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Colonic primary large cell lymphoma with marginal zone growth pattern presenting as multiple polyps.
K Gloeckner1, F Leithaeuser, W Lang
1Institute of Pathology, Medical University of Luebeck, Germany.
The American Journal of Surgical Pathology
|September 9, 1999
Summary
This study details a rare case of primary gastrointestinal lymphoma in a patient with colonic polyps. The lymphoma mimicked colonic adenomas, highlighting the need for careful differential diagnosis.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Primary gastrointestinal lymphoma is a rare malignancy.
- Colonic polyps can sometimes mimic other neoplastic conditions.
Observation:
- A 58-year-old man presented with multiple colonic polyps.
- Histopathological examination revealed a lymphoma originating in the marginal zone, infiltrating interfollicular spaces and sparing the mucosa.
- Neoplastic cells were intermediate-sized blasts expressing CD20 and cytoplasmic IgM (kappa), with a clonal V-D-J rearrangement.
Findings:
- The lymphoma exhibited a marginal zone growth pattern, frequently showing follicular colonization.
- Tumor cells were negative for CD45RO, CD5, CD10, IgD, and CD23.
- No Bcl-1 or bcl-2 rearrangement was detected.
Implications:
- The findings suggest a diagnosis of primary large cell lymphoma with a marginal zone growth pattern.
- This case underscores the importance of considering lymphoma in the differential diagnosis of colonic polyps.
- Accurate diagnosis requires comprehensive immunophenotypic and molecular analysis.