Department of Gastroenterology, Fundeni Clinical Institute; Bucharest, Romania.
J Gastrointestin Liver Dis. 2009 Mar;18(1):85-8.
A 65-year old patient, with no medical history, was admitted for lower gastrointestinal bleeding. On clinical examination the patient seemed to be in good health. However the examination was completed with a rectosigmoidoscopy revealing the presence of mucosal erosions, ulcerations, multiple papulae. The histopathological examination raised the suspicion of a colonic lymphoma. Gastric biopsies suggested a gastric MALT type lymphoma associated to the colonic lymphoma, but the immunohistochemical profile corresponded to a mantle cell lymphoma. In spite of the general poor prognosis of mantle cell lymphoma, our patient had a good clinical and endoscopic response to the standard cyclophosphamide, vincristine, prednisone (CVP) therapy. The cases of gastric and colonic mantle lymphoma are rare, the response to therapy is poor; fortunately, our patient had a complete resolution after completion of the six cycles of chemotherapy.
一位 65 岁的患者,无既往病史,因下消化道出血入院。临床检查患者看起来健康状况良好。然而,直肠乙状结肠镜检查显示黏膜糜烂、溃疡、多发性乳头。组织病理学检查提示结肠淋巴瘤的可能性。胃活检提示与结肠淋巴瘤相关的胃黏膜相关淋巴组织(MALT)型淋巴瘤,但免疫组化表型符合套细胞淋巴瘤。尽管套细胞淋巴瘤的总体预后较差,但我们的患者对标准环磷酰胺、长春新碱、泼尼松(CVP)治疗有良好的临床和内镜反应。胃和结肠套细胞淋巴瘤的病例罕见,对治疗的反应较差;幸运的是,我们的患者在完成六个周期的化疗后完全缓解。