Case Report
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World J Gastrointest Oncol. Sep 15, 2014; 6(9): 377-380
Published online Sep 15, 2014. doi: 10.4251/wjgo.v6.i9.377
Colonic adenocarcinoma, mucosa associated lymphoid tissue lymphoma and tuberculosis in a segment of colon: A case report
Ambedkar Raj Kulandai Velu, Banushree C Srinivasamurthy, Krishnan Nagarajan, Ilavarasi Sinduja
Ambedkar Raj Kulandai Velu, Banushree C Srinivasamurthy, Department of Pathology, Sri Manakula Vinayagar Medical College, Puducherry 605107, India
Krishnan Nagarajan, Ilavarasi Sinduja, Department of Radiology, Sri ManakulaVinayagar Medical College, Bhubaneswar 751019, Odisha, India
Author contributions: Kulandai Velu AR collected clinical data and gave pathology opinion; Srinivasamurthy BC gave pathology opinion and designed the manuscript; Nagarajan K and Sinduja I gave radiological diagnosis; Nagarajan K did critical editing as well.
Correspondence to: Dr. Banushree C Srinivasamurthy, Assistant Professor, Department of Pathology, Sri Manakula Vinayagar Medical College, Puducherry 605107, India. drbanushree15@hotmail.com
Telephone: +91-674-2473313 Fax:+91-674-2473313
Received: February 24, 2014
Revised: May 11, 2014
Accepted: July 18, 2014
Published online: September 15, 2014
Processing time: 207 Days and 9.2 Hours
Abstract

Synchronous occurrence of adenocarcinoma and mucosa associated lymphoid tissue (MALT) lymphoma of colon is rare, and its presence with coexisting tuberculosis is still rarer. To our knowledge, this may be the first case report. In the present report, we describe a 43-year-old female who presented with a history of abdominal pain, fever, loss of weight and loss of appetite. Colonoscopy showed a large ulceroproliferative mass arising from the caecum, biopsy of which showed it to be adenocarcinoma of the colon. A right hemicolectomy was performed and microscopic study of the colon revealed tuberculosis and synchronous adenocarcinoma with lymphoma. Eight of sixteen lymph nodes showed tuberculosis and three of sixteenpericoloniclymphnodes showed metastatic deposits. Immunostains further confirmed the tumour to be adenocarcinoma with MALT lymphoma. We would like to highlight the diagnostic challenges arising from the multi-faceted presentations of these three conditions.

Keywords: Adenocarcinoma; Mucosa associated lymphoid tissue lymphoma; Tuberculosis

Core tip: We report a first case report of synchronous adenocarcinoma,mucosa associated lymphoid tissue (MALT) lymphoma and tuberculosis in the same segment of colon in 43-year-old immunocompetent female patient. There are around 4 case reports of sychronous adenocarcinoma and MALT lymphoma to date in the literature.What we describe isthe first such case in the literature.