Oesophageal involvement in mantle cell lymphoma

Santra G
Correspondence: Dr Gouranga Santra, g.santra@yahoo.com

ABSTRACT
The stomach and small intestine are common sites for gut lymphomas, but oesophageal lymphomas are very rare. In mantle cell lymphoma (MCL), although multifocal gut involvement is seen, oesophageal involvement is uncommon. Gut involvement may be primary or secondary to systemic involvement. Multiple lymphomatous polyposis (MLP) is the intestinal form of MCL. Most cases of MLP occur in the elderly, usually over 50 years of age, and the presenting symptoms are abdominal pain, melaena, haematochezia and fatigue. In MCL, tumour cells typically express CD5 and cyclin D1 markers. Our patient presented with generalised lymphadenopathy, dysphagia and rapid weight loss. Upper gastrointestinal endoscopy revealed submucosal polypoid lesions in the oesophagus, stomach and duodenum. Histopathology and immunophenotyping confirmed MCL. Although MLP presenting as a primary MCL of the intestine has been described in the literature, our patient also had multiple intestinal polyposis (including the oesophagus) due to secondary involvement from systemic MCL.

Keywords: CD5, cyclin D1 markers, mantle cell lymphoma, multiple lymphomatous polyposis, oesophagus
Singapore Med J 2010; 51(12): e201-e203