case_images: PMC2815843_01
case_images: A 65-year-old man with esophageal MALT lymphoma and concurrent BALT lymphoma of the lung. (A) A barium swallow study revealed a well-demarcated submucosal mass (arrowheads) of 10x3x3 cm in size in the upper thoracic esophagus without surface ulceration or a stalk. (B) A chest CT scan showed a sharply demarcated homogeneous mass within the esophagus. Note the eccentric location, crescent-shape esophageal lumen (compressed by the mass), and the laterally displaced trachea. (C) A chest CT scan of the lower lung showed an ill-defined 4x3 cm size mass in the lateral basal segment of the lower lobe of the left lung. A small focal subpleural consolidation was also seen in the right lower lung; however, this consolidation was not seen in the follow-up CT scan taken before chemotherapy. (D) Upon histologic examination, dense atypical lymphocytic infiltrations were noted in the submucosa of esophagus. The tumor cells showed dark nuclei with abundant clear cytoplasm and occasional Dutcher bodies (H & E stain, x200). (E) Upon immunohistochemical stain, the esophageal tumor cells showed extensive strong immunoreactivity for the B-cell marker and L26, and monoclonal reactivity for kappa light chain immunoglobulin along the cytoplasmic membranes (x200).
case_images: ymj-46-562-g001.jpg
case_images: PMC2815843_01_ymj-46-562-g001.jpg
case_images: F1
case_images: Double-contrast esophagography (Fig. 1A) showed a well demarcated submucosal mass of 10x3x3 cm in size in the upper thoracic esophagus with intact mucosa. Upon chest CT scan, a well-circumscribed homogeneous intramural mass was seen in the upper thoracic esophagus (Fig. 1B). Additionally, an ill-defined mass, about 4x3 cm in size, with internal air bronchograms, was also seen in the lateral basal segment of the lower lobe of the left lung (Fig. 1C). Partial differentiation of plasma cells was observed with occasional Dutcher bodies (Fig. 1D). T-cell markers CD3 and UCHL-1, and appeared monoclonal for kappa light chain immunoglobulin (Fig. 1E).