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Qureshi A, Patel A, Ajumobi AB. H pylori-Negative MALT-Associated Extranodal Marginal Zone Lymphoma: A Comprehensive Case Report and Literature Review. J Investig Med High Impact Case Rep 2024; 12:23247096241238531. [PMID: 38494775 PMCID: PMC10946082 DOI: 10.1177/23247096241238531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/19/2024] [Accepted: 02/25/2024] [Indexed: 03/19/2024] Open
Abstract
Extranodal marginal zone B-cell lymphoma (ENMZL) of mucosa-associated lymphoid tissue (MALT), a rare subtype of B-cell lymphoma, is typically associated with Helicobacter pylori (H pylori) infection, especially in gastric cases. However, this article presents 2 unique cases of H pylori-negative colonic ENMZL, challenging the conventional understanding of the disease. The first case involves an 80-year-old male diagnosed with Stage 1E ENMZL in the descending colon, and the second describes a 74-year-old male with sigmoid colon ENMZL. Both cases lacked H pylori infection, adding complexity to their management. Accompanying these case studies is a comprehensive literature review, delving into the epidemiology, pathology, clinical features, diagnosis, and treatment of H pylori-negative ENMZL, with a focus on gastrointestinal involvement. This review highlights the importance of considering H pylori-negative cases in ENMZL diagnosis and management, illustrating the need for further research and individualized treatment approaches in this uncommon lymphoma subtype.
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Affiliation(s)
| | | | - Adewale B. Ajumobi
- University of California, Riverside, USA
- Eisenhower Health, Rancho Mirage, CA, USA
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2
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Modemann F, Ahmadi P, von Kroge PH, Weidemann S, Bokemeyer C, Dierlamm J, Fiedler W, Ghandili S. The prognostic impact of lymphoma perforation in patients with primary gastrointestinal lymphoma - a single-center analysis. Leuk Lymphoma 2023; 64:1801-1810. [PMID: 37552203 DOI: 10.1080/10428194.2023.2240921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/20/2023] [Indexed: 08/09/2023]
Abstract
Patients with primary gastrointestinal (GI) lymphoma are at risk of GI perforations. Therefore, we aimed to investigate the prognostic impact of non-traumatic GI perforations. 54 patients with a histologically confirmed diagnosis of primary GI lymphoma were included. Non-traumatic lymphoma perforation occurred in ten patients (19%). Perforations occurred only in patients with aggressive B-cell lymphoma. In patients with aggressive B-cell lymphoma, the median overall survival (mOS) was 52 months (95% CI 9.88-94.12) and 27 months (95% CI 0.00-135.48) in patients with and without GI perforation, respectively. The median progression-free survival (mPFS) was 30 months (95% CI 5.6-54.4) in patients with GI perforations. In patients without lymphoma perforation, mPFS was not reached. Both mOS and mPFS did not significantly differ. In conclusion, despite the need for emergency surgery and delay in lymphoma-directed treatment, lymphoma perforation did not negatively impact our study population's OS or PFS.
