Korean J Gastroenterol.  2014 Oct;64(4):229-233. 10.4166/kjg.2014.64.4.229.

A Case of Fungating Type Natural Killer Like T Cell Lymphoma of the Ascending Colon

• Lee CS
• Shin DH
• Choi CW
• Kim HW
• Kang DH
• Koh KW
• Ji BH
• Park SB

• KMID: 1979208
• DOI: http://doi.org/10.4166/kjg.2014.64.4.229

Abstract

Primary colorectal lymphoma is a very rare disease entity that accounts for less than 0.2-0.65% of all colon cancers. It is as an extranodal lymphoma of the colon that mainly arises from B cells and primary colorectal lymphoma that arises from T cells is very rare both in Western countries and in Korea. Colonic lymphoma can be classified endoscopically into 5 categories as follows: fungating, ulcerative, infiltrative, ulcerofungating, and ulceroinfiltrative type. The endoscopic features of primary colorectal lymphoma differ according to their cellular origin; about half of B cell lymphomas are fungating type whereas most of T cell lymphomas are of ulcerative or ulceroinfiltrative type. Mass forming primary T cell lymphoma of the colon is extremely rare. Herein, we present a case of primary natural killer like T cell lymphoma of the colon presenting as fungating type with review of literature.

Keyword

Lymphoma; T-cell; Colon

MeSH Terms

B-Lymphocytes
Colon
Colon, Ascending*
Colonic Neoplasms
Korea
Lymphoma
Lymphoma, B-Cell
Lymphoma, T-Cell*
Rare Diseases
T-Lymphocytes
Ulcer

Figure

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  Fig. 1. Abdominal CT scan findings. (A) CT scan performed 3 months ago shows no evidence of abnormality on the hepatic flexure. (B) CT scan taken at admission shows newly developed huge mass (arrow) with pericolic fat stranding on the hepatic flexure.

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  Fig. 2. Endoscopic finding. A large fungating mass is seen on distal ascending colon which almost obstructs the bowel lumen.

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  Fig. 3. Microscopic findings of the biopsy specimens from the colon mass. (A) Diffuse infiltration of medium-sized atypical lymphoid cells with irregular, pleomorphic, hyperchromatic or vesicular nuclei and many mitotic figures are observed (H&E, ×400). (B) Immunohistochemical stain shows that lymphoma cells are CD3 positive T lymphocytes (×200) that are positive for (C) CD 56 (×200) and (D) CD 8 (×200).

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  Fig. 4. PET scan finding. The mass at hepatic flexure shows intense hypermetabolism with standardized uptake value of 10.8.

Reference

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