Primary Rectal Malignant Lymphoma, Report of a Case Takahiro Fujimori 1,2 , Akira Hirayama 3 , Kou Nagasako 4 , Hiroyoshi Suzuki 4 1Department of Surgical Pathology, Tokyo Women's Medical College 3Department of Gastroenterology, Tokyo Women's Medical College pp.99-103
Published Date 1985/1/25
DOI https://doi.org/10.11477/mf.1403109673
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 A 54 year-old woman patient visited our hospital with a chief complaint of bloody stool. Digital examination revealed a rectal mass. Colonoscopy showed a flat polypoid lesion with superficial erosion and minimal friability. Proctosigmoidectomy was done by the reason that its endoscopic finding was suggestive of malignant lymphoma, although the biopsy specimen revealed no tumor cells.

 The tumor was limited in the rectum without any metastasis in the liver, spleen and retroperitoneal cavity. In the resected specimen the lesion,40×25 mm in diameter, was located in the rectum, about 40 mm from the dentate line. In histologic examination, the most distinctive feature of tumor cells was the nodular pattern of growth at low-power view. Tumor cells were composed of small and large lymphoid cells (the population of large cells was less than 20%). Starry-sky cells were absent. Small to medium-sized cells with irregular nuclei showed occasional cleavage lines. The chromatin was coarse and the nucleoli were inconspicuous. Sometimes small plasma cells or plasmacytoid cells were observed in or among neoplastic cells. Immunoperoxidase studies demonstrated the monoclonal B-cell origin of these cells (lgG (κ)). By these findings, this tumor was diagnosed as primary rectal malignant lymphoma, follicular, mediumsized cell type (Classification of Japan Lymphoma-Leukemia Study Group; LSG), Stage Ⅰ.

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