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Mucosa-Associated Lymphoid Tissue Lymphoma of the Rectum Incidentally Found in a Patient with Ulcerative Colitis [Meeting Abstract]

Mohan, N; Ashamalla, M; Malieckal, A
Introduction: Mucosa-associated lymphoid tissue (MALT) lymphomas are extra-nodal marginal zone B-cell lymphomas, most commonly found in the stomach, associated with Helicobacter pylori infections, and generally not linked with inflammatory bowel disease. Rectal MALT lymphoma is very uncommon and often associated with painful defecation, change in bowel habits, or rectal pressure/prolapse. Here, we present a rare case of an asymptomatic female with ulcerative colitis (UC) found to have benign-appearing rectal polyps during a routine screening colonoscopy. Case Description/Methods: The patient is a 56-year-old female with a history of left-sided UC, diagnosed in 1993, with one flare after receiving the 2nd dose of the Moderna COVID-19 vaccine, taking oral Olsalazine 500 mg twice daily, low-dose Prednisone, and mesalamine suppositories as needed presenting for screening colonoscopy. The patient was asymptomatic, citing regular non-bloody bowel movements and normal stool consistency. Colonoscopy revealed two 7 mm sessile, non-bleeding rectal polyps, surrounded by congested, erythematous, friable, and ulcerated mucosa in the rectosigmoid colon. Cold forceps biopsies were taken. Hematopathology evaluation of the routine colon biopsy samples revealed chronic nonspecific colitis while pathology of the rectal polyps showed marked lymphoplasmacytic infiltrate and extra-nodal marginal zone lymphoma of MALT. Ancillary studies, immunohistochemistry, and molecular studies for B-cell gene rearrangement confirmed extra-nodal marginal zone lymphoma of MALT with prominent plasmacytic differentiation. The patient was informed and close follow-up in Gastroenterology clinic was arranged. (Figure) Discussion: Rectal MALT lymphoma is rare with unclear management options. Treatments of UC include watchful waiting, surgical resection, endoscopic mucosal resection, radiation, and/or chemotherapy. Helicobacter pylori infections, though strongly linked with gastric MALT lymphoma, have not been shown to be strongly correlated with rectal MALT lymphoma. Given that patients with UC have chronic UCassociated colonic inflammation, lymphoma is often difficult to distinguish visually during colonoscopy, frequently masked by ulcerations and pseudo-polyps. In cases like these, more definitive treatments such as surgical resection could therefore be warranted. Long-term follow-up data is sparse and definitive management remains a clinical conundrum, thus these patients require reliable long-term multidisciplinary close follow-up. (Figure Presented)
ISSN: 1572-0241
CID: 5515272

A Case of Isolated Gastrointestinal Histoplasmosis

Bhinder, Jasmine; Mori, Amit; Cao, Wenqing; Malieckal, Anju
Histoplasmosis is a self-limited and asymptomatic disease in immunocompetent individuals. Patients with untreated human immunodeficiency virus (HIV) or immune suppression due to medications such as corticosteroids can present with disseminated and life-threatening infections. We present a case of a 60-year-old female that presented with recurrent diarrhea that was found to have isolated gastrointestinal (GI) histoplasmosis. The rarity of this case is due to the isolated colonic involvement and lack of respiratory symptoms (the portal of infection). In conclusion, clinicians should be aware of isolated histoplasmosis affecting the GI tract and careful endoscopic evaluation with adequate sampling is warranted to confirm the diagnosis.
PMID: 30210949
ISSN: 2168-8184
CID: 3277822

Strongyloides and Dieulafoy on Steroids [Meeting Abstract]

Koya, Rachana; Kanzali, Parisa; Parvin, Russell; Malieckal, Anju; Carey, Jeanne
ISSN: 1572-0241
CID: 2492822

Megaesophagus Causing Elevated Troponins [Meeting Abstract]

Koya, Rachana; Jabbour, Moussa; Abdelfattah, Mohamad; Changela, Kinesh; Malieckal, Anju
ISSN: 1572-0241
CID: 2492792

Herpes Esophagitis in an Immunocompetent Host [Meeting Abstract]

Koya, Rachana; Tejada, Juan; Malieckal, Anju
ISSN: 1572-0241
CID: 2492782

Starvation-Induced Hepatocyte Damage [Meeting Abstract]

Koya, Rachana; Dhaliwal, Amaninder; Changela, Kinesh; Tejada, Juan; Volfinzon, Leonid; Malieckal, Anju
ISSN: 1572-0241
CID: 2492682

Impact of Demographics and Socio-economic Status on Patient's Compliance to Perform Fecal Immunochemical Test (FIT): Experience from Urban-Minority Population [Meeting Abstract]

Dhaliwal, Amaninder; Provencher, LeighMae; Changela, Kinesh; Singh, AjayPal; Deland, Owen; Srialluri, Nityasree; Prokop, Ingmar; Peliska, Michael; Gendy, Mina; Malieckal, Anju; Shahin, George
ISSN: 1572-0241
CID: 2492392

Endoscopic and imaging appearance after injection of an ano-rectal bulking agent

Papafragkakis, Haris; Changela, Kinesh; Bhatia, Taruna; Ona, Mel A; Malieckal, Anju; Paleti, Vani; Fuksbrumer, Moshe S; Anand, Sury
The use of hyaluronic acid and dextranomer (Solesta, Salix) injection in the anal canal is an emerging modality in the treatment of fecal incontinence. However, little is known regarding the endoscopic and radiological appearance following injection of this ano-rectal bulking agent. We report computed tomography and endoscopic findings after hyaluronic acid/dextranomer injection in the ano-rectal area.
PMID: 25031792
ISSN: 1948-5190
CID: 1731952

Hepatitis B Awareness Survey in a Typical Inner-City Minority Population [Meeting Abstract]

Papafragkakis, Charilaos; Malieckal, Anju; Sunkara, Tagore; Lee, Daniel; Anand, Sury; Culliford, Andrea
ISSN: 0002-9270
CID: 4530762

Endoscopic Closure of Gastrocutaneous Fistulas Using Over-The-Scope Clip (OTSC (R)): A Case Series [Meeting Abstract]

Singhal, Shashideep; Malieckal, Anju; Changela, Kinesh; Sunkara, Tagore; Culliford, Andrea; Duddempudi, Sushil; Anand, Sury; Krishnaiah, Mahesh
ISSN: 0002-9270
CID: 4530802