A CASE OF MUCOSA-ASSOCIATED LYMPHOID TISSUE (MALT) LYMPHOMA OF THE ILEUM WITH MULTIPLE LYMPHOMATOUS POLYPOSIS

Abstract

A 73-year-old man was referred to our hospital, complaining of alternating bouts of diarrhea and constipation. Colonoscopy showed a large number of polypoid lesions at the terminal ileum. Histological examination showed diffuse infiltration of atypical lymphocytes at the marginal zone of the lymph node follicle, and immunohistochemical analysis showed that they were positive for CD20, CD79α, and bcl-2, but negative for CD10, CD5, and cycline D1. We diagnosed mucosa-associated lymphoid tissue (MALT) lymphoma of the ileum, clinical stage II1 based on the Lugano International Conference classification. Ileocecal resection and partial resection of the ileum were performed. Pathologic examination showed multiple lymph node metastases in the mesenteric lymph nodes. Although adjuvant chemotherapy was performed with 2 courses of R-THP-COP, lymphoma recurred at 3 years after surgery. Complete remission was obtained again with chemotherapy by two courses of R-CHOP. Seven years after the surgery, the patient is still alive.