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Colon tumor

Lymphoma and hematopoietic lesions

Follicular lymphoma

Reviewers: Charanjeet Singh, M.D. (see Reviewers page)
Revised: 22 February 2012, last major update February 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● See also Lymphoma and plasma cell neoplasms chapter
● Rare in colon; more common in small intestine (Am J Pathol 1992;140:1327)
● Resemble mucosal polyps
● Histopathogenesis: primary gastrointestinal follicular lymphoma usually express immunoglobulin A (IgA) and α4β7 mucosal homing receptor, which suggests origin from intestinal antigen experienced B-cells

Prognosis
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● Primary gastrointestinal follicular lymphoma tends to have indolent, low-stage IE and IIE disease
● Most patients can be followed by watchful waiting

Case reports
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● 47 year old man with 10 cm tumor of splenic flexure (J Clin Oncol 1999;17:3684)
● 59 year old woman with rectal tumor (World J Gastroenterol 2004;10:2602)

Micro description
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● Similar to nodal follicular lymphoma; forms follicles with centrocytes and centroblasts
● Usually grade 1, rarely grade 2 and 3
● Precise grading may be difficult in small biopsy specimens

Micro images
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Rectal tumor-left; CD20: upper right; bcl2: lower right

   

H&E

   

Left-CD20; right-bcl2

Positive stains
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● CD20, bcl2; also CD10

Negative stains
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● CD5, T cell markers (in tumor cells)

Molecular description
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● bcl2-IgH translocation

End of Colon tumor > Lymphoma and hematopoietic lesions > Follicular lymphoma

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