Primary appendiceal MALT lymphoma clinically masquerading as chronic appendicitis: A case report

INTRODUCTION AND IMPORTANCE: Mucosal associated lymphoid tissue (MALT) lymphomas are a type of extranodal indolent lymphoma. They appear in areas ordinarily devoid of lymphoid tissues and are frequently preceded by chronic antigenic stimulation. Primary MALT lymphoma is an extremely rare variant in the appendix. CASE PRESENTATION: A 22-year-old man presented with recurrent abdominal pain of three months. CT scan of the abdomen showed appendiceal wall thickening with ileo-colic lymphadenopathy. The patient was managed with right hemicolectomy and the histopathological examination showed MALT lymphoma. CLINICAL DISCUSSION: MALT lymphomas of the appendix are extremely rare. Chronic appendicitis is an uncommon but possible clinical presentation. Although imaging techniques are essential for making a diagnosis, histological analysis is what leads to a final diagnosis. While there are no specific recommendations for treating appendiceal MALTomas, prior case reports indicate that appendectomy and surveillance may be sufficient. CONCLUSION: Primary MALT lymphoma is extremely uncommon in the appendix. It is indolent in nature and can manifest clinically as chronic appendicitis. The management for localized disease is surgery or radiotherapy. The prognosis is excellent regardless of the initial treatment modality.