Primary malignant lymphoma of the colon and rectum. A histopathological and immunohistochemical analysis of 45 cases with clinicopathological correlations

Abstract

Primary colorectal lymphoma accounts for only about 0.2% of large intestinal malignancies. Management difficulties are compounded by a lack of consistent pathological reporting and by the use of numerous different classifications. Forty-five cases of primary colorectal lymphoma are included in this study. The presenting features are indistinguishable from those of colorectal cancer. Seven patients had a history of chronic ulcerative colitis but no other predisposing factors were identified. Immunohistochemical studies showed that all tumours were of B-cell phenotype. Most tumours were difficult to characterize using standard pathological classifications such as Kiel, except for the 11 cases of malignant (multiple) lymphomatous polyposis, which were morphologically diffuse centrocytic lymphomas. Twenty-nine lymphomas showed the morphological and immunohistochemical features associated with tumours arising in mucosa-associated lymphoid tissue. These tumours showed variable but often marked polymorphism and we have used the term polymorphic B-cell lymphoma to describe them. Consistency was achieved between three observers as to whether these tumours were low or high grade, and grade was found to be prognostically important. A modified Dukes staging system was adopted and there was a trend for early stage to give prognostic advantage. This study supports the view that surgery should be the primary treatment for localized lymphoma of the gastrointestinal tract with radiotherapy and/or chemotherapy for advanced cases and for malignant lymphomatous polyposis.

Lymphoproliferative Disorders of the Gastrointestinal Tract: A Review and Pragmatic Guide to Diagnosis

“…43,44 This is an unusual, but distinct, gastrointestinal lymphoma characterized by the polypoid accumulation of lymphoma involving long segments of the small and large intestine. 3 Lymphomatous polyposis has a reported frequency of 4% to 9% among all gastrointestinal B-cell non-Hodgkin lymphomas. 45 Patients generally are middle-aged males who present with weight loss, fatigue, diarrhea, abdominal pain, and often iron deficiency.…”

“…1 Large intestinal and rectal lymphomas are far less common but are discovered in patients with AIDS and sporadically in patients with ulcerative colitis and Crohn disease. [2][3][4] In a study of 371 patients with primary gastrointestinal lymphomas registered in a German multicenter study, stomach accounted for 277 of cases (74.8%), whereas small intestine and ileocecal region represented 61 cases (16.4%). 5 Only 9 cases (2.4%) in that series were restricted to the colorectal area, with the remaining cases involving multiple gastrointestinal sites.…”

Linfoma primario del intestino delgado: reporte de un caso y revisión de la literatura

“…Existen múltiples propuestas clasificatorias a lo largo de la historia (12,13); no obstante, la Organización Mundial de tino delgado; en África, el LNH de Burkitt intestinal es cincuenta veces más frecuente que en Estados Unidos (2). En el intestino delgado, los LNH de células B predominan en el íleon y el de células T es más frecuente en el yeyuno asociado con la enfermedad celíaca.…”

Primer Kolorektal Lenfoma Deneyimlerimiz

“…Genellikle yaşamın 4. ve 7. dekadları arasında görülmektedir ve ortalama tanı yaşı 55'dir (7,8). Bizim hastalarımız batı ülkelerinde yapılan çalışmalardaki hastalara göre 66 median yaş ortalaması ile daha yaşlı idi.…”