Background: Extra-gastric (particularly colonic) lymphoma of mucosa-associated lymphoid tissue in the\nimmunosuppressed solid organ transplant recipient is rare. We report a case of low-volume mucosa-associated\nlymphoid tissue lymphoma with colonic and bone marrow involvement in a renal transplant recipient that has\nbeen managed conservatively.\nCase presentation: A 62-year-old Caucasian man, 14 years after kidney transplantation, was diagnosed as having\nextra-nodal marginal zone lymphoma of mucosa-associated lymphoid tissue with bone marrow and colonic\ninvolvement, after a colonoscopy identified mucosa-associated lymphoid tissue lymphoma in a sessile sigmoid\npolyp following surveillance fecal occult blood testing that returned a positive result. A gastric biopsy showed no\nevidence of Helicobacter pylori, but Helicobacter pylori immunoglobulin G was positive. He received Helicobacter\npylori eradication treatment and is being managed expectantly. Immunosuppression was unchanged with prednisolone,\nmycophenolate mofetil, and cyclosporine A. Renal allograft function has remained stable.\nConclusions: This case highlights the unexpected occurrence of colonic mucosa-associated lymphoid tissue lymphoma\nin a kidney transplant recipient. The case emphasizes the importance of histopathological diagnosis of colonic lesions in\nthis patient cohort because the unusual diagnosis of low-volume mucosa-associated lymphoid tissue lymphoma can be\nmanaged expectantly as it does not appear to be clinically aggressive in the immunosuppressed solid organ transplant.
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