Mantle cell lymphoma with diffuse gastrointestinal tract involvement: A case report

Gastrointestinal tract mantle cell lymphoma accounts for only approximately 1% to 2% of non-Hodgkin lymphomas. Multiple lymphomatous polyposis is an uncommon disease entity that is regarded as the intestinal form of mantle cell lymphoma. We present here a case of mantle cell lymphoma with peculiar endoscopic presentations in the stomach and colon in a 70 year-old woman. She suffered from abdominal pain, progressive abdominal fullness, and body weight loss of 11 kilograms within 6 months. Big polypoid masses with ulcerations were found at the fundus and high body of the stomach by endoscopy and at the cecal area by colonoscopy. Biopsies from both sites confirmed the diagnosis of mantle cell lymphoma. Computer tomography of the abdomen revealed diffuse wall thickening involving the gastric fundus, high body, antrum, duodenum and proximal ascending colon with extensive mesentery lymph node enlargement. She received one cycle of cyclophosphamide, vincristine and prednisone(COP) followed by seven cycles of rituximab plus cyclophosphamide and prednisone, which resulted in significant tumor regression and prompt symptomatic palliation.