLL. All cases were assigned to four groups by immunoreactivity and primary sites: (1) CyD1 + nodal MCL, 11 cases: (2) CyD1 + extranodal MCL (multiple lymphomatous polyposis, (MLP)) three cases: (3) CyD1 m nodal MCL, three cases: and (4) CyD1 m B-CLL/SLL, seven cases. The average of MIB-1 labeling indexes of the four groups were 30.66, 8.70, 9.30 and 4.66, respectively. The CyD1 m group consisting of nodal MCL and CLL/SLL had a significantly longer median survival time (69 months) than the CyD1 + group consisting of nodal MCL and MLP (22 months, P =0.01 ). These data indicate that CyD1 m nodal MCL may show a lower MIB-1 labeling index, and has a better prognosis, than CyD1 + nodal MCL. In addition, a large difference in the average of MIB-1 labeling indexes between nodal MCL and MLP in the CyD1 + group was found.

Clinicopathological features of primary intestinal lymphoma in Taiwan: a study of 21 resected cases.

In Taiwan, primary intestinal lymphomas (PIL) have rarely been reported and characterized. Using WHO classification, we retrospectively studied the clinicopathological features of PIL cases surgically resected in Taiwan. There were 21 cases, 14 males and seven females, with a median age of 66. The most common symptom at presentation was abdominal pain (n = 14; 66.7%). Six (28.6%) cases showed perforation and two (9.5%) intussusception. Two patients had multicentric tumors. The most common location was ileum (n = 11, 52.4%). Twenty cases (95.2%) were of B-cell lineage, and one (4.8%) was of T-cell lineage. These cases were classified as diffuse large B-cell lymphoma (DLBL) (n = 18; 85.7%), Burkitt lymphoma (n = 2; 9.5%), and enteropathy-type T-cell lymphoma (EATL) (n = 1; 4.8%). One case was lost to follow-up. The 1- and 2-yr survival rates of the remaining 20 patients were 44.4% and 26.7%, respectively. In conclusion, we describe the clinicopathological findings of a rare case of appendiceal DLBL and another one of ileal EATL, that have never been reported in Taiwan previously. We found that in Taiwan PIL occurred in the elderly, with a male predominance, showing a relatively aggressive clinical course, and a pattern similar to that seen in western countries, except for the absence of multiple lymphomatous polyposis.

High dose chemotherapy and autologous stem cell transplantation (PBSCT) in 3 patients with multiple lymphomatous polyposis high dose chemotherapy and autologous stem cell transplantation (PBSCT) in 3 patients with multiple lymphomatous polyposis

High dose chemotherapy and autologous stem cell transplantation (PBSCT) in 3 patients with multiple lymphomatous polyposis high dose chemotherapy and autologous stem cell transplantation (PBSCT) in 3 patients with multiple lymphomatous polyposis

Early Phase of Intestinal Mantle Cell Lymphoma: A Report of Two Cases Associated with Advanced Colonic Adenocarcinoma

Intestinal mantle cell lymphoma characteristically produces multiple polyps, a finding reported as multiple lymphomatous polyposis. The early stages of intestinal mantle cell lymphoma before polyp formation and the pattern of initial lymph node invasion, however, have not been described. We recently encountered two cases of intestinal mantle cell lymphoma in their early development found incidentally associated with advanced colonic adenocarcinoma. We present herein the clinical, histopathological, immunohistochemical, and molecular genetic features of these two cases. In one case, a single polypoid mass was found with invasion limited to mucosa and submucosa of the terminal ileum and without lymph node compromise. In the second case, there were multiple mucosal aggregates of neoplastic cells without formation of polyps. Regional lymph nodes in the latter case showed either partial or complete involvement by lymphoma. In both cases, immunohistochemistry (CD20+, CD5+, cyclin D1+, CD10−, and CD23−), and demonstration of clonal immunoglobulin heavy chain and bcl-1 gene rearrangements by PCR analysis confirmed the diagnosis of mantle cell lymphoma.

