Mucosa-associated lymphoid tissue (MALT) lymphoma arising in the esophagus, stomach, and lung

Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
General Thoracic and Cardiovascular Surgery 12/2011; 59(12):826-30. DOI: 10.1007/s11748-010-0761-1
Source: PubMed

ABSTRACT A 62-year-old woman was referred to our hospital for further investigation of slow-growing gastrointestinal submucosal tumors (SMTs) and multiple lung nodules. Esophageal SMTs had been identified 6 years earlier, following which lung tumors and gastric SMTs had subsequently developed. Despite repeated endoscopic biopsies, these SMTs could not be diagnosed definitively. Moreover, we were unable to detect any serological abnormalities or radiologic findings such as lymph node swelling. Thoracoscopic excision of a lung nodule led to the definitive diagnosis of mucosaassociated lymphoid tissue (MALT) lymphoma. Cytological findings of aspiration biopsy specimens from the esophagus and stomach were compatible with that of the lung nodule. To our knowledge, this is the first case report of esophageal MALT lymphoma with lung and gastric involvement. We discuss this extremely rare disease with reference to the relevant literature.

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    ABSTRACT: We report a very rare case of primary low grade mucosa associated lymphoid tissue (MALT) lymphoma of the oesophagus. An 83 year old woman was referred to our hospital in June 1999 for further examination and treatment of oesophageal tumour. Although a physical examination and laboratory data showed no significant abnormalities, endoscopic observation revealed two slightly elevated submucosal tumour-like lesions of the oesophagus. Tissue specimens were obtained by endoscopic mucosal resection of the oesophagus using a cap fitted panendoscope. The lesions were composed of diffuse small atypical lymphoid cells--that is, centrocyte-like cells--which were stained with CD20, L26, BCL-2, and kappa, but not with CD3, CD5, CD10, or cyclin D1. Monoclonality was detected by polymerase chain reaction analysis using the primer for CDR-3 of immunoglobulin H and diagnosed as low grade MALT lymphoma of the oesophagus. The tumours were considered to be completely resected and therefore additional treatment was not administered. The patient is alive and well 22 months after treatment and diagnosis.
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    ABSTRACT: We report the histomorphologic and immunohistochemical features of another case of mucosa-associated lymphoid tissue (MALT) lymphoma arising from the esophagus and discuss the problems of differential diagnosis. The patient was a 49-year-old man, who had no gastrointestinal symptoms. On endoscopy, a smooth-surfaced, semibulbous lesion was found 36 cm from the incisors. We performed radical resection of this submucosal tumor with video-assisted thoracoscopic surgery for the purpose of diagnosis and treatment. The immunophenotype of the centrocyte-like-cells was CD20+, BCL2+, CD5-, CD10-, CD23- CD45RO- and cyclin D1-. Diffuse immunostaining of bcl-2 was detected in the nuclei of the tumor cells without lymph follicles. Southern blotting analyses of the IgH gene detected a single dominant band indicative of a clonal IgH rearrangement. From the pathological, immunohistochemical, and molecular biological features we concluded that the tumor was a MALT lymphoma. Only three cases of primary esophageal MALT lymphoma have been reported to date. On the basis of the present case and the three previously reported cases, we suggest that MALT lymphoma of the esophagus is usually an elevated type. The spectrum of sites in which gastrointestinal MALT lymphoma occurs should be expanded to include the esophagus.
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    ABSTRACT: Non-Hodgkin's lymphoma very rarely involves the esophagus, occurring in less than 1% of patients with gastrointestinal lymphoma. A few cases of mucosa-associated lymphoid tissue (MALT) lymphoma of the esophagus have been reported in the English literature. To our knowledge, there has been no report of MALT lymphoma of the esophagus coexistent with bronchus-associated lymphoid tissue lymphoma (BALT) of the lung. This report details the radiological and clinical findings of this first concurrent case.
    Yonsei Medical Journal 09/2005; 46(4):562-6. DOI:10.3349/ymj.2005.46.4.562 · 1.29 Impact Factor
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