Endoscopy 2004; 36(11): 1022-1024
DOI: 10.1055/s-2004-825958
Case Report
© Georg Thieme Verlag Stuttgart · New York

Ileal Mucosa-Associated Lymphoid Tissue Lymphoma Showing Several Ulcer Scars Detected Using Double-Balloon Endoscopy

N.  Yoshida1 , N.  Wakabayashi1 , K.  Nomura2 , H.  Konishi1 , H.  Yamamoto3 , S.  Mitsufuji1 , K.  Kataoka1 , M.  Taniwaki4 , H.  Yamagishi5 , T.  Okanoue1
  • 1Dept. of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
  • 2Dept. of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
  • 3Dept. of Internal Medicine, Division of Gastroenterology, Jichi Medical School, Tochigi, Japan
  • 4Dept. of Clinical Molecular Genetics and Laboratory Medicine, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
  • 5Dept. of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
Further Information

Publication History

Submitted 17 May 2004

Accepted after Revision 11 August 2004

Publication Date:
02 November 2004 (online)

A 72-year-old man was admitted to our hospital to undergo a novel small-intestinal endoscopic procedure. He had had occasional episodes of hematochezia over a 2-year period, during which he had been hospitalized twice previously. However, numerous investigations, including hematological and biochemical studies, gastroscopy, colonoscopy, computed tomography, scintigraphy, and angiography had failed to detect the source of bleeding in the gastrointestinal tract. On this admission, double-balloon enteroscopy was performed and revealed several ulcer scars with localized dilation of the ileum. Histopathological examination of the biopsy specimens revealed no abnormal findings. Partial resection of the ileum was performed to prevent further gastrointestinal bleeding, and histopathological examination of the resected specimen revealed aggregation of atypical lymphocytes, predominantly in the muscularis propria layer. Immunohistochemical examination demonstrated that the tumor cells were positive for CD20 and BCL2, but negative for UCHL1. Based on these findings, the lesion was diagnosed as a marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue. Eighteen months after surgery, the patient was still in complete remission.

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N. Yoshida, M. D.

Dept. of Molecular Gastroenterology and Hepatology · Kyoto Prefectural University of Medicine Graduate School of Medical Science

Kawaramachi-Hirokoji, Kamigyo-ku · Kyoto, 602-8566 · Japan

Fax: +81-75-251-0710

Email: naohisa@koto.kpu-m.ac.jp