• Contact us
  • E-Submission

Ewha Med J : The Ewha Medical Journal

OPEN ACCESS
mobile search button mobile menu button
Search
Advanced Search
ABOUT
BROWSE ARTICLES
JOURNAL POLICIES
FOR CONTRIBUTORS

Articles

Page Path

Case Report

Diffuse Large B-Cell Lymphoma Transformed from a Rectal Mucosa-Associated Lymphoid Tissue Lymphoma

Sae Han Kang1, Jang Won Park1, Byung Wook Jung1, Jun Gyu Song1, Hyun Sik Oh2, Kwonoh Park3
The Ewha Medical Journal 2016;39(2):51-55. Published online: April 29, 2016

1Department of Internal Medicine, Hanil Hospital, Seoul, Korea.

2Department of Pathology, Hanil Hospital, Seoul, Korea.

3Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.

Corresponding author: Kwonoh Park. Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea. Tel: 82-55-360-2366, Fax: 82-55-360-1129, parkkoh@daum.net
• Received: November 27, 2015   • Accepted: April 20, 2016

Copyright © 2016, The Ewha Medical Journal

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 105 Views
  • 0 Download
  • 1 Crossref
prev next

Full Article

Download PDF Download PDF
  • Primary rectal lymphoma is a rare disease among the gastrointestinal (GI) lymphoma. In particular, diffuse large B-cell lymphoma (DLBCL) transformed from mucosa-associated lymphoid tissue (MALT) lymphoma is often the primary type of GI lymphoma, mostly in stomach or duodenum, but has never been reported in rectum. Here we report an unusual case in which a 75-year-old male patient diagnosed with DLBCL transformed from MALT lymphoma in the rectum. The patient was diagnosed as rectal DLBCL transformed from MALT lymphoma as Lugano stage II2 and was treated with chemotherapy (R-CHOP) with CD-20 monoclonal antibody (rituxaimb). Complete remission of multiple lymphadenopathy and mass forming ulcer of the rectum was achieved after 6 cycles of R-CHOP. He has been free from disease for 12 months.
  • Keywords: MALT lymphoma; Diffuse large B-cell lymphoma; Rectum
  • 1. Herrmann R, Panahon AM, Barcos MP, Walsh D, Stutzman L. Gastrointestinal involvement in non-Hodgkin's lymphoma. Cancer 1980;46:215-222.
  • 2. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer 1972;29:252-260.
  • 3. Koch P, del Valle F, Berdel WE, Willich NA, Reers B, Hiddemann W, et al. Primary gastrointestinal non-Hodgkin's lymphoma: I. Anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German Multicenter Study GIT NHL 01/92. J Clin Oncol 2001;19:3861-3873.
  • 4. Nakamura S, Matsumoto T, Iida M, Yao T, Tsuneyoshi M. Primary gastrointestinal lymphoma in Japan: a clinicopathologic analysis of 455 patients with special reference to its time trends. Cancer 2003;97:2462-2473.
  • 5. Zucca E, Conconi A, Pedrinis E, Cortelazzo S, Motta T, Gospodarowicz MK, et al. Nongastric marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. Blood 2003;101:2489-2495.
  • 6. Montoto S, Fitzgibbon J. Transformation of indolent B-cell lymphomas. J Clin Oncol 2011;29:1827-1834.
  • 7. Lee SH, Jang BI, Kim TN. A case of primary rectal diffuse large B cell lymphoma presented as multiple polypoid lesions. Korean J Gastrointest Endosc 2008;36:302-306.
  • 8. Tokunou K, Yamamoto T, Toshimitsu H, Kitamura Y, Ando S. A case of mucosa-associated lymphoid tissue lymphoma of the rectum. Gan To Kagaku Ryoho 2013;40:2056-2058.
  • 9. Rohatiner A, d'Amore F, Coiffier B, Crowther D, Gospodarowicz M, Isaacson P, et al. Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma. Ann Oncol 1994;5:397-400.
  • 10. Dawson IM, Cornes JS, Morson BC. Primary malignant lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis. Br J Surg 1961;49:80-89.
  • 11. Kim SJ, Lee GH, Park SH, Shin HD, Jo CL, Kim TH, et al. A case of diffuse large b cell lymphoma transformed from a duodenal low grade malt lymphoma. Korean J Gastrointest Endosc 2007;34:103-107.
  • 12. Kim JH, Kang DW, Park MJ, Kim JM. High-grade transformation of primary nodal marginal zone B-cell lymphoma: a case report. Korean J Pathol 2003;37:282-286.
  • 13. Theriault C, Galoin S, Valmary S, Selves J, Lamant L, Roda D, et al. PCR analysis of immunoglobulin heavy chain (IgH) and TcR-gamma chain gene rearrangements in the diagnosis of lymphoproliferative disorders: results of a study of 525 cases. Mod Pathol 2000;13:1269-1279.
  • 14. Al-Tourah AJ, Gill KK, Chhanabhai M, Hoskins PJ, Klasa RJ, Savage KJ, et al. Population-based analysis of incidence and outcome of transformed non-Hodgkin's lymphoma. J Clin Oncol 2008;26:5165-5169.
  • 15. Wang SL, Liao ZX, Liu XF, Yu ZH, Gu DZ, Qian TN, et al. Primary early-stage intestinal and colonic non-Hodgkin's lymphoma: clinical features, management, and outcome of 37 patients. World J Gastroenterol 2005;11:5905-5909.
Fig. 1

