ABSTRACT
The accurate diagnosis and localization of gastrointestinal bleeding may use many tests and procedures including serial hematocrits, angiography, scintigraphy, endoscopy, nasogastric aspiration, barium studies and surgery before success is achieved. However, lower gastrointestinal (GI) bleeding is difficult to localize despite above diagnostic procedures. We had experienced a case of mucosa associated lymphoid tissue (MALT) lymphoma of jejunum. In this case, a 61-year-old male was admitted to our hospital with recurrent lower GI bleeding. The cause of recurrent lower GI bleeding was not defined by extensive evaluation including gastrofiberoscopy, colonoscopy, mesenteric angiography, small bowel series. We diagnosed this case as low grade B cell MALT lymphoma after exploratory laparatomy due to bowel perforation.
Subject(s)
Humans , Male , Middle Aged , Angiography , Barium , Colonoscopy , Diagnosis , Endoscopy , Hematocrit , Hemorrhage , Jejunum , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell, Marginal Zone , Mucous Membrane , Radionuclide ImagingABSTRACT
Low-grade B cell mucosa-associated lymphoid tissue (MALT) lymphoma makes up 8% of non-Hodgkin's lymphomas. It has been characterized by a prolonged clinical course and persistent disease at the site of origin. Most patients with low-grade B cell MALT lymphoma occur in the stomach, orbit, intestine, lung, thyroid, salivary gland, skin, soft tissues, bladder, kidney, and central nervous system. The diagnosis of MALT lymphoma can be established by a characteristic finding of infiltration of small lymphocytes that are monoclonal B cell and CD5 negative. Bone marrow involvement seems uncommom but has been developed. Waldenstr m's macroglobulinemia (WM) is usually defined as bone marrow infiltration of lymphoplasmacytoid lymphocytes with a high level of circulating macroglobulin IgM. Lymphadenopathy and splenomegaly occurs in 20~40% of WM. It is very hard work to do differential diagnosis between disseminated low-grade B cell MALT lymphoma and WM with organ involvement by a bone marrow examination. We reprot one case of low grade mediastinal MALT lymphoma with bone marrow involvement and a high level of serum monoclonal IgM with clinical appearance of WM.
Subject(s)
Humans , Bone Marrow , Bone Marrow Examination , Central Nervous System , Diagnosis , Diagnosis, Differential , Immunoglobulin M , Intestines , Kidney , Lung , Lymphatic Diseases , Lymphocytes , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell, Marginal Zone , Lymphoma, Non-Hodgkin , Mediastinum , Orbit , Salivary Glands , Skin , Splenomegaly , Stomach , Thyroid Gland , Urinary Bladder , Waldenstrom MacroglobulinemiaABSTRACT
Adenocarcinoma is the most common type of malignant tumor arising in the stomach, accounting for approximately 95% of malignant gastric neoplasms. The majority of remainder is lymphoma. Although H. pylori infection has been implicated as a common cause of both adenocarcinoma and lymphoma of the stomach, synchronous occurrence of both tumors is very rare. We present a case of a 23- year-old-female who presented with epigastric discomfort and was found to have synchronous low-grade B-cell MALT lymphoma and adenocarcinoma of the stomach in association with H. pylori infection.