A rare case of mantle cell lymphoma as lymphomatous polyposis with widespread involvement of the digestive tract. 2011

C Chung Kim Yuen, and C Tomowiak, and M Yacoub, and T Barrioz, and C Barrioz, and D Tougeron
Department of Pathology, Poitiers University Hospital, 2, rue de la Milétrie, 86000 Poitiers, France.

Lymphomatous polyposis of the gastrointestinal tract is rare. It refers to a heterogeneous group of small B-cell lymphomas including mantle cell lymphoma, follicular lymphoma and MALT lymphoma. It is characterized by the presence of multiple lymphomatous polyps along one or more segments of the digestive tract. Clinical symptoms are non-specific. We herein report the case of a 74-year old man initially admitted for an upper and lower gastrointestinal endoscopy to explore a positive Hemoccult test. The endoscopy revealed multiple polyps all along the gastrointestinal tract. Histopathological study showed a diffuse lymphomatous proliferation of small B-cells whose immunohistochemical features were compatible with a mantle cell lymphoma. Tumoral B-cells showed a positivity of cyclin D1 markers but negativity for CD5. Immunochemotherapy with R-CHOP (rituximab, cyclophosphamide, adriamycine, vincristine and prednisone) was initiated. Based on this case study, the pitfalls of gastrointestinal tract lymphomatous polyposis diagnosis, prognosis and treatment options are discussed.

UI MeSH Term Description Entries
D008297 Male Males
D009361 Neoplasm Invasiveness Ability of neoplasms to infiltrate and actively destroy surrounding tissue. Invasiveness, Neoplasm,Neoplasm Invasion,Invasion, Neoplasm
D004067 Digestive System Neoplasms Tumors or cancer of the DIGESTIVE SYSTEM. Cancer of Digestive System,Digestive System Cancer,Cancer of the Digestive System,Neoplasms, Digestive System,Cancer, Digestive System,Cancers, Digestive System,Digestive System Cancers,Digestive System Neoplasm,Neoplasm, Digestive System
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D044483 Intestinal Polyposis The growth of INTESTINAL POLYPS. Growth processes include neoplastic (ADENOMA and CARCINOMA) and non-neoplastic (hyperplastic, mucosal, inflammatory, and other polyps). Cronkhite-Canada Syndrome,Polyposis, Skin Pigmentation, Alopecia, And Fingernail Changes,Polyposis, Intestinal
D020522 Lymphoma, Mantle-Cell A form of non-Hodgkin lymphoma having a usually diffuse pattern with both small and medium lymphocytes and small cleaved cells. It accounts for about 5% of adult non-Hodgkin lymphomas in the United States and Europe. The majority of mantle-cell lymphomas are associated with a t(11;14) translocation resulting in overexpression of the CYCLIN D1 gene (GENES, BCL-1). Lymphocytic Lymphoma, Diffuse, Poorly-Differentiated,Lymphoma, Centrocytic Small-Cell,Lymphoma, Lymphocytic, Diffuse, Intermediate Differentiated,Lymphoma, Lymphocytic, Diffuse, Poorly-Differentiated,Lymphoma, Lymphocytic, Intermediate,Lymphoma, Small-Cell, Centrocytic,Mantle-Cell Lymphoma,Mantle-Zone Lymphoma,Diffuse Lymphocytic Lymphoma, Poorly-Differentiated,Lymphocytic Lymphoma, Diffuse, Poorly Differentiated,Centrocytic Small-Cell Lymphoma,Centrocytic Small-Cell Lymphomas,Diffuse Lymphocytic Lymphoma, Poorly Differentiated,Lymphoma, Centrocytic Small Cell,Lymphoma, Mantle Cell,Lymphoma, Mantle-Zone,Lymphomas, Centrocytic Small-Cell,Lymphomas, Mantle-Cell,Lymphomas, Mantle-Zone,Mantle Cell Lymphoma,Mantle Zone Lymphoma,Mantle-Cell Lymphomas,Mantle-Zone Lymphomas,Small-Cell Lymphoma, Centrocytic,Small-Cell Lymphomas, Centrocytic

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