title: Mucosa-associated lymphoid tissue lymphoma with unusual18F-FDG hypermetabolism arising at the colorectal anastomosis.
abstract: Mucosa-associated lymphoid tissue (MALT) lymphoma usually originates from the stomach and presents with low18F-fluorodeoxyglucose (FDG) avidity with average maximum standard uptake value of 3.6. Colorectal MALT lymphoma is a rare entity that contributes to 1.6% of all MALT lymphomas and < 0.2% of large intestinal malignancies. The case reported herein firstly revealed stage IIE MALT lymphoma with unexpected higher18F-FDG avidity of 18.9 arising at the colorectal anastomosis in a patient with a surgical history for sigmoid adenocarcinoma, which was strongly suspected as local recurrence before histopathological and immunohistochemical examinations. After accurate diagnosis, the patient received four cycles of standard R-CVP regimen (rituximab, cyclophosphamide, vincristine and prednisone), combined target therapy and chemotherapy, instead of radiotherapy recommended by National Comprehensive Cancer Network guidelines. He tolerated the treatment well and reached complete remission.
authors.affiliation: Na-Sha Zhang, Fang Shi, Li Kong, Hui Zhu, Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China.
authors.forename: Na-Sha
authors.initials: NS
authors.lastname: Zhang
authors.affiliation: Na-Sha Zhang, Fang Shi, Li Kong, Hui Zhu, Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Shi
authors.affiliation: Na-Sha Zhang, Fang Shi, Li Kong, Hui Zhu, Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China.
authors.forename: Li
authors.initials: L
authors.lastname: Kong
authors.affiliation: Na-Sha Zhang, Fang Shi, Li Kong, Hui Zhu, Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D059186:Chemoradiotherapy, Adjuvant; D003082:Colectomy; D012809:Colon, Sigmoid / Q000473:pathology / Q000601:surgery; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D012074:Remission Induction / Q000379:methods; D000069283:Rituximab / Q000008:administration & dosage / Q000627:therapeutic use*; D012811:Sigmoid Neoplasms / Q000473:pathology / Q000628:therapy*; D014750:Vincristine / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D019788:Fluorodeoxyglucose F18; D000069283:Rituximab; D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone
keywords: 18F-FDG-PET/CT imaging; Colorectal anastomosis; Etiopathogenesis; Mucosa-associated lymphoid tissue lymphoma; Patient-tailored treatment; Unusual 18F-FDG hypermetabolism