A Case of Malignant Lymphoma appearing Lesions as like Multiple Lymphomatous Polyposis (MLP) in the Esophagus, Stomach, Duodenum and Colon

A 80-year-old male patient referred to our hospital because of constipation and fresh bloody stool. On admission, superficial lymph nodes were palpable in the inguinal resions, and spleno megaly was detected by CT scan examination. Endoscopic examination revealed multiple polypoid lesions in the whole colon, esophagus and duodenum, and tuberous lesions with central depression in the stomach, cecum and rectum. Histopathological examinations of biopsy specimens showed diffuse proliferation of abnormal lymphocytes. Immunohistochemical staining demonstrated that these consisted of L-26, CD-79α positive, and of UCHL1, DFT1, CD3 negative. Consequently this case was diagnosed as B-cell malignant lymphoma, diffusemedium sized cell type. We think that it should be appropriate to deal lymphomatous tumors forming multiple polypoid lesions with distant lymph node involvement as an advanced type of MLP, even if they can not be confirmed as gastrointestinal origin. Further discussion should be raised on diagnostic criteria of MLP.

4521 Clinicopathological features of malignant lymphoma discovered by colonoscopy: an analysis according to the endoscopic classification.

Background and Aims: There have been only a few endoscopic studies with respect to primary ileocolonic lymphomas. The aims of this study were to classify these lesions according to the colonoscopic findings and to reveal the clinicopathological relationship according to the classes. Methods: Subjects were 24 cases of primary malignant lymphoma of the terminal ileum and colon which were diagnosed by colonoscopy at Asan Medical Center in the past 10 years. There were 17 men and 7 women, with a median age of 54.5 years (range, 29-75 years). We evaluated the clinicopathological features according to their endoscopic findings. Results: The chief complaints of the patients were abdominal pain (16 cases, 56%), bleeding (5 cases, 18%), and abdominal mass (4 cases, 14%). Twenty six lesions from 22 patients were endoscopically classified as follows: fungating (10 lesions, 38%), ulcerofungating (7 lesions, 27%), infiltrative (5 lesions, 19%), ulceroinfiltrative (3 lesions, 12%), and ulcerative (1 lesion, 4%). The other 2 patients were excluded from the endoscopic classification, since they had the special type, multiple lymphomatous polyposis, which involved the whole gastrointestinal tract diffusely. The location of the lesions other than multiple lymphomatous polyposis was the terminal ileum in 11 lesions (42%), the colon in 10 lesions (39%), and both regions in 5 lesions (19%). Within the large bowel, the cecum was involved most frequently, followed by the ascending colon: 6 in cecum, 3 in ascending colon, and 3 in both cecum and ascending colon. The other 3 lesions were located in the transverse colon (1), sigmoid colon (1), and rectum (1). The pathological studies revealed the diffuse large cell type in 13 cases, the large cell immunoblastic type in 5 cases, the diffuse small cleaved cell type in 3 cases, and the follicular, predominantly large cell type, and the diffuse mixed, small and large cell type in the remainder. There was no relationship between the endoscopic findings and the histologic types. Eight cases (33%) were manifested as intussusception. All of them had the fungating type in the endoscopic classification. Conclusions: Primary ileocolonic lymphomas can be classified endoscopically into the fungating, ulcerative, infiltrative, ulcerofungating, and ulceroinfiltrative types. Among the types, fungating and ulcerofungating types are the most frequent. Intussusception is a common finding in ileocolonic lymphomas and occurs mainly in the fungating type.

