N A RECENT study of 38 apparently primary I malignant tumors of lymphoid tissue occurring in the gastrointestinal tract, examined in the pathology laboratories of St. Mark's, Westminster, and Gordon hospitals, London, England,lo there were 5 cases of multiple lymphomatous polyposis. T h e polyps, composed of varying types of lymphoid tissue, were sessile or pedunculated and involved considerable segments of the gastrointestinal tract. In attempting to assess the importance of this condition, we found very few cases reported in the literature and no review of the subject since the study by Symmers in 1909.24 T h e first case, reported by Briquet in 1835,3
was that in a man, aged 41 years, who had been ill for 6 months with pain and swelling in the right testis and groin, constipation, and abdominal pain. Four months later, he experienced tonsillar enlargement and weakness, and later still, diarrhea and a generalized skin eruption. On examination, he had a generalized lymphadenopathy, palpable abdominal masses, stomatitis, and enteritis. H e died 12 days after admission to hospital, and at autopsy there were multiple, tiny, polypoid lesions throughout the entire gastrointestinal tract, a generalized lymphadenopathy, and involvement of the liver and spleen by a malignant lymphoma. T h e polypoid lesions in the gastrointestional tract were composed of hyperplastic lymphoid tissue confined to the mucosa and submucosa. A diagnosis of a malignant lymphoma involving lymph nodes, liver, spleen, and tonsils was made, but the significance of the lymphoid polyps in the bowel was missed. Pitt in 1889,16 reporting a case Seen at Westminster Hospital, London, England, reviewed the cases reported by Briquet,3 Carrington,4 and Hadden,l2 and recognized them all as sarcomas of lymphoid tissue. Wells and Maver in 1904,27 reporting a case seen at the University of Chicago, Chicago, Ill., reviewed 7 similar cases recorded in the literature and grouped them all under the title "Pseudoleukzmia Gastrointestinalis." Symmers in 1909,24 used the same title to describe a case seen at the New York Hospital, New York, N.Y. Schmieden and Westhues20 in a survey of colonic polyposis, described polyps containing hyperplastic lymphoid tissue that could not be grossly distinguished from common polyposis, and called this condition "pseudo-polyposis lymphatica." Russell in 1953,IS describing a case seen at the Christie Hospital, Manchester, England, grouped them all under the title "gastro-intestinal lymphomatosis." Since lymphoma implies a tumor of lymphoid tissue, and since these cases present as multiple, sessile, or pedunculated polyps of the gastrointestinal tract, we prefer to call them all "multiple lymphomatous polvposis of the gastrointestinal tract.