Primary Low-grade Mucosa-associated Lymphoid Tissue (MALT) Lymphoma of the Ascending Colon

Nobukazu Watanabe, Masaru Takeuchi, Mitsuru Ino, Hiroshi Tateoka, Susumu Oishi, Sakae Ota, Hitoshi Ogasawara^* and Takao Tanaka^**

Department of Surgery, the Second Department of Internal Medicine^* and Department of Pathology^**, Odate Municipal Hospital

We report a case of primary low-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the ascending colon. An 82-year-old woman with transient ischemic was found to have a tumor with tenderness in the right lower quadrant of the abdomen. Barium enema showed a huge tumor about 5cm in diameter in the ascending colon. Colonoscopy revealed a nonepithelial, submucosal tumor, and biopsy specimens showed normal colonic musosa. Malignant lymphoma arising from the ascending colon was strongly suspected. Right hemicolectomy was conducted for diagnostic and therapeutic purposes due to the possibility of intestinal obstruction. Final diagnosis was low-grade MALT lymphoma of the ascending colon. Tumor invasion was limited to the serosa without nodal involvement. Adjuvant chemotherapy was not done. In the 4.5 years since surgery, the woman remains alive without recurrence. Low-grade MALT lymphoma rarely occurs in the large bowel, especially in the ascending colon. No standard surgery or therapeutic regimen has been established for this condition. MALT lymphoma has been reported to have a relatively good prognosis. Related surgery, however, should include lymph node dissection the same as for colon cancer due to the risk of nodal involvement.

Key words
low-grade mucosa-associated lymphoid tissue lymphoma, ascending colon

Reprint requests
Nobukazu Watanabe Department of Surgery, Odate Municipal Hospital 3-1 Yutakachou, Odate, 017-8550 JAPAN

Accepted
July 30, 2001

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