Li JJ, Chen BC, Dong J, Chen Y, Chen YW. Synchronous colonic mucosa-associated lymphoid tissue lymphoma found after surgery for adenocarcinoma: A case report and review of literature. World J Clin Cases 2020; 8(24): 6456-6464 [PMID: 33392331 DOI: 10.12998/wjcc.v8.i24.6456]
Corresponding Author of This Article
You-Wei Chen, MSc, Chief Doctor, Department of Gastroenterology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. cyw@zju.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 26, 2020; 8(24): 6456-6464 Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6456
Synchronous colonic mucosa-associated lymphoid tissue lymphoma found after surgery for adenocarcinoma: A case report and review of literature
Juan-Juan Li, Bing-Chen Chen, Jie Dong, Yuan Chen, You-Wei Chen
Juan-Juan Li, Department of Intensive Care Unit and Comprehensive Support, Wang-Jiang-Shan Branch of Zhejiang Provincial People's Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Bing-Chen Chen, Department of Colorectal Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Jie Dong, You-Wei Chen, Department of Gastroenterology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Yuan Chen, Department of Pathology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Author contributions: Li JJ was responsible for collecting the medical history of the patient and drafting the paper; Chen BC was the patient’s doctor and performed colonoscopy and endoscopic mucosal resection; Dong J was responsible for drafting the paper; Chen Y was the pathologist who provided the pathological results; Chen YW reviewed the literature and revised the manuscript; all authors issued the final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient to publish this report and any accompanying images.
Conflict-of-interest statement: The authors have declared that no conflicts of interest exist.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: You-Wei Chen, MSc, Chief Doctor, Department of Gastroenterology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. cyw@zju.edu.cn
Received: September 4, 2020 Peer-review started: September 4, 2020 First decision: September 30, 2020 Revised: October 11, 2020 Accepted: October 26, 2020 Article in press: October 26, 2020 Published online: December 26, 2020 Processing time: 106 Days and 2.3 Hours
Abstract
BACKGROUND
Mucosa-associated lymphoid tissue (MALT) lymphoma is a subtype of non-Hodgkin lymphoma that is mainly involved in the gastrointestinal tract. The synchronous occurrence of colonic MALT lymphoma and adenocarcinoma in the same patient is extremely rare. We here report a case of synchronous colonic MALT lymphoma found on surveillance colonoscopy five months after surgery and chemotherapy for sigmoid adenocarcinoma.
CASE SUMMARY
A 67-year-old man was admitted because of hematochezia for two months. Colonoscopy suggested a colonic tumor before hospitalization. Abdominal computed tomography (CT) revealed local thickening of the sigmoid colon. The patient underwent a left hemicolectomy with local lymph node dissection. The histopathology revealed moderately differentiated adenocarcinoma and partially mucinous adenocarcinoma. The pTNM stage was T3N1Mx. The patient received chemotherapy with six cycles of mFOLFOX6 after surgery. Colonoscopy was performed five months later and revealed single, flat, polypoid lesions of the colon 33 cm away from the anus. Subsequently, the patient underwent endoscopic mucosal resection for further diagnosis. The pathological diagnosis was MALT lymphoma. Positron emission tomography /CT suggested metastasis. The patient refused further treatment and died ten months later.
CONCLUSION
Colonic MALT lymphoma may occur after surgery and chemotherapy for adenocarcinoma as a synchronous malignancy. Regular surveillance colonoscopy and careful monitoring after surgery are critical.
Core Tip: The synchronous occurrence of colonic mucosa-associated lymphoid tissue (MALT) lymphoma and adenocarcinoma in the same patient is extremely rare. Few cases have been reported in the literature to date. Colonic MALT lymphoma is often asymptomatic and found on surveillance colonoscopy. When it presents synchronously with colonic adenocarcinoma, MALT lymphoma is easily missed. Regular surveillance colonoscopy and careful monitoring after surgery are critical. We report a case of synchronous colonic MALT lymphoma found on surveillance colonoscopy five months after surgery and chemotherapy for sigmoid adenocarcinoma.
