Mucosa-associated Lymphoid Tissue in Lymphoma of the Rectum

Eiji Takeuchi, Youichiro Kobayashi, Kanji Miyata, Makoto Kato, Fumihiko Yoneyama, Hideki Nishio, Tatsuo Hattori and Norio Hirabayashi^*

Department of Surgery and Department of Pathology^*, Japanese Red Cross Nagoya First Hospital

An 83-year-old woman was presented to our hospital because of complaining of anal bleeding. Physical examination disclosed a tumor with a hard consistency on the posterior aspect of the rectum, 5 cm beyond the anal verge. A barium enema examination showed the tumor to have a hemispheric contour with a central depression and was located on the posterior wall of the Ra and Rb areas. Endoscopic examination revealed an elevated lesion with a smooth surface covered with slightly erythematous mucosa, 5 cm beyond the anal verge. Examination of a biopsy specimen near from the surface of the mass revealed no evidence of malignancy. Low-anterior resection with a regional lymph node dissection was performed for as a preoperative diagnosis of leiomyosarcoma. The resected specimen confirmed features which was seen in barium and endoscopic studies. The tumor was measured 35×30mm. Histopathologic examination demonstrated that the tumor was composed of centrocyte-like lymphoid cells invading the muscular layer, and that lympho-epithelial lesions were present at the epithelial surface. No evidence of lymph node involvement was present. We also discussed the features of the 14 cases including present case in MALT lymphoma of the rectum previously reported in the Japanese literature. As the recurrence rate in cases of local excision was 50%, it is necessary to perform the radical resection with lymph node dissection on the basis of precise diagnosis.

Key words
mucosa-associated lymphoid tissue, lymphoma, rectum

Reprint requests
Eiji Takeuchi Department of Surgery, Japanese Red Cross Nagoya First Hospital 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453 JAPAN

Accepted
October 26, 1999

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