Small bowel (small intestine)

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Small bowel (small intestine)

Lymphoma

MALT lymphoma

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 22 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Tumor of Mucosa Associated Lymphoid Tissue; a type of marginal cell lymphoma
● More common in stomach than small bowel
● Often relapses in GI tract only
● In adults, occurs anywhere in gut but only rarely in appendix and esophagus
● Initially a type of hyperplasia, then monoclonal T cell dependent (from H. pylori infection), then T cell independent
● Initial stages may be “cured” by antibiotics or surgery

Case reports
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● 38 year old man with ileal MALT lymphoma with large-cell component that regressed spontaneously (Gut Liver 2010;4:117)
● 50 year old woman with MALT related multiple lymphomatous polyposis (World J Gastroenterol 2007;13:1453)
● Ileal MALT lymphoma causing massive gastrointestinal haemorrhage (Postgrad Med J 2009;85:163)

Micro description
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Low grade:
● Small or monocytoid lymphocytes with irregular nuclei that form lymphoepithelial lesions
● Reactive germinal centers and plasmacytoid cells are common

High grade:
● Resembles diffuse large B cell lymphoma, but may have Reed-Sternberg like cells

Micro images
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Various images

Positive stains
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● CD20

Negative stains
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● CD3, CD5, CD10, CD23, BCL1

Molecular description
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● t(11;18) involving c-myc is common

End of Small bowel (small intestine) > Lymphoma > MALT lymphoma

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