Table of Contents
Definition / general | Clinical features | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stainsCite this page: Gulwani H. Immunoproliferative small intestinal disease (ISID). PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/smallbowelmediterranean.html. Accessed December 3rd, 2024.
Definition / general
- Also called Meditteranean lymphoma, Middle Eastern lymphoma
- More common among non-European Jews, Middle Eastern Arabs, South African blacks
- B cell lymphoma that arises in background of chronic diffuse mucosal plasmacytosis, with IgA heavy chain synthesis (no variable chain synthesized)
Clinical features
- Many have preexisting malabsorption
- May initially respond to antibiotics
- Often due to Campylobacter jejuni, another human pathogen responsible for immunoproliferative states (N Engl J Med 2004;350:239)
Case reports
- 53 year old woman with immunoproliferative small intestinal disease (Turk J Gastroenterol 2012;23:91)
Gross description
- Low grade: nonflattened mucosa
- High grade: diffusely thickened folds with small nodules in distal duodenum / proximal jejunum
Microscopic (histologic) description
Low grade:
High grade:
- Heavy lymphoplasmacytic infiltrate by mature cells
High grade:
- Resembles diffuse large cell lymphoma with plasmacytoid features
- May have starry sky pattern, follicular hyperplasia