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Affiliation(s)
- Franziska Modemann
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Mildred Scheel Cancer Career Center, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Paymon Ahmadi
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Philipp H von Kroge
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sören Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Judith Dierlamm
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Walter Fiedler
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Ghandili
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Vu KV, Trong NV, Khuyen NT, Huyen Nga D, Anh H, Tien Trung N, Trung Thong P, Minh Duc N. Synchronous rectal adenocarcinoma and intestinal mantle cell lymphoma: A case report. World J Clin Cases 2023; 11:5772-5779. [PMID: 37727717 PMCID: PMC10506007 DOI: 10.12998/wjcc.v11.i24.5772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/18/2023] [Accepted: 07/11/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Mantle cell lymphoma (MCL) of the gastrointestinal tract is a rare malignancy, accounting for about 0.2% of malignant colorectal tumors. MCL synchronous with rectal adenocarcinoma is extremely rare. We know of only a few cases reported in the literature. We describe the case of a patient with synchronous rectal adenocarcinoma and intestinal MCL. CASE SUMMARY A 63-year-old man was admitted to our hospital due to abdominal pain and hematochezia over the past month. The patient was diagnosed with middle rectal cancer cT2N0M0 and underwent surgery. However, we found a large tumor in the small intestine during surgery. The patient underwent total mesorectal excision for rectal cancer and resectioning of the ileal segment containing the large mass. Pathology and immunohistochemistry revealed the presence of both rectal adenocarcinoma and pathognomonic MCL stage IIE presenting as multiple lymphomatous polyposis. The patient subsequently underwent RDHAP/RCHOP chemotherapy and was maintained with rituximab. A Positron Emission Tomography and Computed Tomography (PET/CT) scan showed that the disease responded well to treatment without tumor-increased metabolism in the gastrointestinal tract. CONCLUSION Synchronous rectal adenocarcinoma and intestinal MCL presenting as multiple lymphomatous polyposis are extremely rare. MCL is often discovered fortuitously when rectal cancer is diagnosed. The coexistence of these tumors poses treatment challenges.
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Affiliation(s)
- Kim-Van Vu
- Department of General Surgery, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
- Department of Practical Surgery, Hanoi Medical University, Ha Noi 100000, Viet Nam
| | - Nguyen-Van Trong
- Department of Oncology, Hanoi Medical University, Ha Noi 100000, Viet Nam
| | - Nguyen-Thi Khuyen
- Pathology and Molecular Biology Center, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
| | - Do Huyen Nga
- Department of Hematologic Oncology, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
| | - Hoang Anh
- Department of General Surgery, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
- Department of Practical Surgery, Hanoi Medical University, Ha Noi 100000, Viet Nam
| | - Nguyen Tien Trung
- Department of General Surgery, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
| | - Pham Trung Thong
- Department of General Surgery, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Viet Nam
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Battah A, Abed H, Shamoon D, DaCosta T, Farouji I, Fedida A. A rare case of diffuse large B-cell lymphoma presenting as a malignant mass in both duodenum and ascending colon. Radiol Case Rep 2022; 17:3286-3290. [PMID: 35846504 PMCID: PMC9278029 DOI: 10.1016/j.radcr.2022.06.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/25/2022] Open
Abstract
Lymphoma in the gastrointestinal tract most commonly occurs in the stomach, small intestine and around the ileocecal region. Usually gastrointestinal lymphoma occurs secondary to widespread nodal disease and is rarely found to be the primary site. Of the different types of lymphoma, diffuse large B-cell non-Hodgkin's lymphoma makes up the majority of lymphomas in the gastrointestinal tract. Primary colorectal lymphoma is even less common and accounts for 3% of all gastrointestinal lymphomas and to our knowledge, gastrointestinal lymphoma involving 2 different regions in the GI tract has not been discussed in the literature. Herein, we are presenting a rare case of diffuse large B-cell lymphoma presenting as a malignant mass in both the duodenum and ascending colon.
