Clin Endosc > Volume 53(4); 2020 > Article
CME for
KSGE members
Lee, Chung, and Kwon: Rare Cause of a Colonic Laterally Spreading Tumor


A laterally spreading tumor was found during a screening colonoscopy in a 71-year-old woman. The lesion was flat and irregular shaped, 20 mm × 30 mm in size, and located 10 cm above the anal verge. There was no ulcer or erosion on the lesion. For histologic diagnosis and therapeutic purpose, a piecemeal endoscopic mucosal resection was performed. The endoscopic and histologic images are shown in Fig. 1.

What is the most likely diagnosis?



Conflicts of Interest: The authors have no financial conflicts of interest.

Fig. 1.
Colonoscopy and microscopy findings. (A-C) Colonoscopy revealed a flat, irregularly marginated, and superficially elevated lesion at the mid-rectum for which a piecemeal endoscopic mucosal resection was performed; (D) Microscopy revealed dense lymphoid infiltration involving the mucosa and submucosa (hematoxylin and eosin, ×40).
Fig. 2.
Immunohistochemistry results. (A) Positive for CD20; (B) Positive for Bcl-2; (C) Negative for cyclin D1; (D) Negative for Bcl-6.


1. Khalil MO, Morton LM, Devesa SS, et al. Incidence of marginal zone lymphoma in the United States, 2001-2009 with a focus on primary anatomic site. Br J Haematol 2014;165:67–77.
crossref pmid pmc
2. Lecuit M, Abachin E, Martin A, et al. Immunoproliferative small intestinal disease associated with Campylobacter jejuni. N Engl J Med 2004;350:239–248.
crossref pmid
3. Rhee JC, Lee HY, Rhee PL, et al. [Esophagus, stomach & intestine; endoscopic findings of gastric mucosa: associated lymphoid tissue (MALT) lymphoma]. Korean J Gastrointest Endosc 1997;17:125–132.

4. Cavalli F, Isaacson PG, Gascoyne RD, Zucca E. MALT lymphomas. Hematology Am Soc Hematol Educ Program 2001;241–258.
crossref pmid pdf
5. Chung CH, Kim HG, Park WS, et al. [A case of mucosa-associated lymphoid tissue lymphoma of colon as multiple large polypoid lesions]. Korean J Gastrointest Endosc 2001;23:122–126.

6. Lee YG, Lee S, Han SW, Lee JS. A case of multiple mucosa-associated lymphoid tissue (MALT) lymphoma of the colon identified as simple mucosal discoloration. J Korean Med Sci 2005;20:325–328.
crossref pmid pmc
PDF Links  PDF Links
PubReader  PubReader
ePub Link  ePub Link
XML Download  XML Download
Full text via DOI  Full text via DOI
Download Citation  Download Citation
Related articles
A Rare Cause of Gastric Subepithelial Tumor  2020 May;53(3)
Endoscopic Submucosal Dissection of a Colonic Calcifying Fibrous Tumor  2020 July;53(4)
Many Options to Manage Laterally Spreading Tumors  2015 January;48(1)
A Case of B-Lymphoblastic Leukemia/Lymphoma Detected as a Laterally Spreading Tumor  2011 July;43(1)
A Case of Rectal Adenocarcinoid Tumor  2007 December;35(6)
Editorial Office
Korean Society of Gastrointestinal Endoscopy
#817, 156 Yanghwa-ro (LG Palace, Donggyo-dong), Mapo-gu, Seoul, 04050, Korea
TEL: +82-2-335-1552   FAX: +82-2-335-2690    E-mail:
Copyright © Korean Society of Gastrointestinal Endoscopy.                 Developed in M2PI
Close layer