Follicular Lymphoma Manifesting as an Isolated Colorectal Polyp‐Like Morphology

TL;DR

A rare case of follicular lymphoma in the colon was mistaken for a polyp, showing the difficulty in diagnosing such conditions.

Contribution

This case report presents an uncommon presentation of primary gastrointestinal follicular lymphoma as an isolated colorectal polyp.

Findings

A 60-year-old woman had a polyp-like lesion in the transverse colon diagnosed as Grade 1 follicular lymphoma.

The patient also had FL involvement in the proximal jejunum, leading to a stage I diagnosis of primary GI-FL.

The case emphasizes the diagnostic challenge of distinguishing FL from adenomatous polyps.

Abstract

Primary gastrointestinal (GI) follicular lymphoma (FL) is a rare entity, and colorectal FL presenting as a solitary polyp is particularly uncommon.

A 60‐year‐old woman presented with hematochezia. Colonoscopy incidentally identified an 8‐mm polyp in the transverse colon, which was subsequently removed via cold snare polypectomy. Histopathological examination confirmed Grade 1 FL, with immunohistochemical analysis revealing positivity for CD10, CD20, and Bcl‐2. Further diagnostic evaluation demonstrated FL involvement in the proximal jejunum, leading to a diagnosis of clinical stage I primary GI‐FL. The patient elected to undergo a watch‐and‐wait approach.

This case highlights the potential for colorectal‐FL lesions to be misidentified as adenomatous polyps, posing a diagnostic challenge.

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