Lymphomatous Polyposis: Case Report and Literature Review / Poliposis linfomatosa: reporte de caso y revisión de la literatura

Abstract Lymphomatous polyposis (LP) is the endoscopic feature of primary gastrointestinal mantle cell lymphoma (MCL), a rare type of B-cell non-Hodgkin's lymphoma (NHL) and a typical but rare endoscopic pattern of gastrointestinal tract involvement (GIT) by nodal MCL. We present the case of a 62-year-old man with nodal MCL, with LP as a manifestation of GIT, and review the literature.

Resumen La poliposis linfomatosa (PL) es la característica endoscópica del linfoma de células del manto (LCM) gastrointestinal primario, un tipo infrecuente de linfoma no Hodgkin (LNH) de células B, así como un patrón endoscópico típico, pero infrecuente, del compromiso del tracto gastrointestinal (TGI) por LCM nodal. Presentamos el caso de un hombre de 62 años con LCM nodal, con PL como manifestación del compromiso gastrointestinal, y realizamos una revisión de la literatura.

Poliposis linfomatosa múltiple gastrointestinal / Gastrointestinal multiple lymphomatosus polyposis

La poliposis linfomatosa es una forma poco frecuente de linfoma gastrointestinal primario que ocurre sobre todo en pacientes de la tercera edad. Se reporta un caso de un paciente masculino de 74 años que presenta diarreas de 2 meses de evolución asociado a dolor abdominal, astenia, anorexia y pérdida de peso. Se realiza estudios complementarios que concluyen Poliposis linfomatosa intestinal. (Linfoma de las células del Manto).

Lymphomatous polyposis is a rare form of primary gastrointestinal that occurs mainly in older adults. This is the case of a male patient aged 74 years who had diarrheas for 2 months associated to abdominal pain, asthenia, anorexia and weight loss. Supplementary studies were performed to finally diagnose intestinal lymphomatous polyposis (Mantle cell lymphoma).

Poliposis linfomatosa intestinal secundaria a: 1.1 linfoma no hodgkin inmunofenotipo celulas b:linfoma folicular primario. A propósito de un caso / SECONDARY INTESTINAL LYMPHOMATOUS PO- LYPOSIS IMMUNE CELLS B: PRIMARY FOLLICULAR LYMPHOMA NON-HODGKIN LYMPHOMA. A CASE PRESENTATION

Paciente femenino de 30 años de edad, con enfermedad actual de 7 meses de evolución, caracterizado por Astenia, adi- namia, palidez cutáneo mucosa, pérdida de peso 12 kg en el último mes y episodios de evacuaciones liquidas de 10 días de evolución en #15 veces al día en abundante cantidad, sin moco, ni sangre; también refería vómito #01 vez al día de contenido alimentario. Antecedentes personales, familiares y hábitos psicobiológicos: no contributorios. Exploración funcional: niega síntomas B. Examen físico positivo: Signos Vitales: normales, IMC: 17.2 kg/m2 leve palidez cutáneo-mucosa e hipotrofia muscular. Paraclínicos positivo: Anemia macrocítica e hipercrómica severa, sin alteración del recuento leucocitario, LDH: 1578 U/L y el resto de la química básica normal. Ultrasonido abdominal: normal. TAC de abdomen con doble contraste: esplenomegalia leve adenopatías retroperitoneales y mesentéricas de aspecto inespecífico, Endoscopia Digestiva Superior: poliposis duodenal. Enteroscopia: Poliposis Intestinal. Colonoscopia: normal. Biopsia e inmunohistoquimico: poliposis linfomatosa intestinal: linfoma no hodgking inmunofenotipo celulas B: linfoma folicular. Un tipo infrecuente de linfoma extranodal del estirpe celular B, infrecuente como forma de presentación de poliposis linfomatosa, con el que debemos que hacer diagnóstico diferencial con: 1.Linfoma del Manto 2. Hiperplasia Linfoide Folicular Reactiva 3. Pólipos Epiteliales 4. Compromiso secundario de linfoma folicular ganglionar.

