Abstract
A 65-year-old man was treated for gastric MALT lymphoma and concomitant duodenal diffuse large B-cell lymphoma in 2001. He had undergone 2 courses of CHOP therapy, after which the ascending part of the duodenum had developed complete stenosis, necessitating resection in January 2002. The serum IL-2 receptor antibody level gradually started to elevate in 2006. The patient underwent upper gastrointestinal endoscopy, which showed recurrence of MALT lymphoma in the duodenal bulbus, and he was admitted to our institution for treatment.
Colonoscopy identified diffuse reddish markings, which were similar to those often observed on the liver surface in laparoscopic examination, from the terminal ileum and cecum to the descending colon. Biopsy confirmed MALT lymphoma. The tumor cells were positive for CD20, and the patient underwent 5 courses of R-CHOP, which attained improvement in both the endoscopic and histological findings. Colonic MALT lymphoma commonly presents as a nodular lesion, and the reddish markings as observed in this case represent a rare endoscopic feature, suggesting diffuse infiltration. This finding is sometimes associated with multiple organ invasion of lymphoma, for which systemic examination is mandatory.
