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Primary rectal mucosa-associated lymphoid tissue lymphoma masquerading as proctitis
Jin-Yan Zhang1, Bao-Zhong Fu2, Zhi-Kun Yin3
1Gastroenterology and Hepatology, The First Affiliated Hospital of Xiamen University, China.
Revista Espanola De Enfermedades Digestivas
|September 14, 2023
Summary
This study reports a rare case of Stage I primary rectal mucosa-associated lymphoid tissue (MALT) lymphoma in a young male. Radiotherapy effectively treated the lymphoma, leading to complete symptom resolution and lesion disappearance.
Area of Science:
- Gastroenterology
- Hematology
- Oncology
Background:
- Mucosa-associated lymphoid tissue (MALT) lymphoma is a rare extranodal non-Hodgkin lymphoma.
- Primary rectal MALT lymphoma is exceptionally uncommon, posing diagnostic challenges.
Observation:
- A 29-year-old male presented with chronic bloody stools and endoscopic findings suggestive of proctitis.
- Histopathology and immunohistochemistry confirmed diffuse infiltration of CD20+, CD79a+, CD19+ lymphoid cells, characteristic of MALT lymphoma.
- Extensive staging investigations, including PET/CT, revealed no extrarectal involvement, indicating Stage I disease.
Findings:
- The patient was diagnosed with Stage I primary rectal MALT lymphoma.
- Treatment with 30 Gy radiotherapy over 15 fractions resulted in symptom alleviation.
- A 3-month follow-up colonoscopy demonstrated complete resolution of the rectal lesion.
Implications:
- This case highlights the importance of thorough histopathological and immunohistochemical evaluation for diagnosing rare gastrointestinal lymphomas.
- Radiotherapy appears to be an effective and curative treatment modality for localized rectal MALT lymphoma.
- Early diagnosis and treatment can lead to excellent outcomes and complete remission in patients with primary rectal MALT lymphoma.
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