title: Multiple lymphomatous diverticulosis and comorbid chronic lymphocytic leukemia: novel manifestations of ileocolic mantle cell lymphoma.
abstract: Mantle cell lymphoma (MCL) has tropism for the gastrointestinal tract (GIT) identifiable as multiple polyps and mass lesions throughout the GIT. We describe 2 novel manifestations of MCL. A 60-year-old woman with known chronic lymphocytic leukemia (CLL) had an exophytic mass of the appendiceal orifice. Multiple polypoid masses of the distal ileum were identified in the right hemicolectomy specimen (multiple lymphomatous polyposis). Ancillary studies confirmed the coexistence of the 2 independent lymphoproliferative disorders. A 69-year-old man had recurrent urinary tract infections and pneumatouria caused by a colovesicular fistula complicating diverticulosis coli. Segmental resections of the sigmoid and ileocecum confirmed diverticulosis of the left and right colon. Histology identified infiltrates of MCL confined to the penetrating aspects of colonic diverticula. MCL has not been documented to coexist with CLL. An invaginating morphology of lymphoma, multiple lymphomatous diverticulosis is also a novel presentation. These 2 scenarios expand MCL's known manifestations within the GIT.
authors.affiliation: Department of Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada. shaun.medlicott@cls.ab.ca
authors.forename: Shaun A C
authors.initials: SA
authors.lastname: Medlicott
authors.forename: Holly A
authors.initials: HA
authors.lastname: Brown
authors.forename: Birgitte
authors.initials: B
authors.lastname: Roland
authors.forename: Paul L
authors.initials: PL
authors.lastname: Beck
authors.forename: Iwona
authors.initials: I
authors.lastname: Auer
authors.forename: Adnan
authors.initials: A
authors.lastname: Mansoor
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001854:Bone Marrow Cells / Q000473:pathology; D003110:Colonic Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D004240:Diverticulum / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D017404:In Situ Hybridization, Fluorescence; D007412:Intestinal Fistula / Q000150:complications / Q000473:pathology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D020522:Lymphoma, Mantle-Cell / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D016896:Treatment Outcome; D001747:Urinary Bladder Fistula / Q000150:complications / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor