一例罕见的套细胞淋巴瘤表现为淋巴瘤性息肉病，广泛累及消化道。

A rare case of mantle cell lymphoma as lymphomatous polyposis with widespread involvement of the digestive tract.

机构信息

Department of Pathology, Poitiers University Hospital, 2, rue de la Milétrie, 86000 Poitiers, France.

出版信息

Clin Res Hepatol Gastroenterol. 2011 Jan;35(1):74-8. doi: 10.1016/j.gcb.2010.10.003.

DOI:10.1016/j.gcb.2010.10.003

Abstract

Lymphomatous polyposis of the gastrointestinal tract is rare. It refers to a heterogeneous group of small B-cell lymphomas including mantle cell lymphoma, follicular lymphoma and MALT lymphoma. It is characterized by the presence of multiple lymphomatous polyps along one or more segments of the digestive tract. Clinical symptoms are non-specific. We herein report the case of a 74-year old man initially admitted for an upper and lower gastrointestinal endoscopy to explore a positive Hemoccult test. The endoscopy revealed multiple polyps all along the gastrointestinal tract. Histopathological study showed a diffuse lymphomatous proliferation of small B-cells whose immunohistochemical features were compatible with a mantle cell lymphoma. Tumoral B-cells showed a positivity of cyclin D1 markers but negativity for CD5. Immunochemotherapy with R-CHOP (rituximab, cyclophosphamide, adriamycine, vincristine and prednisone) was initiated. Based on this case study, the pitfalls of gastrointestinal tract lymphomatous polyposis diagnosis, prognosis and treatment options are discussed.

摘要

胃肠道淋巴瘤息肉较为罕见。它是指一组异质性的小 B 细胞淋巴瘤，包括套细胞淋巴瘤、滤泡性淋巴瘤和黏膜相关淋巴组织淋巴瘤。其特征是沿一条或多条消化道存在多个淋巴瘤性息肉。临床症状无特异性。我们在此报告一例 74 岁男性，最初因潜血试验阳性而上消化道和下消化道内镜检查。内镜检查显示胃肠道内有多个息肉。组织病理学研究显示弥漫性小 B 细胞淋巴瘤增殖，其免疫组化特征符合套细胞淋巴瘤。肿瘤 B 细胞 cyclin D1 标志物阳性，但 CD5 阴性。采用利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松的 R-CHOP（利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松）免疫化疗。基于该病例研究，讨论了胃肠道淋巴瘤息肉的诊断、预后和治疗选择的陷阱。