PMC6699002_01
EGD showed a large posterior antral wall ulcer with heaped up edges and
surrounding infiltrated-appearing mucosa.
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EGD with biopsy showed multiple antral ulcerations and a large posterior antral wall ulcer with heaped up edges with surrounding infiltrated-appearing mucosa (Figure 1).
H&E staining of the ulcerated region revealed a marked lymphoid
infiltrate of monotonous, bland-appearing, small lymphoid cells with clear
cytoplasm forming occasional lymphoepithelial lesions.
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A hematoxylin and eosin (H&E) stain of the ulcerated tissue revealed a markedly dense lymphoid infiltrate, which was suspicious for lymphoma (Figure 2).
Immunohistochemical staining confirmed a B-cell predominance (CD20 positive
stain) without co-expression of CD5 or CD10.
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Immunohistochemical staining confirmed a B-cell predominance (Figure 3).
Flow cytometry revealed a prominent B-cell population with lambda light chain
restriction without co-expression of CD5 or CD10, consistent with marginal
zone lymphoma (MALT lymphoma).
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Flow cytometry confirmed the clonal nature of this process consistent with a marginal zone lymphoma immunophenotype (Figure 4).
FISH for BIRC3-MALT1 (11;18) fusion was negative. BIRC3 is represented in
green and MALT1 is represented in orange.
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Fluorescence in situ hybridization (FISH) analysis was negative for t(11;18)(q21;q21) (Figure 5).
PET-CT in the (a) axial and (b) sagittal views showed a hypermetabolic focus
in the antrum of the stomach with no other hypermetabolic foci or enlarged
lymph nodes.
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Positron emission tomography-computed tomography (PET-CT) demonstrated a hypermetabolic focus in the antrum of the stomach with no other hypermetabolic foci or enlarged lymph nodes (Figure 6).