Radiotherapy for mucosa-associated lymphoid tissue (MALT) lymphoma of the rectum: a case report

Hayakawa, Toyokazu; Nonaka, Tetsuo; Mizoguchi, Nobutaka; Hagiwara, Yasuhito; Shibata, Shino; Sakai, Rika; Nakayama, Norisuke; Yokose, Tomoyuki; Nakayama, Yuko

doi:10.1007/s12328-017-0769-5

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…Okamura et al [ 20 ] reported that three stage I cases achieved complete remission by radiotherapy. This clinical effect was also confirmed in case reports of Amouri et al [ 21 ], Foo et al [ 22 ], and Hayakawa et al [ 23 ]. The lesion in our case, limited to the rectum with no other tumor, was classified as stage I and was completely removed by ESD.…”

Section: Discussionsupporting

confidence: 81%

Laterally spreading tumor-like primary rectal mucosa-associated lymphoid tissue lymphoma: A case report

Wei¹,

Min²,

Ren³

et al. 2021

WJCC

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BACKGROUND Colorectal mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease, and only a few cases have been reported to date. It has no specific clinical presentations and shows various endoscopic appearances. There is no uniform consensus on its treatment. With the advancement of endoscopic technology, endoscopic treatment has achieved better results in individual case reports of early-stage patients. CASE SUMMARY We report a case of rectal MALT in a 57-year-old Chinese man with no symptoms who received endoscopy as part of a routine physical examination, which incidentally found a 25 mm × 20 mm, laterally spreading tumor (LST)-like elevated lesion in the rectum. Therefore, he was referred to our hospital for further endoscopic treatment. Complete and curable removal of the tumor was performed by endoscopic submucosal dissection. We observed enlarged and dilated branch-like vessels similar to those of gastric MALT lymphoma on magnifying endoscopy with narrow-band imaging. And immunopathological staining showed hyperplastic capillaries in the mucosa. Histopathological findings revealed diffusely hyperplastic lymphoid tissue in the lamina propria, with a visible lymphoid follicle structure surrounded by a large number of diffusely infiltrated lymphoid cells that had a relatively simple morphology and clear cytoplasm. In addition, immunohistochemical analysis suggested strongly positive expression for CD20 and Bcl-2. Gene rearrangement results showed positivity for IGH-A, IGH-C, IGK-B, and IGL. Taking all the above findings together, we arrived at a diagnosis of extranodal marginal zone B-cell lymphoma of MALT lymphoma. Positron emission tomography-computed tomography examination showed no other lesions involved. The patient will be followed by periodic endoscopic observation. CONCLUSION In conclusion, we report a case of rectal MALT with an LST-like appearance treated by endoscopic submucosal dissection. Further studies will be needed to explore the clinical behavior, endoscopic appearance, and treatment of rectal MALT.

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Section: Discussionsupporting

confidence: 81%

Laterally spreading tumor-like primary rectal mucosa-associated lymphoid tissue lymphoma: A case report

Wei¹,

Min²,

Ren³

et al. 2021

WJCC

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“…On the other hand, in our study, none of the patients with non-gastric intestinal MALT lymphoma developed recurrence or died. Long-term recurrence-free cases have been reported after RT for rectal and duodenal MALT lymphomas [10,11,22]. Our study suggests that non-gastric intestinal MALT lymphoma has a similar prognosis to gastric MALT lymphoma.…”

Section: Discussionsupporting

confidence: 59%

“…RT is an effective treatment method for gastric and non-gastric intestinal MALT lymphoma with favorable outcomes, with mild, tolerable adverse events reported. Prescription doses, such as 30 Gy/20 Fr, 30 Gy/15 Fr, and 34 Gy/17 Fr, are frequently used for gastric and non-gastric intestinal MALT lymphomas [8,10,22]. Recently, there have been reports of low-dose RT using intensity-modulated radiation therapy (IMRT) [23].…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy for non-gastric intestinal versus gastric MALT lymphoma: a comparison of treatment outcomes

Watanabe

Ogino

Hata³

2020

Blood Res

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Background: Radiotherapy is often used for treating patients with gastric mucosa-associated lymphoid tissue (MALT) lymphomas who fail to respond to Helicobacter pylori eradication. However, non-gastric intestinal MALT lymphoma is rare, and no standard therapeutic strategies have been established. This study was designed to assess the long-term prognosis of non-gastric intestinal MALT lymphoma treated with radiotherapy and to compare the outcomes with that of post-radiotherapy gastric MALT lymphoma. Methods: The study included 34 patients with stage I EA gastrointestinal MALT lymphoma according to the Ann Arbor classification who underwent definitive radiotherapy. The primary site was the rectum in 3, the duodenum in 1, and the stomach in 30 patients. The radiotherapy dose was 1.5-2.0 Gy (median, 1.5 Gy) and the total dose was 30-40 Gy (median, 30 Gy). The clinical target volume (CTV) was defined as the volume of the entire organ with the lymphoma. Adjacent lymph node areas were not routinely included in the CTV. Results: Complete response (CR) was achieved in all patients. There were no local recurrences, and two cases of recurrence were observed at other sites. The 5-year overall survival rates for non-gastric and gastric MALT lymphomas were 100% and 94.7%, respectively, and the 5-year disease-free survival rates were 100% and 95.7%, respectively. None of the patients died of the current illness. Conclusion: Radiotherapy for non-gastric intestinal MALT lymphoma is expected to result in good local control and long-term survival, similar to that for gastric MALT lymphoma.

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“…Tsang et al. reported that the median RT dose was 30 Gy (range, 17.5-35 Gy), and the most frequent doses were 25 Gy, 30 Gy, and 35 Gy for IEA and ⅡEA MALT [ 25 , 31 ]. We planned the dose of 36-40 Gy and monitored the tumor response during radiotherapy every week.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy for mucosa-associated lymphoid tissue (MALT) lymphoma of the rectum: a case report

Cited by 6 publications

References 27 publications

Laterally spreading tumor-like primary rectal mucosa-associated lymphoid tissue lymphoma: A case report

Laterally spreading tumor-like primary rectal mucosa-associated lymphoid tissue lymphoma: A case report

Radiotherapy for non-gastric intestinal versus gastric MALT lymphoma: a comparison of treatment outcomes

Mucosa-associated lymphoid tissue of nasopharynx: A case report and literature review

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