A Case of Primary MALT Lymphoma of the Cecum Causing Adult Intussusception

Masataka Ando, Makoto Yamada, Shin Kohga* and Hideki Takanari*

Department of Surgery and Department of Pathology*, Kohga Hospital

A 88-year-old man admitted for severe constipation and lower abdominal pain was found in abdominal CT to have a tumor with multiple concentric rings in the right upper abdomen. Ultrasonography showed a target sign and a hay-fork sign in the tumor. Barium enema showed a cup-shaped filling defect in the transverse colon, but invagination was released after inflation and a tumor shadow 5 cm in diameter was recognized in the cecum. Colonoscopy showed a smooth-surfaced Type 1 tumor in the cecum, but no definitive diagnosis was obtained from biopsy specimens (Group 2). From these studies, we diagnosed this as intussusception due to a tumor of the cecum, necessitating ileocecal resection with lymph node dissection. Histologically, this was diagnosed as MALT lymphoma invading the serosa with lymph node involvement. The Japanese literature showed only 10 cases of adult intussusception due to primary malignant lymphoma of the colon, including our case, and our case is the first report of intussusception due to primary MALT lymphoma of the colon. In general, MALT lymphoma is a low-grade malignancy, but some cases of MALT lymphoma with high-grade malignant potential or lymph node involvement have been reported. These findings suggest that extensive lymph node dissection, in addition to complete tumor resection, should be done in cases of advanced MALT lymphoma of the colon.

Key words
MALT lymphoma, colon tumor, intussusception

Reprint requests
Masataka Ando Department of Surgery, Kohga Hospital
655 Daikakuji, Yaizu, 425-0088 JAPAN

Accepted
September 22, 2004

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