Nodular Lymphoid Hyperplasia: An Asymptomatic Case Report

Alvarez-Garcia M, Otegui L and Bosch O

Published on: 2025-07-17

Abstract

Nodular lymphoid hyperplasia (NLH) is a condition with unknown etiology characterized by the presence of numerous mucosal nodules between 2 and 10 millimeters in diameter distributed mainly in the small intestine [1]. Some patients have an associated disease, namely, common variable immunodeficiency, IgA deficiency, or giardiasis [2]. NLH generally presents as an asymptomatic disease; diagnosis is made at endoscopy or contrast barium studies and should be confirmed by histology. Treatment is directed at associated conditions, with malignancy being the greatest concern, as NLH has been linked to lymphoma and may be a premalignant disorder [3].

Keywords

Nodular lymphoid hyperplasia; Small intestine; lymphoma

Introduction

We report a 44-year-old female patient with a history of Hodgkin’s lymphoma and lung adenocarcinoma, both with complete remission. In a Positron Emission Tomography-computed control, the result showed pathological uptake in the ileum segment. Colonoscopy reveals nodules ranging in size from 10 to 20 millimeters. Histological results revealed Epstein-Barr virus-positive lymphoid follicular hyperplasia, ruling out malignancy. In the absence of clinical symptoms, conservative management was decided upon.

Figure 1: Endoscopic Feature of the Mucosa of the Distal Ileum with Multiple Nodular, Polypoid Lesions, 10-20 mm in Diameter.

Figure 2: Histological Image Compatible with Large-Sized Cells of Blastic Morphology in Interfollicular Areas, Positive for CD30 and EBV (EBER), Diagnosis of Epstein-Barr Virus-Associated Lymphoid Hyperplasia.

References

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