Colorectal MALT lymphoma and oral manifestation in an African black sickle child
Summary
Colorectal MALT lymphoma associated with oral manifestations has not been described to our knowledge. We report a case of colorectal MALT lymphoma associated with oral manifestations in a 17-year-old sickle homozygous black African Child (SSFA2). The initial clinical symptomatology was a diarrhea of bloody liquid stools and abdominal pain that 3 years later was associated with oral manifestations in the form of gloss, labial and lingual ulcers. The endoscopic lesion was a ulcerative, polyploid, and Nodular pancolite by location. histological examination of staged colic samples was in favor of colorectal MALT lymphoma, confirmed by the positivity of CD20 and CD79a antibodies to the immuno-histochemical examination. Digestive and oral manifestations disappeared after chemotherapy.
Keywords
Colon malt lymphoma Oral Event sickle cell Africa sub-Saharan colonic malt lymphoma with oral manifestation in African child with sickle cell anemia
Abstract
Mucosa Associated lymphoid tissue (MALT) colorectal lymphoma with oral manifestations has not been described previously. We herein report a case of MALT colorectal lymphoma with oral manifestations in a black African child with sickle cell anaemiaing with chronic bloody diarrhea and abdominal pain. These symptoms were associated with lips and tongue ulcerations that occurred 3 years later after the onset of the colorectal symptoms. Colonoscopic examination shown multiple ulcerations, polypoïd and nodular lesions. Histological examination of multiple fragments biopsy throughout the colon shown dense and diffuse lymphocytic seepage without lymphoepithelial lesions. Immunohistochemical analysis stained with CD20 and CD79a confirming colorectal MALT lymphoma. The patient received chemotherapy that allowed the disappearance of oral and colorectal protests.
Keywords
Colon Mucosa-associated lymphoid tissue Lymphoma oral manifestations sickle cell anaemia Sub-Saharan Africa colorectal MALT lymphoma and oral manifestation in a child
African Black Sickle
Colonic MALT lymphoma with oral manifestation in African child with sickle cell anemia
A.K. Mahassadi · C. Dan · H.Y. Kissi · A.D. Bailey · S. Doyle · GD Kaya · F.Y. K. Akin ·
T.A. Nami-Yap
© Springer-Verlag France 2014
Summary Colorectal MALT lymphoma associated with
Oral demonstrations have not to our knowledge been
Described. We report a case of MALT lymphoma
associated with oral manifestations that appeared at the
A child sickle homozygous black African (SSFA2)
of 17 years. The initial clinical symptomatology was a
Diarrhea made of bloody liquid stools and pain
Abdominals that 3 years later was associated with demonstrations
Orally in the form of gloss, labial ulcerations
and lingual. The endoscopic lesion was a pancolite
Ulcerative-hemorrhagic, polyploid and nodular by location.
histological examination of the colicky samples
was in favor of colorectal MALT lymphoma,
Confirmed by the positivity of CD20 and CD79a antibodies to
The immuno-histochemical examination. Digestive Events
and oral disappeared after chemotherapy.
Colon key Words · MALT lymphoma · Event
Oral Sickle Sub-Saharan Africa
Abstract Mucosa associated lymphoid colorectal tissue (MALT)
Lymphoma with oral events has not been
The We herein report a case of colorectal MALT
Lymphoma with oral events in a black African
Child with sickle cell anaemia complaints with chronic
Bloody diarrhea and abdominal pain. These symptoms were
associated with lips and tongue ulcerations that occurred
3 years later after the onset of the colorectal symptoms.
Colonoscopic examination shown multiple ulcerations,
Polypoïd and nodular lesions. Histological Examination of
Multiple fragments biopsy throughout the colon shown
Dense and diffuse lymphocytic seepage without lymphoepithelial
Lesions. Immunohistochemical analysis Stained with
CD20 and CD79a confirming colorectal MALT lymphoma.
The patient received chemotherapy that allowed the disappearance
of oral and colorectal events.
Colon keywords Mucosa-associated lymphoid tissue ·
Lymphoma Oral Events · Sickle cell Anaemia ·
Sub-Saharan Africa
Introduction
Mucosa Associated lymphoid tissue (MALT lymphoma)
Was individualized in 1983 by Issacson and Wright, made
Part of the large group of non-Hodgkin's malignant lymphomas
of the marginal zone B of lymphoid follicles
[1]. This is a small cell lymphoma of
Low grade type B that can occur in all organs
Or epithelial tissues containing lymphocytes with a
Predilection for the digestive tract especially the stomach and intestine
Hail [1.2]. However, colorectal MALT lymphoma
is a rare and very poorly documented disease in black Africa
Both in adults and children [2.3].
Colorectal MALT lymphoma has a symptomatology
Polymorphic with abdominal pain, diarrhea sometimes
Bloody [4-7]. The oral events associated with this
Type of lymphoma have not been described to our knowledge.
We report the first case of MALT lymphoma
Combination of digestive and oral symptomatology,
occurred in a child sickle homozygous black
African.
