Mucosa-associated lymphoid tissue lymphoma simulating Crohn’s disease:A case report  

作　　者：Ieva Stundiene Vaidota Maksimaityte Valentina Liakina Jonas Valantinas 

机构地区：[1]Centre of Hepatology,Gastroenterology and Dietetics,Faculty of Medicine,Vilnius University,Vilnius 03101,Lithuania [2]Department of Chemistry and Bioengineering,Faculty of Fundamental Science,Vilnius Gediminas Technical University,Vilnius 10223,Lithuania [3]Clinic of Gastroenterology,Nephrourology and Surgery,Faculty of Medicine,Vilnius University,Vilnius 03101,Lithuania

出　　处：《World Journal of Clinical Cases》2020年第8期1454-1462,共9页世界临床病例杂志

摘　　要：BACKGROUND Differential diagnosis between extranodal marginal zone lymphoma of mucosaassociated lymphoid tissue and inflammatory bowel disease is mainly based on histopathologic evaluation of intestinal biopsies,although there is no single definitive diagnostic investigation and that circumstance can lead to misdiagnosis in particular cases.Herein we present a rare,ulcerative form of marginal zone lymphoma which mimics the Crohn’s disease(CD)of upper digestive tract.CASE SUMMARY A 50-year-old man was presented with recurrent episodes of malaise and melena also weight loss.Enteroscopy of the small bowel demonstrated an ulcer in the jejunum.Microscopically,biopsies showed lymphoplasmacytic infiltrate.Diagnosis of CD was made.Primary treatment consisted of prednisone and azathioprine and was followed by azathioprine 100 mg per day with good clinical response in the following 2 years until relapse.At this time the results of endoscopic biopsies derived from proximal wall of stomach revealed Helicobacter pylori-negative marginal zone lymphoma of the gastric fundus.Immunophenotyping confirmed atypical CD20-positive cell population.Based on these biopsies,marginal zone lymphoma of mucosa-associated lymphoid tissue was diagnosed.Unfortunately,the contact with the patient was lost until one year later he was hospitalized with nausea,vomiting and severe pain because of gastrointestinal perforation.Four months later after laparotomy,the patient was treated with a course of chemotherapy.Complete remission was observed following 6 cycles of treatment.CONCLUSION This case report highlights the clinical relevance of knowledge and awareness of marginal zone lymphoma simulating CD.

关 键 词：CROHN disease Mucosa-associated LYMPHOID tissue LYMPHOMA RARE diagnosis GASTROINTESTINAL diseases THIOPURINES Case report 

分 类 号：R733.1[医药卫生—肿瘤] R574[医药卫生—临床医学]