Colonic Mucosa-Associated Lymphoid Tissue Following Prior Hodgkin Lymphoma: A Diagnostic Challenge and Therapeutic Approach – A Case Report
4 affiliations
- 1Serviço de Gastrenterologia, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal
- 2Serviço de Anatomia Patológica, Unidade Local de Saúde Arco Ribeirinho, Barreiro, Portugal
- 3Serviço de Hematologia, Unidade Local de Saúde Almada-Seixal, Almada, Portugal
- 4Serviço de Gastrenterologia, Unidade Local de Saúde Arco Ribeirinho, Barreiro, Portugal
Abstract
Introduction: Colorectal mucosa-associated lymphoid tissue (MALT) lymphoma is a rare entity, accounting for approximately 1.6% of all MALT lymphoma cases. Its clinical and endoscopic presentation is generally nonspecific, and given the limited number of reported cases, no consensus exists on the optimal therapeutic strategy.
Case Presentation: A 47-year-old male with a 15-year remission history of stage IIb nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) underwent abdominopelvic CT for recurrent urinary tract infections, revealing a suspected sigmoid neoplasm with locoregional lymphadenopathy. Colonoscopy showed two adjacent but noncontiguous subepithelial erythematous lesions (15 mm and 10 mm) with surrounding “chicken skin” mucosal pattern. Initial biopsies demonstrated chronic inflammation only. At endoscopic reassessment, endoscopic mucosal resection (EMR) was performed, yielding a histological diagnosis of MALT lymphoma. Following multidisciplinary discussion, the patient underwent four cycles of rituximab monotherapy, achieving complete remission on reassessment CT. At eighteen months of follow-up, he remains asymptomatic without clinical, radiological, or endoscopic evidence of relapse.
Conclusion: We report the first described coexistence of colonic MALT lymphoma and prior NLPHL, without an established biological association given the absence of comparative molecular studies. This case highlights the role of EMR when conventional biopsies are nondiagnostic and demonstrates the efficacy of rituximab monotherapy in this rare entity.
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BibTeX
@article{pereira2026colonic,
title = {{Colonic Mucosa-Associated Lymphoid Tissue Following Prior Hodgkin Lymphoma: A Diagnostic Challenge and Therapeutic Approach – A Case Report}},
author = {Beatriz Pereira and Rui Mendo and Bárbara Pena and Filipa Campos and Catarina Vieira},
journal = {GE Portuguese Journal of Gastroenterology},
year = {2026},
month = oct,
doi = {10.1159/pjg/acwag011},
url = {https://doi.org/10.1159/pjg/acwag011},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Colonic Mucosa-Associated Lymphoid Tissue Following Prior Hodgkin Lymphoma: A Diagnostic Challenge and Therapeutic Approach – A Case Report
AU - Beatriz Pereira
AU - Rui Mendo
AU - Bárbara Pena
AU - Filipa Campos
AU - Catarina Vieira
PY - 2026
DA - 2026/10/15
JO - GE Portuguese Journal of Gastroenterology
DO - 10.1159/pjg/acwag011
UR - https://doi.org/10.1159/pjg/acwag011
AB - Introduction: Colorectal mucosa-associated lymphoid tissue (MALT) lymphoma is a rare entity, accounting for approximately 1.6% of all MALT lymphoma cases. Its clinical and endoscopic presentation is generally nonspecific, and given the limited number of reported cases, no consensus exists on the optimal therapeutic strategy. Case Presentation: A 47-year-old male with a 15-year remission history of stage IIb nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) underwent abdominopelvic CT for recurrent urinary tract infections, revealing a suspected sigmoid neoplasm with locoregional lymphadenopathy. Colonoscopy showed two adjacent but noncontiguous subepithelial erythematous lesions (15 mm and 10 mm) with surrounding “chicken skin” mucosal pattern. Initial biopsies demonstrated chronic inflammation only. At endoscopic reassessment, endoscopic mucosal resection (EMR) was performed, yielding a histological diagnosis of MALT lymphoma. Following multidisciplinary discussion, the patient underwent four cycles of rituximab monotherapy, achieving complete remission on reassessment CT. At eighteen months of follow-up, he remains asymptomatic without clinical, radiological, or endoscopic evidence of relapse. Conclusion: We report the first described coexistence of colonic MALT lymphoma and prior NLPHL, without an established biological association given the absence of comparative molecular studies. This case highlights the role of EMR when conventional biopsies are nondiagnostic and demonstrates the efficacy of rituximab monotherapy in this rare entity.
SN - 2341-4545
SN - 2387-1954
ER -