Multiple lymphomatous polyposis of the entire GI tract: Report of two cases

Multiple lymphomatous polyposis (MLP) is an uncommon type of primary non-Hodgkin gastrointestinal (GI) B cell lymphoma. It is considered the counterpart of mantle cell lymphoma (MCL) of the GI tract. We report two cases who received diagnosis of MLP. A 52-year-old woman presented with a several-month history of abdominal pain, diarrhoea and night fever. Upper endoscopy revealed lymphomatous polyps involving several GI segments. Histologically the lesions were compatible with diagnosis of Mucosa Associate Lymphoma Tissue (MALT). Immunophenotypic studies confirmed the typical phenotype of MCL. The patient was treated with a CEOP regimen and obtained a complete response lasting seven months. The patient was then treated by high dose chemotherapy followed by stem cell reinfusion and obtaining complete continuous remission lasting more than 28 months after the diagnosis. The second case is a 70-year-old man presenting with the same symptoms. MALT lymphoma was diagnosed histologically. The patient received 6 courses of treatment with fludarabine without results. An histological evaluation by a second colonscopy allowed diagnosis of MCL. Combined chemotherapy (CEOP) followed by autotransplantation was then scheduled. MLP more commonly occurs in men between 55 and 64 years and rarely involves the entire GI tract. Immunophenotypic studies are very helpful for the correct diagnosis. The prognosis of MLP is very poor due to its accelerated proliferation. An intensive therapy including autotransplantation seems to be effective in this disease.