PMC8460763_01
(a) Colonoscopy showed a slightly yellowish, submucosal tumor-like 5-mm protrusion in the rectum. (b-e) The procedure of ESD. (f) Three months after ESD, a follow-up colonoscopy showed complete resolution of the elevated lesion and a residual titanium clip. (g) Nine months after ESD, a follow-up colonoscopy showed complete resolution of the elevated lesion. (h) PET/CT revealed no evidence of malignancy in the whole body after ESD.
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F1
A slightly yellowish 5-mm protrusion was detected in the rectum, resembling a submucosal tumor (Figure 1a). The white light image of the lesion indicated a possibility of a neuroendocrine tumor and therefore we resected it using ESD (Figures 1b-e). PET/CT demonstrated negative evidence of malignancy in the whole body after ESD (Figure 1h). The endoscopic follow-up at the 3rd month and the 9th month, respectively, after ESD showed no residual or recurrent lesions (Figures 1f,g).
Histopathologic examination revealed a MALT lymphoma of the rectum. (a) Hematoxylin-eosin (HE) staining x20. (b) HE staining x200. (c) Immunohistochemistry (IHC) was negative for CD3. (d) IHC was positive for CD20. (e) IHC was positive for CD21. (f) IHC was positive for Bcl-2.
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F2
The resected margin was clean both horizontally and vertically (Figure 2).