PMC6140731_01
Colonoscopy findings including Indigo carmine spraying (A, ascending colon; B, cecum; C, rectum).. Notes: (A) Mass of the submucosal-like tumor. (B and C) Isolated small polypoid tumors. An abnormal microvascular tree was noted on the surface of these lesions.
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A-colon had a unique form resembling a mass of small submucosal tumors (Figure 1A), whereas the other lesions were small and isolated polypoid feature. Abnormal telangiectasia was observed on the surface of these lesions (Figure 1B and C).
Histopathology findings (A, hematoxylin-eosin staining; B, CD20 immunostaining; C, BCL2 immunostaining, x100).. Notes: (A) Small- to medium-sized lymphoid cells with mild atypia proliferation and follicular patterns were observed. (B and C) The tumor cells stained strongly positive for CD20 and BCL2.
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Histopathology revealed small- to medium-sized lymphoid cells with mild atypia proliferation and follicular pattern (Figure 2A). Immunohistochemically, the tumor cells stained strongly positive for CD20 and B-cell lymphoma 2 (BCL2) (Figure 2B and C) but were negative for CD3, CD5, CD10, and cyclin D1.
IgH/BCL2 rearrangement by FISH analysis.. Notes:
IgH probe for 14q32 (green signals) and BCL2 probe for 18q21 (orange signals) and arrows (yellow signals) indicate IgH/BCL2 fusion. We detected IgH/BCL2 fusion in 95.2% of tumor cells.. Abbreviation: FISH, fluorescence in situ hybridization.
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Fluorescence in situ hybridization (FISH) analysis identified IGH/BCL2 in 95.2% of the tumor cells (Figure 3).
18F-FDG-PET/CT finding.. Notes: In the ascending colon, abnormal uptake that was consistent with malignant lymphoma was observed. SUVmax was 4.09.. Abbreviations: CT, computed tomography; 18F-FDG-PET, [fluorine-18]-fluorodeoxy-glucose-positron emission tomography; SUVmax, maximum standardized uptake value.
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Contrast computed tomography (CT) and [fluorine-18]-fluorodeoxy-glucose-positron emission tomography (18F-FDG-PET)/CT revealed abnormal uptake in the A-colon, which is consistent with malignant lymphoma (Figure 4).
Bone marrow aspiration smear (May-Giemsa staining, x1,000). Note: The frequency of plasma cells was 30% of all nucleated cells.
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In contrast, bone marrow aspiration revealed the frequency of plasma cells to be 30% of all nucleated cells (Figure 5).