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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
PubMed

Insights

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.

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