© Georg Thieme Verlag KG Stuttgart · New York
Giant atypical lymphoid hyperplasia of the colon
15 September 2010 (online)
A 57-year-old woman with a history of acute myelogenous leukemia had received chemotherapy. Thereafter, she was relatively stable with complete remission.
After 8 years, the woman visited hospital for evaluation of intermittent abdominal fullness. Both physical examinations and laboratory studies were unremarkable. Double-contrast barium study and abdominal computed tomography disclosed a single mass of about 2 × 3 cm in the ascending colon ([Figs. 1] and ).
Fig. 1 Double-contrast barium study disclosed a mass of approximately 2 × 3 cm (arrow) in the ascending colon.
Fig. 2 Abdominal computed tomography (CT) showed one mass (arrow) in the ascending colon.
Colonoscopy confirmed a single polypoid mass in the ascending colon ([Fig. 3]).
Fig. 3 Colonoscopy revealed one polypoid mass (arrow) in the ascending colon.
Endoscopic mucosal resection was accordingly performed. Histopathological examination showed proliferation and aggregation of many atypical lymphoid cells, consistent with atypical lymphoid hyperplasia ([Fig. 4]).
Fig. 4 Histopathological examination showed proliferation and aggregation of many atypical lymphoid cells, consistent with atypical lymphoid hyperplasia (hematoxylin and eosin [H&E]; × 400).
The woman underwent colonoscopy 3 months later, which revealed that the mucosa of the lesion site had healed well.
Atypical lymphoid hyperplasia is a condition usually related to an underlying immune dysregulation, or a reactive change to various inciting antigens or irritating stimuli    . To our knowledge, this is the first reported case of polyp-like atypical lymphoid hyperplasia in the colon; this may be considered a pre-lymphomatous state, and close follow-up is recommended  .
Competing interests: None
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T.-Y. Huang, MD, PhD
Division of Gastroenterology
Department of Internal Medicine
Tri-Service General Hospital
National Defense Medical Center
325 Cheng-Kung Road, Section 2