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A rare case of primary non-metastatic Non-Hodgkin's diffuse large B-cell lymphoma in the ileum in a 19-year-old male manifested as intestinal obstruction- A case report. Int J Surg Case Rep 2022; 90:106748. [PMID: 34999469 PMCID: PMC8749221 DOI: 10.1016/j.ijscr.2021.106748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/08/2021] [Accepted: 12/31/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction and importance The gastrointestinal system is the most common site for extra-nodal NHL. Adolescent population are among the rarest of compromised groups, especially males. The gastrointestinal system is more involved by secondary metastasis rather than by primary lymphomas. Cardinal B-Symptoms and obstipation constituted the presentation of our patient who was diagnosed postoperatively as a case primary non-metastatic NHL. NHL can have misleading presentations which result in the implementation of different treatment modalities. We ought to have high clinical suspicion when presented with a patient suffering from B-Symptoms and obstipation to make timely judgements which help in performing effective therapeutic interventions to limit the morbidity and mortality which result from this pathology. Case presentation We present the case of a 19-year-old male, who presented with obstipation and B-Symptoms. CT scan indicated loop dilation, a lobulated mass, and what radiologically seemed to be intussusception. Surgery was done and the resected specimens were DLBCL. Clinical discussion We treated him by surgical excision of the affected ileal segments. Histopathology indicated a primary Non-Hodgkin's DLBCL of the ileum. Afterwards, we referred him for adjuvant chemotherapy. Treatment modalities for this malignancy are mainly surgical in addition to Chemotherapy. Conclusion Intestinal extranodal NHL presents with an array of vague symptoms. As a result, this type of tumors can be clinically indistinguishable from other gastrointestinal malignancies. It is vital to keep this type of malignancy in mind as a differential diagnosis when presented with a surgical abdomen in a patient with B-Symptoms. The gastrointestinal system is the most common occurrence site for extra-nodal Non-Hodgkin's Lymphoma. Cardinal B-Symptoms can mislead the diagnosis as the incidence rate in such a patient demographic is undocumented. The most frequently compromised site in the small intestine is the ileum followed by the jejunum, and the duodenum. Primary non-metastatic NH-DLBCL is so rare in adolescent males that it warrants documentation and follow-up. It's vital to consider this pathology when presented with obstipation and B-Symptoms in an adolescent male.
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Yoon BH, Huh CW. [Rectal Mucosa-associated Lymphoid Tissue Lymphoma Treated with Endoscopic Resection]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2021; 78:344-348. [PMID: 34955511 DOI: 10.4166/kjg.2021.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 10/18/2021] [Indexed: 11/03/2022]
Abstract
A primary extranodal B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is a distinct clinical-pathological entity that develops in diverse anatomic locations. However, colorectal involvement is rare. The authors encountered a case of a MALT lymphoma of the rectum in a 69-year-old woman who complained of up to 3 kg weight loss during 3 months. A colonoscopy demonstrated a 1.0×1.0 cm sized subepithelial tumor (SET) at the lower rectum. The patient underwent an endoscopic mucosal resection with ligation for the SET. Pathological analysis revealed marked small to medium-sized lymphocytic infiltration. Immunohistochemistry revealed neoplastic cells positive for CD20 and bcl-2. A polymerase chain reaction detected immunoglobulin H gene rearrangement. Finally, rectal MALT lymphoma was diagnosed. Computed tomography and positron emission tomography scans showed that there was no lymph node metastasis or other organ involvement. A bone marrow biopsy was found to be negative for any neoplastic process. Therefore, the Ann Arbor stage was IeB. Helicobacter pylori (H. pylori) was not detected in the gastric biopsy specimens. Thus far, she has had no relapse since the endoscopic resection. The incidence of rectal MALT is very rare, and treatment is unclear. This paper reports a case of rectal MALT lymphoma treated successfully with only an endoscopic resection.
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Affiliation(s)
- Baek Hyun Yoon
- Division of Gastroenterology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Cheal Wung Huh
- Division of Gastroenterology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
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Ng HJ, Schmigylski R, Nale K, Collins P. Primary intestinal follicular lymphoma presenting as multiple lymphomatous polyposis. BMJ Case Rep 2020; 13:13/12/e238626. [PMID: 33318279 PMCID: PMC7737031 DOI: 10.1136/bcr-2020-238626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Multiple lymphomatous polyposis (MLP) is a rare condition, described in the literature as a presentation of extranodal mantle cell lymphoma. We report a rare case of follicular lymphoma presenting as MLP in a young woman with a short history of haematochezia who underwent colonoscopy. Immunohistochemistry on colonic biopsies confirmed follicular lymphoma. Microscopic examination found an extensive and dense lymphoid infiltrate, which demonstrated a follicular growth pattern. The neoplastic cells were positive with BCL2, BCL6, CD10 and CD20, and were negative with CD3, CD5, Cyclin D1 and SOX11. CT staging showed disseminated lymphadenopathy and the patient was commenced on chemotherapy. Endoscopic evaluation and histopathological analysis are vital for the accurate diagnosis of MLP. Our case demonstrates that follicular lymphoma should be considered as a differential, as not all cases of diffuse colonic MLP are related to mantle cell lymphoma. This distinction must be made to provide the best clinical management for the patient.
