Giant atypical lymphoid hyperplasia of the colon

Inhaltsübersicht

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 [2]).

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 [1] [2] [3] [4]. 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 [4] [5].

Competing interests: None

Endoscopy_UCTN_Code_CCL_1AD_2AC

References

• 1 Crowson A N, Magro C M. Antidepressant therapy. A possible cause of atypical cutaneous lymphoid hyperplasia.  Arch Dermatol. 1995;  131 925-929
• 2 Tanahashi T, Tatsumi Y, Sawai N. et al . Regression of atypical lymphoid hyperplasia after eradication of Helicobacter pylori.  J Gastroenterol. 1997;  32 543-547
• 3 Viraben R, Lamant L, Brousset P. Losartan-associated atypical cutaneous lymphoid hyperplasia.  Lancet. 1997;  350 1366
• 4 Krauss E, Konturek P, Maiss J. et al . Clinical significance of lymphoid hyperplasia of the lower gastrointestinal tract.  Endoscopy. 2010;  42 334-337
• 5 Takano Y, Kato Y, Sugano H. Histopathological and immunohistochemical study of atypical lymphoid hyperplasia and benign lymphoid hyperplasia of the stomach.  Jpn J Cancer Res. 1992;  83 288-293