Lymphoid hyperplasia of the large intestine: a case report with immunohistochemical and gene analysis.
A case of lymphoid hyperplasia arising in the large intestine of a 54-year-old woman is described. Barium enema X-ray and colonoscopic examination revealed multiple small polyps in the right side of the colon. Pathological findings from forceps biopsy revealed similar features to a mucosa-associated lymphoid tissue (MALT) lymphoma. A right hemicolectomy with mesenteric lymph node dissection was carried out. Histological sectioning demonstrated hypertrophic lymphoid follicles with well-formed germinal centers. Occasionally, lymphocytes infiltrated the crypts, in a way similar to that found in lymphoepithelial lesions, which was suggestive of a MALT lymphoma diagnosis. Cryptitis was also observed in the lamina propria. Immunohistochemically, proliferating lymphocytes were positive for CD20 (L26) and negative for CD45RO (UCHL-1). Analyses of immunoglobulin gene (IgHJH) rearrangement could not detect any monoclonality in these cells. These findings suggested that the present case should be categorized as lymphoid hyperplasia rather than lymphoma.
Nagaoka
S
S
Department of Gastroenterological Surgery, Japanese Red Cross Medical Center, Tokyo, Japan. onaga@a2.mbn.or.jp
Bandoh
T
T
Takemura
T
T
D018951:Antigens, CD20 / Q000378:metabolism; D003106:Colon / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D004247:DNA / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D015321:Gene Rearrangement; D005803:Genes, Immunoglobulin / Q000235:genetics; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D007417:Intestinal Polyps / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D007621:Karyotyping; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis; D008232:Lymphoproliferative Disorders / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged
D018951:Antigens, CD20; D004247:DNA