Intestinal MALT lymphoma with long-term remission after systemic chemotherapy: A case report

Yıl 2010, Cilt: 9 Sayı: 1, 34 - 37, 01.04.2010

Kendal Yalçın Zuhat Urakçı Mustafa Yakut Nihal Kılınç

Öz

Mucosa-associated lymphoid tissue lymphoma, as a type of extranodal lymphoma, originates in various organs. Low-grade mucosa-associated lymphoid tissue lymphomas often tend to recur after surgical resection, radiotherapy and chemotherapy. Here, we report a case of intestinal mucosa-associated lymphoid tissue lymphoma with long-term remission after systemic chemotherapy. A 27-year-old male patient admitted to our clinic due to symptoms of abdominal pain, weight loss and fever. Physical examination revealed diffuse tenderness throughout the abdomen. Gastroduodenoscopy revealed nodular lesions in the duodenum. There was a thickened bowel wall in the left hypochondrium with several mesenteric lymphadenopathies on the abdominal tomography. Duodenal biopsy was composed of centrocyte-like cells, with infiltration of the lamina propria, and was positive for B cell surface markers, including CD20. Helicobacter pylori was found to be negative. The diagnosis of low-grade mucosa-associated lymphoid tissue lymphoma was made. The patient has had sustained clinical, endoscopic, histological, and radiological remission for four years after six courses of cyclophosphamide, vincristine, doxorubicin and prednisone chemotherapy. In conclusion, although surgery is the first-line therapy in localized low-grade mucosa-associated lymphoid tissue lymphoma, it may be possible to induce long-term remission with cyclophoshamide, vincristine, doxorubicin and prednisone chemotherapy alone.

Anahtar Kelimeler

Malt lymphoma, duodenum, chemotherapy

Sistemik kemoterapi sonrası uzun dönemli remisyonla seyreden intestinal MALT lenfoma: Olgu sunumu

Öz

MALT lenfoma çeşitli organlarda ortaya çıkan ekstranodal lenfomanın bir türüdür. MALT lenfoma özellikle düşük grade olanlar cerrahi rezeksiyon, radyoterapi ve kemoterapi sonrası sıklıkla nüks etme eğilimindedir. Bu olgu sunumunda sistemik kemoterapi sonrası uzun dönemli remisyonla seyreden intestinal MALT lenfoma olgusu sunulmuştur. 27 yaşında erkek hasta kliniğimize karın ağrısı, kilo kaybı ve ateş şikayetleri ile başvurdu. Yapılan fizik muayenesinde batında tüm kadranlarda hassasiyeti mevcuttu. Endoskopik incelemede ise duodenumda nodüler görünüm mevcuttu. Batın tomografisinde sol hipokondriumda barsak duvar kalınlaşması mevcuttu ve çok sayıda mezenterik lenfadenopatisi vardı. Duodenum biyopsisinde lamina propriayı infiltre eden sentrosit benzeri hücreler mevcuttu. B hücre yüzey belirteçlerinden CD20 pozitif saptandı. Helikobakter pylori negatifti. Hastaya düşük dereceli MALT lenfoma tanısı konuldu. 6 kür CHOP kemoterapisi sonrası 4. yılda hastada klinik, endoskopik, histolojik ve radyolojik remisyon hali mevcuttu. Sonuç olarak düşük grade MALT lenfomada lokalize hastalıkta ilk tedavi seçeneği cerrahi olmasına rağmen sadece CHOP kemoterapisi ile bazı vakalarda uzun süreli remisyon sağlamak mümkün olabilir.

Anahtar Kelimeler

Malt lenfoma, duodenum, kemoterapi

Kaynakça

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