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Affiliation(s)
- Hwei Jene Ng
- Department of General Surgery, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Rudi Schmigylski
- Department of Pathology, Dumfries and Galloway Royal Infirmary, Dumfries, UK
| | - Krsty Nale
- Department of Pathology, Dumfries and Galloway Royal Infirmary, Dumfries, UK
| | - Patrick Collins
- General Surgery Department, Dumfries and Galloway Royal Infirmary, Dumfries, UK
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8
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Won JH, Kim SM, Kim JW, Park JH, Kim JY. Clinical features, treatment and outcomes of colorectal mucosa-associated lymphoid tissue (MALT) lymphoma: literature reviews published in English between 1993 and 2017. Cancer Manag Res 2019; 11:8577-8587. [PMID: 31572011 PMCID: PMC6759223 DOI: 10.2147/cmar.s214197] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/13/2019] [Indexed: 12/14/2022] Open
Abstract
Background Colorectal mucosa-associated lymphoid tissue (MALT) lymphoma (cMALToma) is rare and comprises only 2.5% of the MALT lymphomas. Its etiology and treatment have not been well established. The aim of this systematic literature review was to try to characterize cMALToma and analyze the risk factors for treatment failure with various therapeutic strategies. Methods We retrospectively reviewed 50 case reports from 1993 to 2017 through a PubMed search of English medical literature, describing cMALToma. We included 67 patients from previous case reports and we added 6 patients treated for cMALToma in our multicenter institutes. Risk factor analysis was done for treatment failure, defined as remission failure and recurrence. Results Of 73 patients diagnosed with cMALToma, tumors were located in 54 patients (74.0%) in the rectum, in 10 patients (13.6%) in the right colon, in 3 patients (4.1%) in the transverse colon, and in 6 patients (8.2%) in the sigmoid colon. In first-line treatment, patients achieved complete remission (CR) with surgery (18/19 cases), local resection (18/19 cases), chemotherapy (12/13 cases), radiation therapy (4/5 cases), antibiotics therapy including Helicobacter pylori eradication (12/15 cases), and no treatment (1/2 cases). Among these, eight cases (10.9%) needed second-line treatment, and there was overall remission failure in 3 cases (4.1%). Of the remaining 70 patients with CR, the tumor recurred in 5 patients (6.8%). The multivariable analysis showed that male sex, multiple tumors, and first-line treatment failure were significantly related to treatment failure (p=0.03, p=0.05, p=0.03, respectively). Conclusion CR of primary cMALToma was achieved using various therapeutic strategies. First-line treatment failure and multiple tumors were associated with treatment failure, although the numbers of cases that failed are too small to draw definitive conclusions.
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Affiliation(s)
- Jae Hee Won
- Department of Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
| | - Sung Min Kim
- Department of Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
| | - Jong Wan Kim
- Department of Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
| | - Jun Ho Park
- Department of Surgery, Kangdong Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
| | - Jeong Yeon Kim
- Department of Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
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Lee SH, Nam SJ, Lee SJ, Park SC, Kang CD, Choi DH, Park JM, Lee SK. Colonic Diffuse Large B-cell Lymphoma Hidden in Actinomycosis. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2019; 74:46-50. [PMID: 31344772 DOI: 10.4166/kjg.2019.74.1.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 04/04/2019] [Accepted: 04/29/2019] [Indexed: 11/03/2022]
Abstract
Actinomycosis can mask malignant diseases. This paper reports a case of colonic diffuse large B-cell lymphoma (DLBCL), which was misdiagnosed as abdominal actinomycosis. A 76-year-old woman presented with right flank pain and weight loss. Abdominal CT and colonoscopy revealed a huge ascending colon mass. Despite the initial impression of a malignancy, a colonoscopic biopsy revealed no malignant cells, but sulfur granules and a filamentous organism suggesting actinomycosis. Intravenous penicillin G was administered under the impression of abdominal actinomycosis but her condition deteriorated rapidly. Follow up CT showed markedly increased colon mass and new multiple nodular lesions around the ascending colon. Sono-guided percutaneous biopsy of the nodular lesion was performed. The pathological result was DLBCL. The patient was scheduled to undergo chemotherapy but the patient expired due to cancer progression. The diagnosis of gastrointestinal infiltrating tumors is often difficult because a superficial biopsy usually does not provide a confirmative diagnosis. This case highlights the difficulty in making a correct diagnosis of lymphoma due to the concomitant actinomycosis. Malignant conditions must be considered in cases of actinomycosis with no response to antimicrobial therapy.
