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Case Reports
. 2021 Dec 13;14(3):1761-1767.
doi: 10.1159/000520428. eCollection 2021 Sep-Dec.

Multiple Colorectal Mucosa-Associated Lymphoid Tissue Lymphoma Successfully Treated with Chemotherapy

Makoto Saito  1 , Shihori Tsukamoto  1 , Takashi Ishio  1 , Emi Yokoyama  1 , Koh Izumiyama  1 , Akio Mori  1 , Masanobu Morioka  1 , Takeshi Kondo  1 , Hirokazu Sugino  2
Affiliations
Case Reports

Multiple Colorectal Mucosa-Associated Lymphoid Tissue Lymphoma Successfully Treated with Chemotherapy

Makoto Saito et al. Case Rep Oncol. .

Abstract

The standard treatment for colorectal mucosa-associated lymphoid tissue (MALT) lymphoma has not yet been established due to the rarity of the disease. Here, we report a case of long-term response to chemotherapy for colorectal MALT lymphoma (stage I). A 77-year-old frail female patient with diabetes mellitus and dementia developed melena of unknown etiology, and a colonoscopy was performed at a nearby hospital. A biopsy suggested malignant lymphoma, and she was referred to our department. As a result of re-examination of colonoscopy, a total of 3 submucosal tumor-like lesions were confirmed. Of these, a biopsy of the lesions in the ascending colon and rectum was performed, and MALT lymphoma was diagnosed on the basis of the histopathological findings. Following close examination, no other lymphoma lesions were found, and the patient was diagnosed with primary colorectal MALT lymphoma, stage I. After 1 course of R-THP-COP chemotherapy (rituximab + cyclophosphamide, pirarubicin, vincristine, and prednisone), the rectal lesion was confirmed to have almost disappeared endoscopically, and lymphoma cells were not found histopathologically. The patient was determined to be in complete remission (CR). However, due to hematological toxicity and a slight worsening of glucose control, the second chemotherapy course was changed to the BR regimen (rituximab + bendamustine), and 4 courses were performed (5 total courses of chemotherapy). Currently, >3 years have passed since reaching CR, and the patient is alive without recurrence.

Keywords: Chemotherapy; Colorectal lymphoma; Mucosa-associated lymphoid tissue lymphoma; Treatment.

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Conflict of interest statement

The authors declare no potential conflicts of interest in this work.

Figures

Fig. 1
Fig. 1
Colonoscopic findings. (left) 1.5-cm diameter lesion in the ascending colon, (right) 2- to 2.5-cm diameter lesion in the rectum. Submucosal tumor-like lesions with shallow ulcered surfaces were observed.
Fig. 2
Fig. 2
Histopathological findings. (left) (HE staining) Small- to medium-sized abnormal lymphocytes were uniformly distributed; (middle) CD20 staining was positive; (right) the MIB-1 index was 20–30%. These findings were consistent with MALT lymphoma. MALT, mucosa-associated lymphoid tissue.
Fig. 3
Fig. 3
PET-CT findings. Clear uptake was observed in 2 regions, (left) the ascending colon (SUVmax 5.5) and (right) the rectum (SUVmax 8.1).
Fig. 4
Fig. 4
Colonoscopic findings in the rectum. After 1 course of R-THP-COP chemotherapy, the MALT lymphoma lesion disappeared. MALT, mucosa-associated lymphoid tissue.
See this image and copyright information in PMC

References

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