PMC10169616_01
Clinical data of the patient with colonic mucosa-associated lymphoid tissue lymphoma. (A) Normal colonoscopy shows a 0-IIb-type lesion; (B) indigo carmine staining; (C) narrow-band imaging magnifying endoscopy shows an irregular branching vasculature; (D) disappeared glandular structure; (E) diagnostic ESD resection of lesions; (F) colonoscopy results after the operation.
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F1
The electronic gastroscopy suggested chronic gastritis, and the electronic colonoscopy revealed a mucosal redness in the sigmoid colon under white light (Figure 1A). A 0-IIb mucosal lesion of approximately 4.5 cm*5.0 cm with a red surface and clear borders was seen after indigo carmine staining (Figure 1B). The narrow-band imaging magnifying (NBI-M) endoscopy detected some branched abnormal blood vessels and the disappearance of the glandular structure (Figures 1C,D). After full communication with the patient and obtaining his informed consent, diagnostic endoscopic submucosal dissection (ESD) was performed on him on 02 July 2021 (Figure 1E). A repeat colonoscopy 1 year after surgery showed postsurgical scar formation and no recurrent lesions (Figure 1F).
Immunohistochemical profile of colonic mucosa-associated lymphoid tissue lymphoma. MALT lymphoma is positive for CD20 and CD79a but negative for CD3 and Bcl-6. CD21 lymphocytes and FDC are positive, and CD23 FDC is also positive. Bcl-2 is usually positive. The Ki-67 proliferation index is typically low.
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F2
Immunohistochemistry showed CD20, CD79a, and BCL2 (+), CD21 lymphocytes and FDC (+), CD23FDC (+), P53 partial (+), CD3, CD5, CD10, BCL6, and CyclinD1 (-), Ki67 (+, extra follicular 5%), and EBER (-) (Figure 2).
Positron emission computed tomography (PET-CT) of the lesion. (A) PET-CT showed a thickening of the sigmoid canal wall; (B) increased FDG uptake and a maximum SUV of approximately 7.8.
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F3
PET-CT showed a thickening of the sigmoid canal wall (Figure 3A), increased glucose metabolism, and a maximum SUV of approximately 7.8 (Figure 3B).