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Lymphomatoid Polyposis

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A frequent presentation of intestinal mantle cell lymphoma (MCL) is in the form of multiple small polyps in the small and large bowel (as shown in this image) - a condition referred to as lymphomatoid polyposis. Although MCL is the usual cause of lymphomatoid polyposis, it must be remembered that similar appearances (multiple small polyps) can also be caused by follicular lymphomas and marginal zone lymphomas of the MALT type.

This low power scan shows a few lymphoid polyps in a case of mantle cell lymphoma involving the small bowel. The local villous architecture is focally distorted by the monomorphic lymphoid aggregates. In some cases, the tumor cells infiltrate the overlying epithelium creating lymphoepithelial lesions which may make the distinction from marginal zone lymphomas (MALTOMAS) challenging.

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