Mantle Cell Lymphoma of GI Tract Presented as Multiple Lymphomatous Polyposis: A Rare Intestinal Malignancy

Abstract

Primary lymphomas arising in the large intestine are less frequent than either gastric or small bowel lymphomas. Primary colorectal lymphomas account for about 0.2% of all neoplasm. Mantle cell lymphoma in form of multiple lymphomatous polyposis is less frequent in colorectum than in the small bowel.2 We present a case of 68 year-old man suffered from abdominal pain and diarrhoea for one year with complain of blood in stool for last 15 days. Multiple polypoid masses were found in the entire colon and caecum on colonoscopic examination. Computerized tomography of the abdomen revealed a large soft tissue mass lesion in caecum and ascending colon with diffuse polypoidal wall thickening involving the transverse colon, sigmoid colon, descending colon with mesenteric lymph node enlargement. Colonoscopic excision of polyp from ascending colon and transverse colon was done. The histological diagnosis was Non-Hodgkin lymphoma with multiple lymphomatous polyposis. In immunohitochemistry, there was positive staining for CD20, CD 5 and cyclin D1 and suggestive of mantle cell lymphoma B cell type. MCL is an aggressive lymphoma, which typically presents in advanced stage; there is often involvement of mesenteric and peripheral lymph nodes, spleen, bone marrow and peripheral blood 6.