Multiple lymphomatous polyposis overexpressing cyclin D1

A case of mantle cell lymphoma (MCL) associated with multiple lymphomatous polyposis (MLP) is reported is a 62-year-old woman, with special reference to the patient's clinical features and response to treatment. There were multiple widespread polypoid lesions in the entire gastrointestinal tract, with ileocecal masses. Ileocecal resection was performed on immunohistochemical examination, the neoplastic cells in the polypoid lesions stained positively for cyclin D1. Two conventional anthracycline-containing regimens (adriamycin-cyclophosphamide-vincristine-prednisolone [CHOP] and mitantroxone-etoposide-vindesine-prednisolone [MEVP]) were administered, but had limited success. The patient has since been receiving an irinotecan-adriamycin regimen (irinotecan, 25 mg/m(2), days 1 and 2; adriamycin, 40 mg/m(2), day 3, once a month) as an outpatient and has achieved good partial remission. She is well with disease 48 months after the initiation of the initial treatment.

A CASE OF MULTIPLE LYMPHOMATOUS POLYPOSIS OF THE SMALL INTESTINE

We report a case of multiple lymphomatous polyposis (MLP) of the small intestine. A 65-year-old man was admitted to the hospital because of right lower abdominal pain. Intestinal fluoroscopy visualized stenosis of the terminal ileum and a tumor of the jejunum. With a diagnosis of malignant lymphoma of the small intestine, the ileocecum and the jejunum were resected. The resected specimen showed a spread of polyposis in the entire small intestine and histologically, the lesion revealed non-Hodgkin's malignant lymphoma (diffuse medium cell type, B cell type). In case of MLP in the long gastrointestinal tract involving not only from the stomach to the large intestine but from the esophagus to the large intestine, the entire garstrointestinal tract should be examined.

Pathology of intestinal lymphomas.

The advent of immunohistological and molecular techniques has enabled the comprehensive characterization of many lymphoma entities. Furthermore, it has increased the consensus in lymphoma classification among pathologists. In this review we describe the pathological features of primary intestinal lymphomas classified according to the revised European-American classification of lymphoid neoplasms. The majority of primary intestinal lymphomas are of B-cell lineage and most of these are high-grade tumors. By morphology they may be classified as diffuse large B-cell lymphomas of centroblastic, immunoblastic or plasmablastic type and Burkitt lymphomas. The latter occur predominantly in the terminal ileum and affect children or young adults. Low-grade extra-nodal marginal-zone lymphoma of the mucosa-associated lymphoid tissue (MALT) type and, less frequently, follicular center-cell lymphomas are the low-grade B-cell lymphomas most commonly observed in this region. The first mentioned tumor and its specific intestinal variant, alpha-chain disease or immunoproliferative small intestinal disease are well known for their indolent clinical course. Primary intestinal mantle-cell lymphoma often presents as multiple lymphomatous polyposis and similarly to its node-based equivalent is associated with an unfavorable prognosis. Most primary intestinal T-cell lymphomas display a characteristic immunophenotype, particular histological features with prominent epitheliotropism and are often associated with celiac disease indicating that these tumors form a specific lymphoma type. It has been termed intestinal T-cell lymphoma or enteropathy-type T-cell lymphoma. Clinically, these are aggressive diseases with a high mortality rate. In summary, primary intestinal lymphomas consist of several entities which display distinct clinicopathological features thus confirming the relevance of lymphoma typing.

A case of follicle center lymphoma of the small intestine with multiple lymphomatous polyposis

A case of follicle center lymphoma of the small intestine with multiple lymphomatous polyposis

Gastrointestinal lymphomas: the French experience of the Groupe D'etude des Lymphomes Digestifs (GELD).

Since 1983, the French Groupe d'Etude des Lymphomes Digestifs (GELD), under the aegis of the Fondation Française de Cancérologie Digestive, has aimed to identify the different prognostic groups of the primary digestive-tract lymphomas (PDTL) and their optimal treatment. Successive multicenter studies were conducted and 91 PDTL were evaluated. A marked improvement in their prognosis was obtained by a strategy including precise histologic typing and clinical staging followed by a therapeutic approach combining initial surgical resection, whenever possible or reasonable, followed by chemotherapy adapted to the grade of malignancy and resectability of the lymphoma. The multivariate analysis indicated that the factors for good prognosis were age (< 65 yrs), gastric localisation, stage IE and radical or even incomplete surgery. However, Helicobacter pylori eradication should be the first treatment in stage IE low-grade gastric mucosa-associated lymphoid tissue (MALT) tumors. The long-term results of such medical treatment are evaluated together with the management and the place of surgery in these localised tumors. However, owing to the limited number of patients, a large international co-operative trial is needed to confirm the findings. Thirty-one cases of multiple lymphomatous polyposis were also collected and confirmed to be a distinct entity among PDTL and the gastrointestinal counterpart of the mantle-cell-zone lymphomas. High-dose radio-chemotherapy supported by auto-transplantation improved their prognosis.

