Primary Colon Lymphoma in Korea: A KASID (Korean Association for the Study of Intestinal Diseases) Study

Abstract

Although almost all primary colorectal lymphomas are of B-cell lineage in Western countries, primary colorectal T-cell lymphomas are not uncommon in the East. The aim of this study was to review the clinical characteristics and treatment outcomes of primary colorectal lymphomas, with special emphasis on the differences between T-cell and B-cell lymphomas. Ninety-five cases of primary colorectal lymphomas that satisfied Dawson's criteria were identified from the clinical databases of 13 university hospitals in Korea. The mean age at the time of presentation was 51.1 years and the male:female ratio was 64:31. The clinical information, including endoscopic and histological characteristics, was retrospectively analyzed. Of the primary colorectal lymphomas, 78 cases (82.1%) were of B-lineage and 17 cases (17.9%) were of T-cell lineage. Patients with T-cell lymphomas presented at a younger age than patients with B-cell lymphomas (42.8 vs 52.9 years, respectively; P = 0.016). The most common presenting symptom was abdominal pain (87.1%) for B-cell lymphomas, whereas hematochezia or night fever was more common for T-cell lymphomas (52.9% and 35.3%, respectively). The most common endoscopic type was fungating mass (54.0%) for B-cell lymphomas and ulcerative/ulcero-infiltrative lesions (80.0%) for T-cell lymphomas. Intussusception was more common in B-cell lymphomas than in T-cell lymphomas (30.8% vs 5.9%, respectively; P = 0.035), but perforation was more common in T-cell lymphomas than in B-cell lymphomas (23.5% vs 3.8%, respectively; P = 0.005). The prognosis was significantly worse for T-cell lymphomas than for B-cell lymphomas (P = 0.002). Primary colorectal T-cell lymphomas are characterized by multifocal ulcerative lesions in relatively young patients, a high rate of hematochezia, fever, or perforation, and a poor prognosis even for cases of localized disease.

Primary colorectal lymphoma: An overview

“…In the study conducted in 4 continents with 1378 patients, Anderson et al [17] have shown that the distribution of NHL subtypes differs in various geographical areas and suggested that this could be a reflection of differences in etiological factors or the host response to these factors. Unlike western countries, frequency of T cell lymphoma in the East is reported to be 17.9%-42% [18,19] . Primary colorectal lymphoma differs from its gastric counterpart.…”

Primary non-Hodgkin lymphomas in the small and large intestine: clinicopathological characteristics and management of 40 patients

“…Histopathologically, 80*90% of primary GI lymphomas are of B cell origin. Diffuse large B cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma topped the rank of the subtypes of NHL that occurred in the GI tract [1,5,[10][11][12][13][14]. In terms of T-cell lymphoma, there is a discrepancy in the different site of GI tract.…”

Primer Kolorektal Lenfoma Deneyimlerimiz

“…Lokalize hastalığı olanlara küratif maksatlı cerrahi önerilebilir, palyatif cerrahi prosedürler obstrüksiyon ve diğer semptomları düzeltmede kullanılabilir. Bununla beraber perforasyon, kanama ve fistülü olan hastalarda da cerrahi tedavi yöntemi önem arz etmektedir (9,14). Biz çalışmamızda operable ve genel durumu iyi hastalara başlangıç tedavi olarak cerrahi uyguladık.…”

“…Yapılan çok merkezli bir çalışmada sadece kemoterapi verilen hastaların sonuçları kemoterapi ile beraber ya da kemoterapisiz yapılan cerrahiye göre daha kötü olduğunu göstermiştir (14). Bununla birlikte bu sonuç kemoterapi alan hastaların çoğunluğunun, daha kötü prognostik olan T hücreli tipe sahip olması nedeni ile açıklanabilmektedir (14,15). Çekum yerleşimli lenfoması olan bir hastaya sağ hemikolektomi uyguladık, fakat bu hasta anastomoz kaçağı sonrası sepsis nedeni ile ölmüştür.…”