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International Journal of Surgical Pathology
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Multiple Lymphomatous Diverticulosis and Comorbid Chronic Lymphocytic Leukemia: Novel Manifestations of Ileocolic Mantle Cell Lymphoma

Shaun A. C. Medlicott, MD

Department of Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada, shaun.medlicott{at}cls.ab.ca

Holly A. Brown, MD

Department of Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada

Birgitte Roland, MD

Department of Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada

Paul L. Beck, MD

Department of Gastroenterology, University of Calgary, Calgary, Alberta, Canada

Iwona Auer, MD

Department of Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada

Adnan Mansoor, MD

Department of Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada

Mantle cell lymphoma (MCL) has tropism for the gastrointestinal tract (GIT) identifiable as multiple polyps and mass lesions throughout the GIT. We describe 2 novel manifestations of MCL. A 60-year-old woman with known chronic lymphocytic leukemia (CLL) had an exophytic mass of the appendiceal orifice. Multiple polypoid masses of the distal ileum were identified in the right hemicolectomy specimen (multiple lymphomatous polyposis). Ancillary studies confirmed the coexistence of the 2 independent lymphoproliferative disorders. A 69-year-old man had recurrent urinary tract infections and pneumatouria caused by a colovesicular fistula complicating diverticulosis coli. Segmental resections of the sigmoid and ileocecum confirmed diverticulosis of the left and right colon. Histology identified infiltrates of MCL confined to the penetrating aspects of colonic diverticula. MCL has not been documented to coexist with CLL. An invaginating morphology of lymphoma, multiple lymphomatous diverticulosis is also a novel presentation. These 2 scenarios expand MCL's known manifestations within the GIT.

Key Words: mantle cell lymphoma • diverticulosis • chronic lymphocytic leukemia

International Journal of Surgical Pathology, Vol. 15, No. 4, 408-413 (2007)
DOI: 10.1177/1066896907302372
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