Abdominal mass, multiple lymphadenopathies, and polyposis.

An 83-year-old male presented with anorexia, asthenia, weight loss, and profuse sweating. A 2-cm axillary lymphadenopathy and an abdominal mass in the right lower quadrant were palpable. Thoracic and abdominal CT scans were performed (Fig. 1). Colonoscopy revealed numerous sessile, erythematous polyps up to 1 cm in size with a white apex, and also pale, non-adenomatous polyps in the sigmoid and descending colon. Polyps in the transverse and right colon were less frequent. Polypoid masses prolapsed through the ileocecal valve. Figure 2 corresponds to an ileoscopy. Biopsy demonstrated colonic mucosal infiltration with proliferating monotonous small and medium-sized atypical lymphoid cells with irregular and cleaved nuclei, consistent with mantle lymphoma (Fig. 3). Immunohistochemistry was positive for CD20, CD43, bcl-2, CD79a, and CD5 stains. There was moderate expression of cyclin d1, but bcl-6, CD 10, kappa or lambda chains were not expressed. The patient received systemic R-CHOP chemotherapy. Abdominal mass, multiple lymphadenopathies, and polyposis