RSS-Feed abonnieren
DOI: 10.1055/s-2004-825958
Ileal Mucosa-Associated Lymphoid Tissue Lymphoma Showing Several Ulcer Scars Detected Using Double-Balloon Endoscopy
Publikationsverlauf
Submitted 17 May 2004
Accepted after Revision 11 August 2004
Publikationsdatum:
02. November 2004 (online)
![](https://www.thieme-connect.de/media/endoscopy/200411/lookinside/thumbnails/10.1055-s-2004-825958-1.jpg)
A 72-year-old man was admitted to our hospital to undergo a novel small-intestinal endoscopic procedure. He had had occasional episodes of hematochezia over a 2-year period, during which he had been hospitalized twice previously. However, numerous investigations, including hematological and biochemical studies, gastroscopy, colonoscopy, computed tomography, scintigraphy, and angiography had failed to detect the source of bleeding in the gastrointestinal tract. On this admission, double-balloon enteroscopy was performed and revealed several ulcer scars with localized dilation of the ileum. Histopathological examination of the biopsy specimens revealed no abnormal findings. Partial resection of the ileum was performed to prevent further gastrointestinal bleeding, and histopathological examination of the resected specimen revealed aggregation of atypical lymphocytes, predominantly in the muscularis propria layer. Immunohistochemical examination demonstrated that the tumor cells were positive for CD20 and BCL2, but negative for UCHL1. Based on these findings, the lesion was diagnosed as a marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue. Eighteen months after surgery, the patient was still in complete remission.
References
- 1 Amer M H, El-Akkad S. Gastrointestinal lymphoma in adults: clinical features and management of 300 cases. Gastroenterology. 1994; 106 846-858
- 2 Kohno S, Ohshima K, Yoneda S. et al . Clinicopathological analysis of 143 primary malignant lymphomas in the small and large intestines based on the new WHO classification. Histopathology. 2003; 43 135-143
- 3 Nakamura S, Matsumoto T, Takeshita M. et al . A clinicopathologic study of primary intestine lymphoma. Cancer. 2000; 88 286-294
- 4 Yamamoto H, Sekine Y, Higashizawa T. et al . Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc. 2001; 53 216-220
- 5 Yamamoto H, Yano T, Kita H. et al . New system of double-balloon enteroscopy for diagnosis and treatment of small intestinal disorders. Gastroenterology. 2003; 125 1556
- 6 Ell C, Remke S, May A. et al . The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding. Endoscopy. 2002; 34 685-689
- 7 Herrerias J M, Caunedo A, Rodriguez-Tellez M. et al . Capsule endoscopy in patients with suspected Crohn’s disease and negative endoscopy. Endoscopy. 2003; 35 564-568
- 8 Flieger D, Keller R, Fischbach W. Capsule endoscopy in gastric MALT lymphoma and other gastrointestinal lymphomas. Gastroenterology. 2004; 126 A-621
- 9 Voderholzer W A, Ortner M, Rogalla P. et al . Diagnostic yield of wireless capsule enteroscopy in comparison with computed tomography enteroclysis. Endoscopy. 2003; 35 1009-1014
N. Yoshida, M. D.
Dept. of Molecular Gastroenterology and Hepatology · Kyoto Prefectural University of Medicine Graduate School of Medical Science
Kawaramachi-Hirokoji, Kamigyo-ku · Kyoto, 602-8566 · Japan
Fax: +81-75-251-0710
eMail: naohisa@koto.kpu-m.ac.jp