**8. References**

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**19** 

*Italy* 

**Appendiceal MALT Lymphoma in** 

*1Pediatric Surgery, 2nd University of Naples, Naples 2General Surgery, 2nd University of Naples, Naples* 

**Childhood – Presentation and Evolution** 

Antonio Marte1,\*, Gianpaolo Marte2, Lucia Pintozzi1 and Pio Parmeggiani1

Lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) was first described by Isaacson et al. in 1983 (Isaacson & Wright, 1984). According to the WHO lymphoma classification, the indolent B cell lymphoma of MALT type is classified as a marginal zone lymphoma, thus called because it originates from the B lymphocytes normally present in a distinct anatomical location (marginal zone) of the secondary lymphoid follicles (Harris et al., 2001). MALT lymphomas comprise up to 40% of adult non-Hodgkin lymphomas (NHL); the median age at occurrence is 60 years, with a female predominance (Anonymous, 1997). In paediatric age MALT lymphomas are very rare. We report on a case of MALT lymphoma involving the appendix in a 6-year-old immunocompetent girl and its evolution toward an

P.A., a 6-year-old girl, was referred to our institution in May 2005 with a diagnosis of appendicitis. The girl had been complaining of right lower abdominal pain for 6 months. More recently, the pain was exacerbated by walking and coughing. Abdominal ultrasound showed a slight effusion of the pelvic fossa. Her postnatal history showed some period of constipation spaced by regular daily evacuations. Blood examinations showed neutrophil leucocytosis. The patient underwent laparoscopic appendectomy using the three-trocar technique, three endo-loops and the Liga-Sure for the hemostasis. During the laparoscopic exploration no hyperplastic mesenteric lymphnode was found. The appendix appeared moderately hyperemic with a slight enlargement of two-thirds of its distal portion (Fig. 1). The postoperative course was uneventful and the girl was discharged on day 1, without any complications. The appendix underwent a routine histological examination. The morphological appearance showed thickened lamina propria and submucosa, which were occupied by pseudonodules of immunocompetent cells (Fig. 2), characterized by lymphocytes with small nuclei with a narrow cytoplasmic rim and plasma cell (Fig. 3). Immunohistochemical studies revealed positivity for CD20 (CD20, pan B cell), and

inflammatory bowel disease (IBD) at a middle-term follow-up.

**1. Introduction** 

**2. Case report** 

 \*

Corresponding Author

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