Caratteristiche endoscopiche e outcome del MALT-linfoma nel colon

 

Endoscopic Features and Clinical Outcomes of Colorectal Mucosa-associated Lymphoid Tissue Lymphoma.Jeon MK, So H1, Huh J, Hwang HS, Hwang SW, Park SH, Yang DH, Choi KD, Ye BD, Myung SJ, Yang SK, Byeon JS. Gastrointest Endosc. 2017 Sep 4. [Epub ahead of print]

 

BACKGROUND & AIMS:Colorectal mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease. The purpose of this study was to investigate the clinical and endoscopic features of colorectal MALT lymphoma.

METHODS:Patients diagnosed with colorectal MALT lymphoma at Asan Medical Center from 2002 to 2016 were eligible. Medical records were reviewed to investigate clinical features and treatment outcomes. Endoscopic pictures were assessed to characterize the endoscopic features of colorectal MALT lymphoma.RESULTS:A total of 51 patients were enrolled. The median age was 60 years (interquartile range, 55-71) and 21 (41%) were male. Twenty-six patients (51%) were asymptomatic. Forty-four patients (86%) were in early disease stages, namely, Lugano stage I, II and IIE. Endoscopic appearances were classified as 4 distinct types: (1) subepithelial tumor type (26 patients, 51%); (2) polyposis type (10 patients, 20%); (3) epithelial mass type (7 patients, 14%); and (4) ileitis type (8 patients, 16%). The rectum (20 patients, 39%) was the most common location, followed by the ileocecal area (15 patients, 30%). An initial endoscopic impression of lymphoma was made in only 7 patients. Forceps biopsy as the initial tissue acquisition method could histologically diagnose MALT lymphoma in 28 of 35 patients (80%). Polypectomy as the initial histological diagnosis could diagnose MALT lymphoma in 16 of 16 patients. Progression-free and overall survivals at 5 years were 92% and 94%, respectively.CONCLUSIONS:Colorectal MALT lymphomas show various endoscopic appearances, complicating the endoscopic suspicion of colorectal MALT lymphoma. The prognosis of colorectal MALT lymphoma was excellent.

 

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