Diffuse polyposis of small intestine

Primary lymphomas of the gastrointestinal tract account for about one third of extranodal lymphomas (1). Multiple lymphomatous polyposis (MLP) is a rare pres- entation of gastrointestinal lymphomas. It is character- ized by extensive involvement of the gut by lymphoma cells macroscopically appearing as multiple small poly- poid lesions. A 53-year-old man presented with a one-month his- tory of abdominal pain, weight loss and fever. His past medical history was unremarkable. He was extremely tired and cachectic. Laboratory findings were normal except for than low hemoglobin (7.1 g/dL), high erythro- cyte sedimentation rate (87 mm/h) and positive stool blood test. Upper gastrointestinal endoscopy revealed diffuse nodules and polyps (2-8 mm) in whole duo- denum. Colonoscopy showed similar lesions at the ileo-cecal valve and in the ileum (Fig. 1). Abdominal computed tomography revealed multiple abdominal lymphadenopathies and diffuse thickening of intestinal wall. Duodenum and ileum biopsies were compatible with diffuse large B cell lymphoma. They were positive for CD-20, Bcl-6, CD45 and negative for CD3, Bcl-2 and CD1O.Ki67 staining showed 90% reactivity. Although chemotherapy was planned, the patient died as a result of sepsis two days after diagnosis.