title: Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of the ileum in a 35-year-old Japanese woman.
abstract: MALT lymphoma of the ileum is extremely rare: only several cases have been reported. A 34-year-old woman presented abdominal pain and melena. Colorectal and small intestinal endoscopes revealed multiple tumors and ulcers of the entire ileum. Biopsy was taken. Histologically, the biopsy consisted of 6 tissue specimens taken from the various sites of the ileum. All the tissue specimens showed infiltration of small atypical cells resembling centrocyte-like cells (CLC). Immunoblastic cells were scattered, though the number was scant. Monocytoid, plasma cell differentiation, and germinal centers were seen. Lymphoepithelial lesions (LEL) were scattered. Some small atypical lymphocyte were destructive the vessels and stromal tissues. Giemsa and Gram stains demonstrated no Helicobacter pylori and any bacteria. Immunohistochemically, the atypical small lymphocytes were positive for vimentin, but negative for various kinds of cytokeratins (CKs), EMA, CEA and CA19-9. The CK highlighted the LEL. They were positive for CD45, and B-cell markers (CD20, CD79a, CD10, CD23, bcl-2). CD138-positive plasma cells were seen in large number. CD68-positive macrophages were scattered. CD30- and CD15-positive immunoblastic cells were scattered. Most of the lymphoid cells were negative for T-cell markers (CD3, CD4, CD5, CD45RO, and CD43) and negative for NK cell markers (CD56 and CD57). The lymphoid cells were positive for κ-chain but negative for λ-chain; thus the light chain restriction was seen. TdT and cyclin D1 were negative. P53 was positive and Ki-67 labeling index was 67%. The lymphoid cells were negative for neuroendocrine markers (NCAM, NSE, chromogranin, and synaptophysin). The pathological diagnosis was MALT lymphoma of the ileum. Post-biopsy imaging techniques including CT, MRI, PET endoscope and gallium scintigraphy identified no tumors and no lymphadenopathy in the body except the ileum. The stomach was free from MALT lymphoma. She was treated by low dose chemotherapy and strictly followed up.
authors: Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan. piyo0111jp@yahoo.co.jp
authors: Tadashi
authors: T
authors: Terada
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D044466:Asian People; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D007150:Immunohistochemistry; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor
keywords: Ileum; MALT lymphoma; histopathology; immunohistochemistry
references: Int J Clin Exp Pathol. 2013;6(4):630-8
references: 23573309
references: Int J Clin Exp Pathol. 2013;6(4):613-21
references: 23573307
references: Gastrointest Endosc. 1999 Jul;50(1):115-7
references: 10385738
references: Int J Clin Exp Pathol. 2013;6(4):703-10
references: 23573317
references: Pathol Int. 2004 Feb;54(2):116-23
references: 14720143
references: Abdom Imaging. 2000 Mar-Apr;25(2):139-41
references: 10675454
references: Pathol Int. 2003 Nov;53(11):790-5
references: 14629305
references: Tohoku J Exp Med. 2005 Jul;206(3):271-5
references: 15942157
references: Int J Clin Exp Pathol. 2013;6(2):191-8
references: 23330004
references: Gut Liver. 2010 Mar;4(1):117-21
references: 20479924
references: Int J Clin Exp Pathol. 2012;5(3):203-9
references: 22558474
references: Gastroenterology Res. 2009 Jun;2(3):148-151
references: 27933124
references: Cancer. 1983 Oct 15;52(8):1410-6
references: 6193858
references: Int J Clin Exp Pathol. 2012;5(3):260-3
references: 22558482
references: Int J Clin Exp Pathol. 2013;6(3):385-94
references: 23412998
references: Int J Clin Exp Pathol. 2013;6(1):113-5
references: 23236552
references: Int J Clin Exp Pathol. 2013;6(1):97-9
references: 23236548
references: Am J Blood Res. 2012;2(3):194-200
references: 23119230
references: J Gastrointest Oncol. 2012 Sep;3(3):209-25
references: 22943012
references: J Gastroenterol Hepatol. 2006 Sep;21(9):1495
references: 16911702
references: Endoscopy. 2005 May;37(5):466-9
references: 15844027
references: Pathol Int. 2002 Nov;52(11):740-6
references: 12685552