Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Oct 7;16(37):4661-9.
doi: 10.3748/wjg.v16.i37.4661.

Endoscopic features and prognoses of mantle cell lymphoma with gastrointestinal involvement

Masaya Iwamuro  1 , Hiroyuki Okada, Yoshiro Kawahara, Katsuji Shinagawa, Toshiaki Morito, Tadashi Yoshino, Kazuhide Yamamoto
Affiliations

Endoscopic features and prognoses of mantle cell lymphoma with gastrointestinal involvement

Masaya Iwamuro et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the endoscopic manifestations and prognoses of gastrointestinal (GI) mantle cell lymphoma (MCL).

Methods: A database search at the Department of Pathology of Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences revealed 57 MCL patients with GI involvement. Clinical records were available for 35 of the 57 patients from 21 institutions, and those 35 patients were enrolled in this study. We summarized the gross types of endoscopic features, event-free survival (EFS), and overall survival (OS) of those patients.

Results: Of the 35 patients, GI involvement in the esophagus, stomach, and duodenum was found in 2 (5.7%), 26 (74.3%), and 12 (34.3%) patients, respectively. Twenty-one of the 35 patients underwent colonoscopy; among them, GI involvement in the ileum, cecum, colon, and rectum was found in 10 (47.6%), 3 (14.3%), 12 (57.1%), and 10 (47.6%), respectively. Various lesions, such as superficial, protruded, fold thickening, or ulcerative, were found in the stomach, whereas multiple lymphomatous polyposis (MLP) was dominant from the duodenum to the rectum. Twelve patients were treated with a hyper-CVAD/MA regimen, and they had better OS (3-year rate, 88.3% vs 46.4%, P < 0.01) and better EFS (3-year rate, 66.7% vs 33.8%, P < 0.05) than the remaining 23 patients who were not treated with this regimen.

Conclusion: MLP was a representative form of intestinal involvement, whereas a variety of lesions were found in the stomach. The hyper-CVAD/MA regimen may improve survival in these patients.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Histological features of mantle cell lymphoma. A: Rectal biopsied specimen demonstrated monomorphic proliferation of medium-sized lymphoid cells (Hematoxylin and eosin staining). This case illustrated typical immunohistochemical features of mantle cell lymphoma, showing positivity for cyclin D1 and CD5 staining; B: Immunohistochemical staining for cyclin D1; C: Immunohistochemical staining for CD5; D: Approximately 5% of neoplastic cells were positive for Ki-67 staining; consequently, this case was classified as a low mitotic rate. A-C: Original magnification, × 200; D: × 400.
Figure 2
Figure 2
Esophageal lesions of mantle cell lymphoma. A: A protruded tumor was seen in the esophagogastric junction; B: In another patient, multiple whitish plaques were seen throughout the whole esophagus.
Figure 3
Figure 3
Gastric lesions of mantle cell lymphoma. A: Protruded type (n = 6) often resembled submucosal tumor; B: One patient with a protruded type lesion was diagnosed with stage I primary gastrointestinal mantle cell lymphoma; C: Fold thickening type (n = 6); D: Ulcerative type (n = 6); E: In one patient, only a change in mucosal color with redness was seen. This case was classified as the superficial type (n = 7); F: Among superficial type lesions, cobblestone-like mucosa with a few shallow ulcers was also seen.
Figure 4
Figure 4
Intestinal lesions of mantle cell lymphoma. From the duodenum to the rectum, multiple lymphomatous polyposis (MLP) was dominant (n = 17). A, B: Typical features of MLP were diffuse multiple micropolyps; C: Some large tumorous polyps were sometimes found together with micropolyps; D: Protruded type (n = 4); E: Superficial type (n = 1, arrow).
Figure 5
Figure 5
Overall survival (A) and event-free survival (B) according to administration of the hyper-CVAD/MA regimen. 1Log-rank test.
See this image and copyright information in PMC

References

    1. Jaffe ES, Harris NL, Stein H, Vardiman JW, editors . World Health Organization classification of tumours: pathology and genetics of tumours of haematopoietic and lymphoid tissues. Lyon: IARC Press; 2001.
    1. Cornes JS. Multiple lymphomatous polyposis of the gastrointestinal tract. Cancer. 1961;14:249–257. - PubMed
    1. Fraga M, Lloret E, Sanchez-Verde L, Orradre JL, Campo E, Bosch F, Piris MA. Mucosal mantle cell (centrocytic) lymphomas. Histopathology. 1995;26:413–422. - PubMed
    1. Ruskoné-Fourmestraux A, Delmer A, Lavergne A, Molina T, Brousse N, Audouin J, Rambaud JC. Multiple lymphomatous polyposis of the gastrointestinal tract: prospective clinicopathologic study of 31 cases. Groupe D'étude des Lymphomes Digestifs. Gastroenterology. 1997;112:7–16. - PubMed
    1. Romaguera JE, Medeiros LJ, Hagemeister FB, Fayad LE, Rodriguez MA, Pro B, Younes A, McLaughlin P, Goy A, Sarris AH, et al. Frequency of gastrointestinal involvement and its clinical significance in mantle cell lymphoma. Cancer. 2003;97:586–591. - PubMed

Substances