Lymphomatous polyposis

Epidemiology

This is a rare gastrointestinal non-Hodgkin lymphoma forming numerous polyps. Only 4% of intestinal lymphomas result in polyposis.

Clinical features

Patients range from 37 to 83 years of age, with a male predominance.

Macroscopic appearances

Most cases occur at multiple sites from oesophagus to rectum. There are multiple polyps, which may form aggregates.

Histopathology

Most cases of lymphomatous polyposis are due to mantle cell lymphoma. Less commonly, the lymphoma is a MALT lymphoma. Polyposis in the duodenum has been reported with follicular lymphoma. These subtypes cannot be clearly differentiated on morphology alone. The lymphomatous infiltrate predominantly involves the submucosa and lamina propria.

Immunohistochemistry

	Mantle cell lymphoma	MALT lymphoma	Follicular lymphoma
CD20	12/12	9/9	14/14
Cyclin D1	12/12	0/9	0/14
CD5	12/12	0/9	0/14
CD 10	1/12	0/9	13/14
CD20	12/12	9/9	14/14

t(11;14)(q13;q32), IGH/CCND1 fusion	111/11	0/9	0/10
t(14;18(q32;q21), IGH/bcl2 fusion	0/11	0/9	7/10

Prognosis

Mantle cell lymphoma is associated with poorer outcome than are follicular and MALT lymphoma.

References

1 Kodama T, Ohshima K, Nomura K, et al. Lymphomatous polyposis of the gastrointestinal tract, including mantle cell lymphoma, follicular lymphoma and mucosa-associated lymphoid tissue lymphoma. Histopathology 2005; 47:467-78

This page last revised 28.11.2005.