Patient women 30 years of age, with 7 months of current disease, characterized by asthenia, adinamia, mucous skin pallor, loss of weight 12 kg in the last month, and episodes of evacuations liquid 10 days of evolution in #15 times a day in copious amounts, without mucus, or blood; also meant vomiting #01 time per day of food content. Personal history, family, and psychobiological habits: not contributorios. Functional exploration: denies symptoms B. positive physical examination: vital signs: normal BMI: 17.2 kg/m2 light pale mucosa and muscular hypotrophy. Positive paraclinical: anemia macrocytic e hyperchromic severe, without alteration of the Leukocyte count, LDH: 1578 u / and the rest of basic chemistry was normal. Abdominal ultrasound: normal. CT of abdomen with doublecontrast: splenomegaly mild retroperitoneal adenopathies and mesenteric nonspecific aspect, upper digestive endoscopy: duodenal polyposis. Enteroscopy: Intestinal polyposis. Colo- noscopy: normal. Biopsy and immunohistochemical: intestinal lymphomatous polyposis: Lymphoma non-Hodgkins immune b cells follicular lymphoma. An uncommon type of extranodal lymphoma cell line B, uncommon as a form of presentation of lymphomatous polyposis, that we have to make differential diagnosis with: 1. Mantle cell Lymphoma. 2. Reactive follicular Lymphoid Hyperplasia. 3. Epithelial polyp. 4. Nodal follicular Lymphoma secondary commitment.

Multiple intestinal lymphomatous polyposis in a Jindo dog

A male, 5-year-old Jindo dog underwent enterectomy and enteroanastomosis due to ileus of the intestine at a local veterinary hospital. Grossly, the excised intestine showed markedly thickened multinodular masses in the serosal layer of the upper part, and soft-to-firm, creamcolored neoplastic masses that displayed extensive nodular mucosal protuberances into the lumen. The neoplastic masses were filled with large round cells that were ovoid in shape and they had pale and/or hyperchromatic nuclei. The neoplastic cells had mainly infiltrated into the mucosal and submucosal layers, and they had diffusely invaded the muscular and serosal layers. Therefore, the diagnosis of canine multiple intestinal malignant lymphomatous polyposis was made based on the gross and histopathological findings. The origin of these tumor cells was determined to be B-cells since they were positive for anti-CD20.

A Case of Mantle Cell Lymphoma Presenting as Multiple Lymphomatous Polyposis Involving Skeletal Muscles / 대한소화기내시경학회지

Multiple lymphomatous polyposis (MLP) is an uncommon type of primary non-Hodgkin's gastrointestinal B cell-lymphoma characterized by the presence of multiple lymphomatous polyps along the gastrointestinal tract. Unlike MALT-lymphoma, MLP has a strong tendency for histologically monomorphic character, extra-digestive localization, rare lymphoepithelial lesion and poor prognosis. The malignant cells of MLP share morphological, immunohistologic and cytogenetic similarities with cells of node-based mantle cell lymphoma. We report a case of mantle cell lymphoma presenting with MLP involving various segments of the gastrointestinal tract, skeletal muscles of the right thigh and bone marrow observed in a 71-year-old woman who complained of lower abdominal pain and a palpable right thigh mass.

A Case of Gastrointestinal Multiple Lymphomatous Polyposis with Conjunctival Involvement / 대한소화기내시경학회지

Multiple lymphomatous polyposis (MLP) is a distinctive type of primary gastrointestinal lymphoma, characterized by multiple polyps involving long segments of the gastrointestinal tract. Because MLP has a high tendency toward extraintestinal involvement such as bone marrow, lymph node, spleen and liver, MLP can cause various clinical manifestations and has a poor prognosis. We report a case of gastrointestinal MLP, who had an unusual conjunctival involvement during the course of anti-cancer chemotherapy.

