Publication details

Rare Case of Mantle Cell Lymphoma With Multiple Rectal Lesions

Authors

KUNOVSKÝ Lumír TVRDÍKOVÁ Eliška MICHALKA Jozef TRNA Jan

Year of publication 2025
Type Article in Periodical
Magazine / Source UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
MU Faculty or unit

Faculty of Medicine

Citation
web https://onlinelibrary.wiley.com/doi/10.1002/ueg2.12752
Doi http://dx.doi.org/10.1002/ueg2.12752
Keywords biopsy; chemotherapy; colorectal cancer; endoscopy; lymphoma; multiple lymphomatous polyposis
Description A 67-year-old man was referred for colonoscopy following a positive fecal occult blood test and the detection of thrombocytopenia. Clinically, the patient was asymptomatic. He was under oncological follow-up after previous surgical treatment for testicular cancer. During the colonoscopy, a laterally spreading tumor (LST) non-granular lesion measuring 25 × 20 mm was found in the upper rectum, classified as Paris IIa + IIc (Figure 1). The lesion was carefully evaluated using narrow band imaging (NBI) (Figure 2a) and magnifying endoscopy (Figure 2b). However, due to the unclear polyp surface and signs of pseudo-depression, biopsies were taken from the lesion. An additional five smaller lesions, each measuring 4–5 mm (Is), were found in the mid-rectum (Figure 3). All small polyps in the mid-rectum were resected using cold snare polypectomy. Histopathological examination (Figure 4a,b: HE staining, Figure 5a–d: Immunohistochemistry staining) confirmed the diagnosis of Mantle Cell Lymphoma (MCL) from both the main lesion and the smaller ones. Subsequently, the patient was referred to the Department of Hematology and Oncology, where standard staging procedures were completed. The disease was classified as stage IV A according to the Ann Arbor classification, with generalized lymphadenopathy identified on staging PET/CT imaging. Histological and flow cytometric analysis confirmed minor bone marrow infiltration. After six cycles of rituximab-based chemoimmunotherapy, the patient achieved complete remission of the lymphoma.

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