Colonic Mucosa-Associated Lymphoid Tissue Following Prior Hodgkin Lymphoma: A Diagnostic Challenge and Therapeutic Approach – A Case Report
Year: 2026
Type: article
Study design: Case Report
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.
DOI: 10.1159/pjg/acwag011
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7221869375