Observation
The child J.C., born on 06 August 1994, was followed since the age of
1 year for a sickle cell homozygous SSFA2 in the
A.K. Mahassadi (*) · H.Y. Kissi · A.D. Bailey · S. Doyle ·
GD Kaya · F.Y. K. Akin · T.A. Nami-Yap
Service of Hepato-Gastroenterology, CHU of Yopougon,
21 BP 632 Abidjan, Ivory Coast
E-mail: mahassadi@yahoo.com
C. Dan
Clinical Hematology Service, CHU de Yopougon,
21 BP 632 Abidjan, Ivory Coast
J. Afr. Hépatol. Gastroentérol. (2014) 8:20-24
DOI 10.1007/s12157-014-0507-2
Clinical Hematology Service at CHU de Yopougon.
In 2004, the child had chronic diarrhea made
of phlegm-bloody liquid stools (average 6 to 8 stools
per day) with abdominal pain, unaccompanied
of fever and no triggering factor. The child was not
Sickle crisis during the onset of symptoms
Digestive. The clinical exam showed a child in good condition
General, with slightly pale subictériques conjunctive,
A hepatomegaly and a clinical splenomegaly. It
There were no peripheral adenopathies. The exams
Paraclinical showed anemia at 6 g/DL; A leukocytosis
To 13700 elements/mm3
, with a neutrophilia to
5343 elements/mm3; A blood Hypereosinophilia to
2055 Elements/Mm3
. parasitological Examination of stools
Showed the presence of many yeasts in the stool.
There were no amoebae or intestinal worms. The Coproculture
and serology of hepatitis B, C and immunodeficiency virus
Human beings were negative. A treatment by
Metronidazole, Amoxycilline and Albendazole was established
For seven days. This treatment resulted in a transient reduction in
of the stool frequency from 8 to 4 liquid stools
With little blood alternating with the emission phases of
Pasty stools.
With the resumption of diarrhea, a first colonoscopy
was carried out in October 2006, which concluded at a pancolite
Ulcérohémorragique and Pseudopolypoide. histological examination
Biopsy-storied samples made in Abidjan
(Ivory Coast) evoked colorectal MALT lymphoma
By the presence of an abundant infiltration lymphoplasmocytaire
Diffuse and nodular of chorion with disappearance of glands
Without lymphoépithéliales lesions. The gastroscopy was normal.histological Examination of biopsy samples
At the level of the Den and the fundus showed a gastritis
Superficial antro without Helicobacter pylori. The review
Immunohistochemical for confirmation that cannot be
Be carried out in Abidjan, treatment with prednisone at dose
Degressive at a rate of 1 mg/kg/d was decided in July 2007.
Diarrhoeal episodes became less frequent (<
4 Stools/d) with a minimum dose of 5 mg prednisone
A day. In September 2007, oral signs appeared
Made of labial ulcers, necrotic per place, a
Ulcerative-erosive Gloss (Fig. 1) and small erosions in the
Level of the scalp. The stools were pasty with
Average 3 to 4 exemptions per day not bloody. The Anorectoscopie
Showed a rectal staining mucosa
Normal. The patient consulted a stomatologist that evoked
A disease of Behcet and decided of a treatment retake
By prednisone at a dose of 3 grams per day during
10 days associated with Spiramycin (3 million/d) and colchicine
(1 tablet/j). This treatment eliminated the
Oral signs and at the level of the scalp. In October of
In the same year, the dose of prednisone was reduced to 20 mg/d
Then gradually decrease to be maintained at 5 mg per
Day. The child was reviewed in February 2008 with a reappearance
Oral signs without lesions at the scalp level
That made us evoke a therapeutic escape
Requiring an increase in the dose of prednisone to
25 mg/d. Again the oral signs disappeared and
The child was kept in remission with the dose of 20 mg
Prednisone. During the year 2008, any attempt to
Decrease in the dose of prednisone in Déça of 20 mg was
appear the oral and digestive signs with an average
3-4 stools a day and had doubts about the diagnosis of
Behcet disease for Crohn's disease or colitis
Requiring us to attempt treatment with Pentasa ®
Started in March 2008 and then stopped in May of the same year.
The diagnosis of corticosensible-inranked colitis was
Then evoked. The child held back in remission
With 20 mg of prednisone per day was lost sight of during
One year and then revised in July 2009 with the same signs
Oral and digestive following a voluntary interruption of
Corticotherapy for 5 days according to the father's words. The child
was again treated with Prednisone (20 mg/d). The colonoscopy
Remade showed a ulcerative-haemorrhagic pancolite and
Nodular (Fig. 2). Biosiques levies made at
The rectum, the sigmoide, the transverse colon and the
Left Colon were then sent to France in the laboratory
CERBA (Cergy Pontoise). Histological examinations
And Immunohistochemical made in this laboratory
Were again showing histological lesions in favor of
of colorectal MALT lymphoma made of an infiltration
Massive lymphoid or in spans composed of lymphocyte cells
Small and medium size (Fig. 3). The review
Immuno-histochemical directed by Immunopéroxydase indirect
In three layers on dewaxed cuts showed
Positive BCL2 antibodies, negative CD5, negative CD10, CD20
Positive, and CD79a positive, definitively confirming the
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