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Affiliation(s)
- Sang Hoon Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seung-Joo Nam
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sung Joon Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sung Chul Park
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Chang Don Kang
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Dae Hee Choi
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jin Myung Park
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seung Koo Lee
- Department of Anatomic Pathology, Kangwon National University School of Medicine, Chuncheon, Korea
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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.
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Affiliation(s)
- Nathan D Gay
- Department of Hematology/Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - Andy Chen
- Department of Hematology/Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - Craig Y Okada
- Department of Hematology/Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon.,Department of Hematology/Oncology, VA Portland Health Care System, Portland, Oregon
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11
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Colonic lymphoma presented as acute abdomen; A case report and review of literature. JOURNAL OF SURGERY AND MEDICINE 2018. [DOI: 10.28982/josam.401832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Roy AC, Wattchow D, Astill D, Singh S, Pendlebury S, Gormly K, Segelov E. Uncommon Anal Neoplasms. Surg Oncol Clin N Am 2017; 26:143-161. [DOI: 10.1016/j.soc.2016.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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13
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Lo AA, Gao J, Rao MS, Yang GY. Composite Epstein–Barr Virus–Associated B-Cell Lymphoproliferative Disorder and Tubular Adenoma in a Rectal Polyp. Int J Surg Pathol 2016; 24:73-77. [DOI: 10.1177/1066896915604736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Composite tumors are formed when there is intermingling between two components of separate tumors seen histologically. Cases demonstrating composite tubular adenoma with other types of tumors in the colon are rare. Composite tubular adenomas with nonlymphoid tumors including carcinoids, microcarcinoids, and small cell undifferentiated carcinoma have been reported in the literature. The occurrence of composite lymphoma and tubular adenoma within the colorectal tract is extremely rare. Only three cases have been reported and include one case of mantle cell lymphoma and two cases of diffuse large B-cell lymphoma arising in composite tubular adenomas. We present the first case of composite Epstein–Barr virus–associated B-cell lymphoproliferative disorder and tubular adenoma in a rectal polyp with a benign endoscopic appearance.
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Affiliation(s)
- Amy A. Lo
- Northwestern Memorial Hospital, Chicago, IL, USA
| | - Juehua Gao
- Northwestern Memorial Hospital, Chicago, IL, USA
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Barbaryan A, Ali AM, Kwatra SG, Saba R, Prueksaritanond S, Hussain N, Mirrakhimov AE, Vladimirskiy N, Zdunek T, Gilman AD. Primary diffuse large B-cell lymphoma of the ascending colon. Rare Tumors 2013; 5:85-8. [PMID: 23888223 PMCID: PMC3719118 DOI: 10.4081/rt.2013.e23] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Revised: 04/03/2013] [Accepted: 04/08/2013] [Indexed: 02/08/2023] Open
Abstract
Primary colorectal lymphoma is a rare malignancy accounting for 3% of all gastrointestinal lymphomas and 0.1-0.5% of all colorectal malignancies. Among primary colorectal lymphomas, the most common histological subtype of colorectal lymphoma is diffuse large B-cell lymphoma. We report a case of an 84-year old Caucasian female who was admitted to the hospital because of a 2 days history of altered mental status. In the emergency department the patient was found to have acute kidney injury and hypercalcemia. On physical examination a large lower quadrant abdominal mass was palpated. Computed tomography scan of abdomen confirmed the presence of a mass along the cecum and proximal ascending colon. Colonoscopy showed a large ulcerated mass and biopsy was consistent with diffuse large B-cell lymphoma. The patient underwent colectomy but refused to receive chemotherapy.
