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Primary intestinal follicular lymphoma presenting as multiple lymphomatous polyposis
  1. Hwei Jene Ng1,
  2. Rudi Schmigylski2,
  3. Krsty Nale2 and
  4. Patrick Collins3
  1. 1Department of General Surgery, NHS Greater Glasgow and Clyde, Glasgow, UK
  2. 2Department of Pathology, Dumfries and Galloway Royal Infirmary, Dumfries, UK
  3. 3General Surgery Department, Dumfries and Galloway Royal Infirmary, Dumfries, UK
  1. Correspondence to Dr Hwei Jene Ng; hweijene.ng{at}ggc.scot.nhs.uk

Abstract

Multiple lymphomatous polyposis (MLP) is a rare condition, described in the literature as a presentation of extranodal mantle cell lymphoma. We report a rare case of follicular lymphoma presenting as MLP in a young woman with a short history of haematochezia who underwent colonoscopy. Immunohistochemistry on colonic biopsies confirmed follicular lymphoma. Microscopic examination found an extensive and dense lymphoid infiltrate, which demonstrated a follicular growth pattern. The neoplastic cells were positive with BCL2, BCL6, CD10 and CD20, and were negative with CD3, CD5, Cyclin D1 and SOX11. CT staging showed disseminated lymphadenopathy and the patient was commenced on chemotherapy. Endoscopic evaluation and histopathological analysis are vital for the accurate diagnosis of MLP. Our case demonstrates that follicular lymphoma should be considered as a differential, as not all cases of diffuse colonic MLP are related to mantle cell lymphoma. This distinction must be made to provide the best clinical management for the patient.

  • oncology
  • pathology
  • general surgery
  • endoscopy

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Footnotes

  • Twitter @Jene_Ng

  • Contributors HJN: drafted the manuscript and managed consent. RS and KN: provided figures and edited the manuscript. PC: edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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