Small bowel (small intestine)
Mediterranean lymphoma

Topic Completed: 1 August 2012

Revised: 15 March 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Mediterranean lymphoma[TIAB] small bowel

Hanni Gulwani, M.B.B.S.
Page views in 2019: 663
Page views in 2020 to date: 138
Cite this page: Gulwani H. Mediterranean lymphoma. website. Accessed February 27th, 2020.
Definition / general
  • Also called immunoproliferative small intestinal disease, Middle Eastern lymphoma
  • More common among non-European Jews, Middle Eastern Arabs, South African blacks
  • B cell lymphoma that arises in background of chronic diffuse mucosal plasmacytosis, with IgA heavy chain synthesis (no variable chain synthesized)
Clinical features
  • Many have preexisting malabsorption
  • May initially respond to antibiotics
  • Often due to Campylobacter jejuni, another human pathogen responsible for immunoproliferative states (N Engl J Med 2004;350:239)
Case reports
Gross description
  • Low grade: nonflattened mucosa
  • High grade: diffusely thickened folds with small nodules in distal duodenum / proximal jejunum
Microscopic (histologic) description
Low grade:
  • Heavy lymphoplasmacytic infiltrate by mature cells

High grade:
  • Resembles diffuse large cell lymphoma with plasmacytoid features
  • May have starry sky pattern, follicular hyperplasia
Microscopic (histologic) images

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Various images

Positive stains
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