A rare cause of hematochezia: colonic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALToma): A case report and literature review

Medicine (Baltimore). 2023 May 26;102(21):e33869. doi: 10.1097/MD.0000000000033869.

Abstract

Rationale: Colonic extranodal mucosa-associated lymphoid tissue lymphoma as a cause of hematochezia is rare. Here, we report a case of colonic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALToma) with presentation of freshy bloody stool and successfully treated by endoscopic mucosal resection.

Patient concerns: This case was a 69-year-old woman with history of hypertension, reflux esophagitis, and peptic ulcer. She had several episodes of hematochezia and thus sought medical attention at the outpatient clinic.

Diagnoses: Colonoscopy revealed a 12-mm semipedunculated lesion in the ascending colon. Histopathological examination and immunochemistry were compatible with colonic extranodal mucosa-associated lymphoid tissue lymphoma.

Interventions: Endoscopic mucosal resection was done for tumor removal and hemoclipping was done to achieve hemostasis.

Outcomes: The patient remained well without recurrence during 3 years of outpatient follow-up.

Lesson: Colonic MALToma is a rare disease, and could present as hematochezia. En bloc endoscopic resection could achieve long-term remission. The prognosis of colonic MALToma is excellent with its indolent characteristics.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Aged
  • Colonoscopy
  • Diagnosis, Differential
  • Female
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / surgery
  • Humans
  • Lymphoma, B-Cell, Marginal Zone* / complications
  • Lymphoma, B-Cell, Marginal Zone* / diagnosis
  • Lymphoma, B-Cell, Marginal Zone* / surgery
  • Peptic Ulcer* / diagnosis