Follicular Lymphoma Manifesting as an Isolated Colorectal Polyp-Like Morphology.

BACKGROUND

Primary gastrointestinal (GI) follicular lymphoma (FL) is a rare entity, and colorectal FL presenting as a solitary polyp is particularly uncommon.

CASE PRESENTATION

A 60-year-old woman presented with hematochezia. Colonoscopy incidentally identified an 8-mm polyp in the transverse colon, which was subsequently removed via cold snare polypectomy. Histopathological examination confirmed Grade 1 FL, with immunohistochemical analysis revealing positivity for CD10, CD20, and Bcl-2. Further diagnostic evaluation demonstrated FL involvement in the proximal jejunum, leading to a diagnosis of clinical stage I primary GI-FL. The patient elected to undergo a watch-and-wait approach.

CONCLUSION

This case highlights the potential for colorectal-FL lesions to be misidentified as adenomatous polyps, posing a diagnostic challenge.