摘要：

Purpose: A 64-year-old Hispanic female presented with a three day history of dark and fresh blood mixed with her stools and diffuse intermittent abdominal pain. She denied any family history of GI related cancers or the use of non-steroidal anti-inflammatory drugs. She had never had a colonoscopy. Her physical exam revealed a vertical scar from a cesarean section. Her hemoglobin was 11.9 gm/dL and her white blood cell count was 7.7 k/muL. Colonoscopy revealed blood throughout the entire colon and a large 4 cm soft ulcerated submucosal mass in the cecum with a patent ileocecal valve. CT scan confirmed a large mass in the cecum with a diameter of 4.7 x 4.2 cm. The patient had a laparoscopic right hemicolectomy. The pathology specimen revealed engorged vessels and a constricted luminal center filled with mucoid tan material. Immunostaining and microscopic appearance revealed marginal zone B-cell mucosa associated lymphoid tissue (MALT) lymphoma involving the colon, appendix and lymph nodes in the fatty tissue with negative resection margins. MALT lymphoma is an extranodal lymphoma arising in various epithelial tissues including the stomach, salivary glands, lung, small bowel, and thyroid. Primary malignant lymphomas of the colon are rare neoplasms and account for approximately 0.2% of colorectal malignancies. MALT lymphoma involving the cecum accounts for only 9.2% of lymphoma lesions in the colon and the gross appearance of ulcerations occurs in 11.9% of cases. With a multidisciplinary approach to the treatment course, including resection of the primary tumor, patients have a good overall prognosis. (Figure presented).

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