Colonoscopic findings. (A) About 10 mm sized mass-forming lesion with nodularity is observed on rectum. It is diagnosed as mucosa-associated lymphoid tissue lymphoma. (B) About 20 mm sized mass-forming ulcer is observed on rectum, Anal verge (AV) 5 cm. This lesion has vulnerability that doesn't have definite demarcation with surrounding normal mucosa. It is diagnosed as diffuse large B-cell lymphoma.

emj-39-51-g001.jpg
Fig. 2

Histopathologic findins of mucosa-associated lymphoid tissue lymphoma (A) and diffuse large B-cell lymphoma (B-D). H&E stain (×200) on rectal biopsy of 20 mm sized mass-forming ulcer shows monomorphic lymphocytic infiltrating of the lamina propria surrounds colonic glands massively infiltrated with atypical lymphocytes and undergoing destruction (lymhpoepithelial lesion) (A). Rectal biopsy specimens of 20 mm sized mass-forming ulcer lesion with nodularity show strong immunoreactivity for BCL 2 stain (×200) (B) and CD 20 stain (×200) (C). (D) H&E stain (×200) shows tumor cells with round or oval nuclei, open chromatin, and prominent nucleoli.

emj-39-51-g002.jpg
Fig. 3

Abdomen and pelvis computed tomography findings at initial presentation. They show circumferential anorectal thickened tissue associated with retro-rectal lymphadenopathy (A) and paraaortic multiple lymphadenpathy (B).

emj-39-51-g003.jpg
Fig. 4

Fluorine-18-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography (18F-FDG PET CT) findings. They show increased FDG uptake in rectal and retroperitoneal paraaortic lymph nodes, which suggest the involvement of lymphoma (A, B).

emj-39-51-g004.jpg

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • Clinical Characteristics and Long-Term Prognosis of Colorectal Mucosa-Associated Lymphoid Tissue Lymphoma According to the Endoscopic Classification and Treatment Modality: A Multicenter Study
      Seung Min Hong, Dong Hoon Baek, Geun Am Song, Hong Sub Lee, Seung Bum Lee, Ra Ri Cha, Tae-Oh Kim, Jae Hyun Kim, Jong Hoon Lee
      Cancers.2025; 17(5): 750.     CrossRef

    Download Citation

    Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

    Format:

    Include:

    Diffuse Large B-Cell Lymphoma Transformed from a Rectal Mucosa-Associated Lymphoid Tissue Lymphoma
    Ewha Med J. 2016;39(2):51-55.   Published online April 29, 2016
    DOI: https://doi.org/10.12771/emj.2016.39.2.51
    Download Citation
    Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
    Format:
    • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
    • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
    Include:
    • Citation for the content below
    Diffuse Large B-Cell Lymphoma Transformed from a Rectal Mucosa-Associated Lymphoid Tissue Lymphoma
    Ewha Med J. 2016;39(2):51-55.   Published online April 29, 2016
    DOI: https://doi.org/10.12771/emj.2016.39.2.51
    Close

    Figure

    • 0
    • 1
    • 2
    • 3
    Diffuse Large B-Cell Lymphoma Transformed from a Rectal Mucosa-Associated Lymphoid Tissue Lymphoma
    Image Image Image Image
    Fig. 1 Colonoscopic findings. (A) About 10 mm sized mass-forming lesion with nodularity is observed on rectum. It is diagnosed as mucosa-associated lymphoid tissue lymphoma. (B) About 20 mm sized mass-forming ulcer is observed on rectum, Anal verge (AV) 5 cm. This lesion has vulnerability that doesn't have definite demarcation with surrounding normal mucosa. It is diagnosed as diffuse large B-cell lymphoma.
    Fig. 2 Histopathologic findins of mucosa-associated lymphoid tissue lymphoma (A) and diffuse large B-cell lymphoma (B-D). H&E stain (×200) on rectal biopsy of 20 mm sized mass-forming ulcer shows monomorphic lymphocytic infiltrating of the lamina propria surrounds colonic glands massively infiltrated with atypical lymphocytes and undergoing destruction (lymhpoepithelial lesion) (A). Rectal biopsy specimens of 20 mm sized mass-forming ulcer lesion with nodularity show strong immunoreactivity for BCL 2 stain (×200) (B) and CD 20 stain (×200) (C). (D) H&E stain (×200) shows tumor cells with round or oval nuclei, open chromatin, and prominent nucleoli.
    Fig. 3 Abdomen and pelvis computed tomography findings at initial presentation. They show circumferential anorectal thickened tissue associated with retro-rectal lymphadenopathy (A) and paraaortic multiple lymphadenpathy (B).
    Fig. 4 Fluorine-18-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography (18F-FDG PET CT) findings. They show increased FDG uptake in rectal and retroperitoneal paraaortic lymph nodes, which suggest the involvement of lymphoma (A, B).

    Fig. 1

    Fig. 2

    Fig. 3

    Fig. 4

    Diffuse Large B-Cell Lymphoma Transformed from a Rectal Mucosa-Associated Lymphoid Tissue Lymphoma
    Ewha Med J : The Ewha Medical Journal

    ABOUT

    BROWSE ARTICLES 

    JOURNAL POLICIES

    FOR CONTRIBUTORS 

    © Ewha Womans University College of Medicine.
    TOP