Editor's quiz: GI snapshot
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From the question on page 902
Histopathological examination of the gastric and jejunal biopsy specimens showed homogenous lymphocytes infiltrating the lamina propria, with the presence of lymphoepithelial lesions (fig 1A,B). Immunohistochemical study showed that the tumour cells were positive for CD20. Mucosa-associated lymphoid tissue (MALT) lymphoma with jejunal involvement was diagnosed. A urea breath test excluded an ongoing infection with Helicobacter pylori. Immunofixation electrophoresis (IFE) showed no abnormal findings. CT revealed lymphadenopathy in the abdomen. Chemotherapy was performed but the patient succumbed to septic shock.
The small intestine is uncommonly involved in gastrointestinal lymphoma. B cell lymphoma accounts for 85% of gastrointestinal lymphomas. Among B cell lymphomas, MALT lymphoma constitutes only 8.2%.1 In this case, it should be differentiated from immunoproliferative small intestinal disease (IPSID). However, because of the prominent lymphocytic infiltration with lymphoepithelial lesions and the negative finding on IFE, the diagnosis of MALT lymphoma is made. "White
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Gut 2008 57: 902.[Extract] [Full Text] [PDF]
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