Okamura Takuma, Suga Tomoaki, Iwaya Yugo, Ito Tetsuya, Yokosawa Shuichi, Arakura Norikazu, Ota Hiroyoshi, Tanaka Eiji
Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Case Rep Gastroenterol. 2012 May;6(2):319-27. doi: 10.1159/000339461. Epub 2012 May 30.
Rectal mucosa-associated lymphoid tissue (MALT) lymphoma is a rare condition. Although the majority of patients undergo surgical resection, a definitive treatment for rectal MALT lymphoma has not yet been established. In the present study, we report the outcome of radiotherapy in 3 patients with rectal MALT lymphoma. Our cohort ranged from 56 to 65 years of age. The male/female ratio was 1:2, and all patients were in stage I (Lugano classification) of the disease. Endoscopic findings revealed elevated lesions resembling submucosal tumors in 2 patients, and a sessile elevated lesion with a nodular surface in 1 patient. One of the 3 patients underwent magnifying endoscopy with crystal violet staining that demonstrated a type I pit pattern (Kudo's classification) lesion with a broad intervening area caused by the upthrust of the tumor from the submucosa. All patients tolerated radiotherapy at doses of 30 Gy without major complications and achieved complete remission. Follow-up ranged from 13 to 75 months (mean 51.0 months), revealing no recurrence of MALT lymphoma. As such, we propose radiotherapy to be a safe and effective means for treating rectal MALT lymphoma.
直肠黏膜相关淋巴组织（MALT）淋巴瘤是一种罕见疾病。尽管大多数患者接受了手术切除，但直肠MALT淋巴瘤的明确治疗方法尚未确立。在本研究中，我们报告了3例直肠MALT淋巴瘤患者的放疗结果。我们的队列年龄在56至65岁之间。男女比例为1:2，所有患者均处于疾病的I期（卢加诺分类）。内镜检查发现，2例患者有类似黏膜下肿瘤的隆起病变，1例患者有表面呈结节状的无蒂隆起病变。3例患者中有1例接受了结晶紫染色放大内镜检查，显示为I型凹陷模式（工藤分类）病变，由于肿瘤从黏膜下层向上隆起导致中间区域较宽。所有患者均耐受30 Gy剂量的放疗，无严重并发症，并实现了完全缓解。随访时间为13至75个月（平均51.0个月），未发现MALT淋巴瘤复发。因此，我们认为放疗是治疗直肠MALT淋巴瘤的一种安全有效的方法。
