Tuesday, December 30, 2008

A case of pancreatic mucosa-associated lymphoid tissue (MALT) lymphoma

A case of pancreatic mucosa-associated lymphoid tissue (MALT) lymphoma

Nippon Shokakibyo Gakkai Zasshi. 2008 Dec
Miwa I, Maruyama Y, Kageoka M, Nagata K, Ohata A, Noda Y, Ikeya K, Koda K, Watanabe F.
Department of Gastroenterology, Fujieda City General Hospital.

A 77-year-old woman underwent abdominal ultrasonic diagnosis in a screening test for diabetes mellitus. A 65x45mm tumor with low echo level was revealed and located from the uncinate process of the pancreas to the body. Contrast-enhanced computed tomography demonstrated the pancreas had a low density area in the arterial phase and a comparable area in the equilibrium phase, compared with the parenchyma of the normal pancreas. Gallium-scintigraphy showed strong accumulation, consistent with the tumor. Mucosa-associated lymphoid tissue (MALT) lymphoma was diagnosed by endosonography-guided fine-needle aspiration biopsy (EUS-FNAB). Complete remission was achieved after radiation therapy.

STAGE Journal Archive

MALT lymphoma of the rectum: A case report treated by radiotherapy

MALT lymphoma of the rectum: A case report treated by radiotherapy
Cancer Radiother. 2008 Dec

Amouri A, Chtourou L, Mnif L, Mdhaffar M, Abid M, Ayedi L, Daoud J, Elloumi M, Boudawara T, Tahri N.
Service d'hépatogastroentérologie, hôpital Hédi-Chaker, 3029 Sfax, Tunisie.

The mucosa-associated lymphoid tissue (MALT) lymphoma is a distinct clinical pathologic entity that develops in diverse anatomic locations such as the stomach, salivary gland, thyroid, lung, skin and breast. However, colorectal involvement is extremely rare. To our knowledge, only ten cases of primary rectal MALT lymphoma have been reported in the literature. We report a 46-year-old woman with rectal MALT lymphoma, which regressed after radiotherapy. The patient had rectal bleeding. Colonoscopy showed a pseudonodular and ulcerated big fold in the rectum. Microscopic and immunohistologic studies of the biopsy specimen showed typical features of low grade MALT lymphoma. Upper endoscopy showed chronic gastritis with lymphoid follicles but without any infiltration of lymphoma cells. Helicobacter pylori infection was confirmed by histology. No extra-intestinal involvement was found on the staging evaluation, which included computed tomography (CT) of the abdomen, chest, pelvis and a bone marrow biopsy. We attempted to eradicate H. pylori with a 7-day course of omeprazole, amoxycillin, and metronidazole. Eradication was proved successful by endoscopy. Repeated colonoscopy 4months after the end of treatment showed that the rectal tumor had not regressed. Biopsy specimens confirmed the persistent infiltration of lymphoma cells. The patient was considered to be a non-responder to eradication therapy and was indicated for radiotherapy. He underwent a total of 34Gy. Complete regression was confirmed by colonoscopic and histologic examination at 2months after the end of treatment. He was followed up closely with colonoscopy, but no relapse of these lesions was detected after 12 months.


Nodular amyloïdoma associated with primary pulmonary Malt lymphoma

Nodular amyloïdoma associated with primary pulmonary Malt lymphoma

Rev Mal Respir. 2008 Nov

Hourseau M, Virally J, Habib E, Juberthie B, Bienvenu L.
Service d'Anatomie et cytologie pathologiques, Hôpital Robert Ballanger, Aulnay sous Bois, France.


Pulmonary amyloïdoma is a nodular formation containing amyloid deposits, which can mimick a pulmonary carcinoma. Its etiologic diagnosis require the search of an underlying infectious disease, a connective tissue disorder or a lymphoma. Case report We report the case of a 73 year old woman, asymptomatic, presenting an incidental pulmonary opacity in the left upper lobe, associated with hilar lymphadenopathies, positive on PET scan. The patient underwent a left superior lobectomy with mediastinal lymphadenectomy. Histologically, the nodule was composed of amylodosis deposits. It was surrounded by a dense lymphoïd infiltrate. The phenotype (CD20+, CD5-, CD3-, CD23-) of the lymphoïd cells, like the demonstration of a lambda light chain restriction permited to pose the diagnostic of pulmonary Malt lymphoma and to characterize the AL lambda type of the amyloïdosis Conclusion Association of amyloïdoma and Malt lymphoma is a rare condition. The histologic diagnosis of lymphoma may be difficult in this case, the lymphomatous process being concealed by the volume of the amyloïd mass. Therefore it is necessary in case of amyloïdoma to search histological signs of Malt lymphoma and to confirm diagnosis by demonstrating a B clonality and a immunoglobulin light chains restriction.

EM Consulte