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Tseng CE, Shu TW, Lin CW, Liao KS. Synchronous adenocarcinoma and extranodal natural killer/T-cell lymphoma of the colon: A case report and literature review. World J Gastroenterol 2013; 19:1850-1854. [PMID: 23555176 PMCID: PMC3607764 DOI: 10.3748/wjg.v19.i11.1850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 01/20/2013] [Accepted: 02/08/2013] [Indexed: 02/06/2023] Open
Abstract
Extranodal natural killer/T-cell lymphoma (ENKTL) is a distinct subtype of non-Hodgkin’s lymphoma and is rare in the colon. Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature. In the present study, we report a 63-year-old male who suffered from intermittent bloody stools for 2 mo. He did not have fever, body weight loss or night sweat. Endoscopic and imaging studies revealed a 4.5-cm ulcerative mass in the ascending colon and a 3.0-cm polypoid, easy bleeding mass in the sigmoid colon, respectively. Thought to have double carcinoma of the colon, he received simultaneous right hemicolectomy and sigmoidectomy. The pathological diagnosis was a synchronous ENKTL (ascending colon) and adenocarcinoma (sigmoid colon). The literature on synchronous adenocarcinoma and malignant lymphoma of the colon was also reviewed.
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Sato H, Yasumi K, Mizuno Y, Ichikawa T, Honda K, Kuroda M. Primary T-cell lymphoma associated with tubulovillous adenoma of the rectum: report of a case. Surg Today 2012; 43:317-20. [PMID: 22926552 DOI: 10.1007/s00595-012-0307-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 11/16/2011] [Indexed: 12/25/2022]
Abstract
We report what to our knowledge is the first documented case of "peripheral T-cell lymphoma-not otherwise specified" (PTCL-NOS) associated with a rectal adenoma. Colorectal lymphomas are relatively uncommon, but colorectal T-cell lymphomas are extremely rare. The patient was a 92-year-old woman, referred to our hospital for investigation of anal bleeding. Rectal examination revealed a 3-cm pedunculated polypoid mass 5 cm above the anal verge. We performed a transanal local excision, and histopathological examination revealed a tubulovillous adenoma, with the diffuse proliferation of large lymphoid cells mainly discernible in the mucus membrane lamina propria, with infiltration to the submucosal layer. Immunohistochemical examination of the lymphoid cells revealed positive staining for CD3, weak staining for CD4 and CD8, and negative staining for CD5, CD10, CD20, CD56, CD79a, TIA-1, and Granzyme B. The tumor was diagnosed as PTCL-NOS associated with rectal tubulovillous adenoma. The patient died 28 days after surgery, most probably of progression of the PTCL-NOS.