Mucosa-associated lymphoid tissue (MALT) lymphoma manifesting as multiple lymphomatosis polyposis of the gastrointestinal tract

There have been a number of previous case reports of lymphomas in the form of multiple mucosal polyps affecting variable lengths of colonic and intestinal mucosa. Invariably these have been classified histologically as mantle cell lymphomas. We report a case of this rare syndrome that illustrates many of its typical features but which demonstrates significant histological and immunophenotypic differences. A 67-yr-old man was referred with a 3-month history of altered bowel habit and a barium enema suggestive of extensive ulcerative colitis. At colonoscopy, diffuse umbilicated mucosal polyps were seen throughout the colon and a larger circumferential mass lesion at the ileocecal valve. Biopsies demonstrated a diffuse B-cell lymphoma consistent with “multiple lymphomatous polyposis” of the colon. Flow cytometry revealed CD25 positive/CD5 negative lymphoid cells confirming marginal B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type. Upper gastrointestinal investigations confirmed similar involvement of the stomach, duodenum, and small bowel. Helicobacter pylori was absent. Flow cytometry abnormalities consistent with marrow involvement were present. These features led to a diagnosis of stage IV marginal zone B-cell lymphoma of MALT type, presenting as multiple lymphomatous polyposis of the gastrointestinal tract. Three months of combination chemotherapy resulted in an excellent symptomatic and endoscopic response.

Mucosa-associated lymphoid tissue lymphoma of the duodenum forming multiple polypoid lesions: Report of a case

We report herein the case of a patient found to have mucosa-associated lymphoid tissue (MALT) lymphoma of the duodenum forming multiple polypoid lesions. Endoscopic examination revealed multiple small nodules with a yellow-white, rough surface in the duodenal bulb. Histopathological and immunological findings subsequently suggested low-grade B-cell MALT lymphoma. Cytologically, MALT lymphoma is similar to multiple lymphomatous polyposis (MLP); however, this case, which involved multiple polypoid lesions, was confirmed not to be MLP.

Multiple lymphomatous polyposis of the gastrointestinal tract is a heterogenous group that includes mantle cell lymphoma and follicular lymphoma: Analysis of somatic mutation of immunoglobulin heavy chain gene variable region

Multiple lymphomatous polyposis (MLP) is characterized by multiple polyps involving long segments of the gastrointestinal (GI) tract. MLP is thought to represent mantle cell lymphoma (MCL) of the GI tract; however, some cases of follicular lymphoma (FL) of the GI tract are found with a multiple polypoid appearance. In the present study, to clarify the cellular origin of MLP, clonal immunoglobulin heavy chain (IgH) gene rearrangement of four cases with MLP was amplified by polymerase chain reaction (PCR) and analyzed for the presence of somatic mutation. The IgH variable (VH) region sequences of three cases (CD5+ CD10− cyclin D1+) showed a little somatic mutation compared with the closest published germline. The other case (CD10+ CD5− cyclin D1−) was highly mutated and showed intraclonal heterogeneity (ongoing somatic hypermutation). These data indicate that three of the cases with MLP are derived from pregerminal center B cells (mantle zone B cells) and one case with MLP from germinal center B cells. Our study suggests that MLP is a heterogenous group that includes MCL and FL.

Multiple lymphomatous polyposisを呈したnon Hodgkin&apos;s lymphomaの1例

Multiple lymphomatous polyposisを呈したnon Hodgkin&apos;s lymphomaの1例