Primary colorectal lymphoma: spectrum of imaging findings with pathologic correlation

Abstract

Primary colorectal lymphoma is a very uncommon disease; therefore, it has received little attention in the radiology literature. Moreover, imaging features of newly described pathologic subtypes have not been reported such as low-grade B-cell lymphoma arising from mucosa-associated lymphoid tissue and peripheral T-cell lymphoma that involves colorectal area. We retrospectively reviewed double-contrast barium enema and CT scans in the patients with primary colorectal lymphoma. In this article the radiologic appearances of primary colorectal lymphoma are categorized into focal lesion and diffuse lesion. Focal lesion includes polypoid mass, circumferential infiltration with smooth mucosal surface, circumferential infiltration with extensive ulceration, cavitary mass, mucosal nodularity, and mucosal fold thickening. Diffuse lesion includes diffuse ulcerative lesion and diffuse nodular lesion. Peripheral T-cell lymphomas that involve the colon manifested as either a diffuse or focal segmental lesion and showed extensive mucosal ulceration. These findings are similar to those of Crohn's disease or tuberculous colitis and are different from those of previously reported colorectal lymphoma. Low-grade B-cell lymphoma arising from mucosa-associated lymphoid tissue manifest as multiple mucosal nodularity. The imaging features of primary colorectal lymphoma are quite variable and overlap with other colonic pathology; however, it is important for radiologists to know the imaging features of primary colorectal lymphoma with their pathologic correlation.

Primary Gastrointestinal Lymphoma: Spectrum of Imaging Findings with Pathologic Correlation

“…Double-contrast barium enema examination and CT may demonstrate the following findings in lymphoma: polypoid masses, most frequently near the ileocecal valve; circumferential infiltration (with or without ulceration); a cavitary mass excavating into the mesentery; endoexoenteric tumors; mucosal nodularity; and fold thickening (33,35). Intussusception may occur with cecal involvement (Figs 8, 16).…”

“…Primary lymphoma of the large bowel accounts for 0.4% of all tumors of the colon, and colorectal lymphomas constitute 6%-12% of gastrointestinal lymphomas (33). Primary lymphoma more often affects the cecum and rectum than other parts of the large bowel (7).…”

“…Primary lymphoma more often affects the cecum and rectum than other parts of the large bowel (7). According to recent classification, primary colorectal lymphoma comprises (besides conventional large cell lymphoma) low-grade B-cell lymphoma arising from MALT, mantle cell lymphoma, and T-cell lymphoma (33). Most colorectal lymphomas are nonHodgkin lymphomas, usually of B-cell origin.…”

Primary colorectal non-Hodgkin’s lymphoma in a retropositive patient

“…Focal lesions can be polypoid, circumferential with smooth mucosal surface, circumferential with extensive ulceration, a cavitary mass, a mucosal fold thickening and a focal mucosal nodularity. Diffuse lesions are described as ulcerated or nodular 4. Despite causing mucosal abnormalities, lymphomas very rarely present as intestinal obstruction.…”

Diseases of the cecum: a CT pictorial review

“…The other rare primary malignancies are carcinoid, leiomyosarcoma, lymphoma, and spindle cell tumors [35]. Polypoid masses are the most frequent form of primary colorectal lymphoma and are most frequently located in the cecum near the ileocecal valve but tend to present as a larger mass than carcinoma [36]. The majority of benign neoplasms are epithelial polyps; others include lipomas, angiomas, and mesenchymal lesions.…”