Successful treatment of an enormous rectal mucosa-associated lymphoid tissue lymphoma by endoscopic full-thickness resection: A case report

Figure 1 Endoscopic features of the lesion. A: White light endoscopy discovered a huge volume of subepithelial tumor in the lower rectum; B: Uneven and hyperemic coverage of mucosa; C: Narrow-band imaging magnifying endoscopy showing the irregular branching vascular (arrow); D: Disappeared glandular structure (arrow), which is called tree-like appearance.

Figure 2 Endoscopic ultrasonography (EUS) and computed tomography (CT) of the lesion. A: EUS showing a 50 mm, low echo, submucosal lesion in the low rectum; B: Abdominal enhanced CT imaging revealing a 50 mm × 30 mm soft tissue mass with defined boundary, uniform density and moderate enhancement.

Figure 3 Histopathological and immunohistochemical analysis of the specimen. A: Hematoxylin–eosin staining, × 100; B: CD20 staining, × 40; C: Ki67, × 200.

Figure 4 Procedures of the modified endoscopic full-thickness resection and purse suture. A: Circumferential ulcer after endoscopic full-thickness resection; B: SureClips^TM and an endoloop were used for purse suture; C: Fraping the endoloop and closing the wound; D: The resected specimen.