Mantle cell lymphoma presented as multiple lymphomatous polyposis: clinical review of 4 cases / 대한내과학회지

Multiple lymphomatous polyposis(MLP) is an interesting clinical entity of non-Hodgkin's lymphoma(NHL) and is defined as B-cell lymphoma characterized by the presence of multiple lymphomatous polyps along the gastrointestinal tract. Recently MLP has been considered as a variant form of mantle cell lymphoma(MCL). The median survival of patients with MCL is only 3 years, and none of the available conventional chemotherapy regimens appears curative. Encouraging results have been reported with high dose chemotherapy with autoSCT and alloSCT for its treatment. We introduce 4 cases of MLP diagnosed as MCL by morphologic and immunologic method. The common clinical findings of these cases were splenomegaly (4/4), multiple intraabdominal lymphadenopathy (4/4), and advanced stage (3/4) at presentation. The overall remission duration was relatively short (5-27 months) and three of four cases relapsed after conventional chemotherapy or autologous stem cell transplant. Our report suggests that MCL presented as MLP is a high risk subgroup of NHL and more aggressive approach may be needed for cure.

A Case of Multiple Lymphomatous Polyposis Developed after Complete Remission of Diffuse Large B-cell Type Nasopharyngeal Lymphoma / 대한소화기내시경학회지

Multiple lymphomatous polyposis (MLP) is a term used to describe malignant lymphoma of the gastrointestinal tract that manifest as polyposis. MLP is believed to represent gastrointestinal involvement by mantle cell lymphoma (MCL), primarily based on its histologic and immunophenotypic similarities with MCL. We have experienced a case of MCL presented as a peculiar feature of multiple lymphomatous polyposis in a 49-year old male patient. He had been diagnosed diffuse large B cell lymphoma of nasopharynx and treated by radiation therapy and CHOP chemotherapy. He newly developed MCL after 10 years in complete remission of diffuse large B cell lymphoma. After newly developed lymphoma was compared with former diagnosed lymphoma, we concluded that they were not same type each other. We reviewed a total of 13 patients including this case, of MLP, which were reported in various Korean literature, and literatures are reviewed.

A Case of Recurrent Mantle Cell Lymphoma in the form of Intestinal Lymphomatous Polyposis / 대한내과학회지

Mantle cell lymphoma (MCL) is a recently redefined category of malignant lymphoma that has been indivisualized under different names, because of classifications, such as the Working Formulation, fail to recognize it. In the Working Formulation, MCL is classified as diffuse small cleaved cell lymphoma most frequently. Immunophenotyping has a tremendous value in diagnosis of MCL and adds the accuracy of diagnosis. It more commonly arises in peripheral lymph nodes, but in colon, usually presents as a diffuse infiltration, known as multiple lymphomatous polyposis and lymphomatous polyposis can be regarded as the intestinal form of MCL. We recently experienced a case of recurrent MCL presented with a peculiar feature of intestinal lymphomatous polyposis in a 57-year old male patient. He had been diagnosed diffuse small cleaved cell lymphoma of tonsil and treated by CHOP chemotherapy. He developed a recurrence in stomach, colon, liver, spleen and bone marrow after 16 months in complete remission. We could confirm the previously diagnosed lymphoma of tonsil as MCL by adding immunophenotyping with cyclin D1 and CD5. He received salvage chemotherapy and responded partially. We report a case of MCL relapse in the form of intestinal lymphomatous polyposis and literatures are reviewed.

Multiple lymphomatous polyposis of the gastrointestinal tract: a report of two cases with immunohistochemical studies

We describe two cases of multiple lymphomatous polyposis in the gastrointestinal tract from the esophagus to the rectum. Clinical findings, histopathologic and immunohistochemical findings in paraffin embedded tissue are discussed. It is important to recognize this rare form of gastrointestinal lymphoma because of the prognostic and therapeutic implications.