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首页> 外文期刊>Sao Paulo Medical Journal >Multiple lymphomatous polyposis of the gastrointestinal tract
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Multiple lymphomatous polyposis of the gastrointestinal tract

机译：胃肠道多发性淋巴瘤性息肉病

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CONTEXT: Gastrointestinal multiple lymphomatous polyposis is a rare type of malignant lymphoma that has aggressive biological behavior, early systemic dissemination and poor prognosis. It is considered to be a manifestation of non-Hodgkin lymphoma and represents the gastrointestinal counterpart of mantle cell nodal lymphoma. OBJECTIVE: A case of gastrointestinal multiple lymphomatous polyposis is presented and the anatomopathological, clinical, diagnostic and treatment aspects of this unusual neoplasia are discussed. CASE REPORT: The patient was a 59-year-old white male with a complaint of asthenia, night sweating, alteration in intestinal habit and weight loss over the preceding two months. The physical examination showed pallid mucosa and a palpable mass in the epigastrium and mesogastrium. Endoscopy of the upper digestive tract showed the presence of gastric and duodenal polyps. An opaque enema showed multiple polypoid lesions, especially in the cecum. A rectal biopsy revealed infiltration of the mucosa and submucosa by diffuse lymphoma consisting of small cleaved cells. Immunohistochemical study showed lymphocytes that expressed the antibody CD20 (L-26) and light-chain kappa (k) immunoglobulin, but not light-chain lambda (l) immunoglobulin. The patient presented a condition of acute intestinal obstruction with the presence of a mesenteric mass formed by agglutinated lymph nodes that surrounded the proximal ileum, thereby obstructing its lumen. He was submitted to a segmental enterectomy and gastrotomy with excisional biopsies of the gastric polypoid lesions. After two cycles of chemotherapy there was a worsening of the general state, with an increase in the dimensions of the abdominal masses and sepsis, accompanied by progressive respiratory insufficiency, leading to death.
机译：背景：胃肠道多发性淋巴瘤性息肉病是一种罕见的恶性淋巴瘤，具有侵袭性的生物学行为，早期的全身传播和不良的预后。它被认为是非霍奇金淋巴瘤的一种表现，并代表了套细胞淋巴瘤的胃肠道对应。目的：介绍1例胃肠道多发性淋巴瘤性息肉病患者，并讨论该异常瘤形成的解剖，病理，临床，诊断和治疗方面。病例报告：该患者是一名59岁的白人男性，前两个月主诉无力，盗汗，肠道习惯改变和体重减轻。体格检查显示上睑和中胃有苍白的粘膜和明显的肿块。上消化道内窥镜检查显示存在胃和十二指肠息肉。不透明的灌肠显示多发性息肉状病变，尤其是在盲肠。直肠活检显示由小分裂细胞组成的弥漫性淋巴瘤浸润了粘膜和粘膜下层。免疫组织化学研究显示，淋巴细胞表达抗体CD20（L-26）和轻链κ（k）免疫球蛋白，但不表达轻链λ（l）免疫球蛋白。该患者表现为急性肠梗阻，伴有由回肠近端围绕的凝集性淋巴结形成的肠系膜肿块，从而阻塞了其管腔。他被接受了节段性肠切除术，并进行了胃息肉样病变的切除活检。经过两个周期的化疗后，总体状态恶化，腹部肿块和败血症的大小增加，并伴有进行性呼吸功能不全，导致死亡。

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