Colorectal Lymphoma: A Review

Abstract

Non-Hodgkin lymphoma (NHL) that primarily involves the colon is rare and should be distinguished from the more common systemic nodal lymphoma. It has unique clinical expectations and management consideration. Different histologic subtypes of NHL involve the colon, which varies in the clinical behavior and likelihood of obtaining durable remissions with treatment. This article will review the current understanding of the different histologic subtypes of primary colorectal lymphoma and propose management algorithms.

Successful Endoscopic Resection of Mucosa-Associated Lymphoid Tissue Lymphoma of the Colon

“…Most of the reported patients with colorectal MALT lymphoma have been managed with surgery, chemotherapy, or combination therapy. 1,3,5,8,14 Raised or polypoid lesions may rarely be endoscopically resected, as is the case with the current reported patient. 1,3,6,9 There are a few case reports of isolated rectal MALTomas managed with endoscopic mucosal dissection with no evidence of residual lymphoma after endoscopic mucosal dissection was performed.…”

“…Although H. pylori has been identified in some patients with colorectal MALT lymphomas, it appears to occur only in a minority of cases. 5,13 In addition, there are case reports of successful treatment of colonic MALTomas with empiric antimicrobial quinolone therapy, but there has been no proven infectious link with any particular microbe. 7 Furthermore, eradication of H. pylori has not been shown to be reliably effective in the treatment of colorectal MALT lymphomas, and there has never been a proven link between the eradication of a particular microbe and the regression of disease.…”

MALT lymphoma of the colon: a clinicopathological review

“…French and American groups have recently addressed management approaches for colorectal non-Hodgkin lymphomas and give some specific attention to MALT lymphoma 37 38. The French intergroup concluded that there is no consensus, but excision, rituximab, alkylating agent are used, and watchful waiting can be justified.…”

“…They disparage radiotherapy due to mobility of the gut and associated risk of toxicity 37. The American study gives no specific recommendations, noting a paucity of data 38. However, it notes that higher stage lesions can be treated with systemic therapy 38.…”

“…The American study gives no specific recommendations, noting a paucity of data 38. However, it notes that higher stage lesions can be treated with systemic therapy 38. Some groups suggested treatment algorithms for colorectal non-Hodgkin lymphomas based on the stage (Paris staging system) and the histological type of the lymphoma 38…”