Primary T-cell Lymphoma of the Colon

Son, Hee Jung; Rhee, Poong‐Lyul; Kim, Jae Jun; Koh, Kwang Choel; Paik, Seong Woon; Rhee, Jong Chul; Koh, Young Hae

doi:10.3904/kjim.1997.12.2.238

Cited by 20 publications

(13 citation statements)

References 8 publications

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“…Previous studies in the West have shown that almost all cases of primary colorectal lymphoma are derived from B cells (6,7). However, primary colorectal lymphomas of T-cell origin have been reported in Eastern countries (8)(9)(10)(11)(12). According to a recent study from Taiwan (11), the proportion of T-cell lymphomas was as high as 42% in the East.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2005

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2005

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“…The gastrointestinal tract is the commonest site of extranodal lymphoma,29 with colorectal lymphomas comprising between 10% and 20% of primary gut lymphomas in larger published series 3031 Several reports of primary intestinal lymphoma masquerading as IBD have been described,32 33 including a patient with ileocolonic T cell lymphoma, originally thought to be Crohn's disease at colonoscopy, whose symptoms initially improved on corticosteroids before the correct diagnosis was made nine months later 34…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of non-Hodgkin's lymphoma in inflammatory bowel disease patients on immunosuppressive therapy but overall risk is low

Farrell

Ang

Kileen

et al. 2000

Gut

244

142

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Background-There is concern that the incidence of non-Hodgkin's lymphoma (NHL) will rise with increasing use of immunosuppressive therapy. Aims-Our aim was to determine the risk of NHL in a large cohort of patients with inflammatory bowel disease (IBD), and to study the association between IBD, NHL, and immunosuppressive therapy. Methods-We studied 782 IBD patients (238 of whom received immunosuppressive therapy) who attended our medical centre between 1990 and 1999 (median follow up 8.0 years). Standardised incidence ratios (SIRs) and 95% confidence intervals (CI) were calculated. Expected cases were derived from 1995 age and sex specific incidence rates recorded by the National Cancer Registry of Ireland. Results-There were four cases of NHL in our IBD cohort (SIR 31.2; 95% CI 2.0-85; p=0.0001), all of whom had received immunosuppressive therapy: azathioprine (n=2), methotrexate (n=1), and methotrexate and cyclosporin (n=1). Our immunosuppressive group had a significantly (59 times) higher risk of NHL compared with that expected in the general population (p=0.0001). Three cases were intestinal NHL and one was mesenteric. Mean age at NHL diagnosis was 49 years, mean duration of IBD at the time of NHL diagnosis was 3.1 years, and mean duration between initiation of immunosuppressive therapy and diagnosis of NHL was 20 months. Conclusions-Although underlying IBD may be a causal factor in the development of intestinal NHL, our experience suggests that immunosuppressive drugs can significantly increase the risk of NHL in IBD. This must be weighed against the improved quality of life and clinical benefit immunosuppressive therapy provides for IBD patients.

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“…A case of intestinal T-cell lymphoma involving the rectum was previously reported in Korea6). However, although the T-cell markers were expressed, the exact subtype was not defined and whether the patient was non-AIDS or not was not clearly mentioned in that case.…”

Section: Discussionmentioning

confidence: 99%

Anorectal and gastric peripheral T-cell lymphoma, unspecified in a non-AIDS patient

Eum

Kim

et al. 2006

Korean J Intern Med

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Anorectum is a rare location for malignant lymphoma. Involvement of is rare even for the lymphoma associated with acquired immune deficiency syndrome (AIDS), and AIDS has a relatively increased frequency of anorectal lymphoma. Most lymphomas in AIDS patients are of a B-cell origin, and T-cell lymphoma of the gastrointestinal tract is extremely rare. We report here on a case of anorectal and gastric peripheral T-cell lymphoma, unspecified (PTCLu) in a non-AIDS patient. A previously healthy 29-year-old man presented with hematochezia and tenesmus that he had suffered with for the previous 2 months. Sigmoidoscopy showed anal and rectal submucosal tumor. Multiple round-shaped, flat and elevated lesions were noted on the gastric antrum and body as well. He underwent excisional biopsy for the anal mass and the diagnosis was PTCLu. Biopsies of the gastric lesions gave the same diagnosis. There was no lymphoma involved in the bone marrow. At admission, no antibodies against human immunodeficiency virus were detected. He underwent systemic chemotherapy and upfront autologous stem cell transplantation.

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Primary T-cell Lymphoma of the Colon

Cited by 20 publications

References 8 publications

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

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

Increased incidence of non-Hodgkin's lymphoma in inflammatory bowel disease patients on immunosuppressive therapy but overall risk is low

Anorectal and gastric peripheral T-cell lymphoma, unspecified in a non-AIDS patient

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