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Affiliation(s)
- Harunobu Sato
- Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
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Felipe-Silva A, de Campos FPF, de Medeiros RSS, Lourenção RM, Zerbini MCN. Enteropathy-associated T-cell lymphoma (type II): a Brazilian case report. AUTOPSY AND CASE REPORTS 2012; 2:31-36. [PMID: 31528569 PMCID: PMC6735548 DOI: 10.4322/acr.2012.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 06/11/2012] [Indexed: 12/04/2022] Open
Abstract
Enteropathy-associated T-cell Lymphoma (EATL) is a rare form of aggressive T-cell lymphoma. It is more prevalent in men over 60 years and the prognosis is very poor. EATL is classified into two groups based on morphology, immunohistochemistry, and genetic profile. EATL type I is highly associated with celiac disease and is more common in Western countries. EATL type II predominates over type I in Asia, where celiac disease is uncommon. We report a case of a 78-year-old previously healthy white male who presented with a 2-month history of diarrhea, weight loss and edema. The abdomen was distended and painful, and a tumor mass was palpable in the hypogastrium. Laboratory tests showed hypoalbuminemia. Serological tests for HIV, viral hepatitis and HTLV-1 were negative. The chest radiography showed pneumoperitoneum, and an exploratory laparotomy revealed perforation of the small bowel. An advanced stage (Ann Arbor IV B/Lugano IIE2B) EATL type II was diagnosed. Four cycles of chemotherapy were interspersed with several complications (anthracycline-induced cardiotoxicity, chemotherapy-induced neutropenic fever and severe sepsis). Performance status progressively worsened and he died 6 months after the diagnosis. This is an illustrative report of a rare and aggressive primary intestinal lymphoma. To the best of our knowledge, this is the first report of EATL type II in Brazil.
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Affiliation(s)
- Aloísio Felipe-Silva
- Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
| | | | | | | | - Maria Claudia Nogueira Zerbini
- Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.,Department of Pathology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
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18
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Lee DY, Hong SW, Chang YG, Lee WY, Lee B, Kang YK. Synchronous T-cell lymphoma in patient with colon cancer: a case report. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2012; 83:60-4. [PMID: 22792536 PMCID: PMC3392318 DOI: 10.4174/jkss.2012.83.1.60] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 02/16/2012] [Accepted: 03/26/2012] [Indexed: 12/29/2022]
Abstract
Colorectal cancer is the third most common malignancy in Korea. In contrast, pericolic or mesenteric lymphoma is relatively rare. We experienced an extremely rare case of synchronous primary colon cancer in the ascending colon with T-cell lymphoma in the pericolic lymph node. A 79-year-old woman presented with complaints of epigastric and right lower abdominal pain combined with anorexia and nausea. Colonoscopic evaluation and biopsy were performed, and the diagnosis was cecal adenocarcinoma. She underwent right hemicolectomy with lymph node dissection. The pathology report revealed adenocarcinoma in cecum with metastasis to 1 regional lymph node out of 37 lymph nodes. In addition, there was malignant angioimmunoblastic T-cell lymphoma in 1 pericolic lymph node. There was no evidence of lymphoma in ileum, cecum and ascending colon, so the possibility of early phase of lymphoma was suggested.
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Affiliation(s)
- Deuk Young Lee
- Department of Surgery, Inje University Seoul Paik Hospital, Seoul, Korea
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19
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Burke JS. Lymphoproliferative disorders of the gastrointestinal tract: a review and pragmatic guide to diagnosis. Arch Pathol Lab Med 2011; 135:1283-97. [PMID: 21970484 DOI: 10.5858/arpa.2011-0145-ra] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
CONTEXT The gastrointestinal tract is the most common site of extranodal lymphomas. Although all histologic categories of malignant lymphoma develop in the gastrointestinal tract, large B-cell lymphomas predominate, followed by extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT) type; the latter is especially prevalent in stomach. The acceptance of extranodal marginal zone lymphoma of MALT type as a clinicopathologic entity has reduced the number of cases that formerly were interpreted as florid lymphoid hyperplasia ("pseudolymphoma"). Nonetheless, the distinction of lymphoid hyperplasia from a lymphoma of MALT type in small biopsy specimens remains problematic. OBJECTIVE To assess the relevant morphologic, immunologic, molecular, and genetic properties of gastrointestinal lymphomas and to present a feasible tactic for diagnosis, expressly for small biopsy specimens. DATA SOURCES Case-derived material and literature review using PubMed (National Library of Medicine). CONCLUSIONS Most gastrointestinal lymphomas are readily amenable to an unqualified diagnosis, primarily those cases consisting of monomorphic large cells whether of B- or T-cell lineage, including cases associated with enteropathy. Diagnosis for infiltrates dominated by small lymphocytes remains taxing, as the differential diagnosis embraces not only MALT lymphoma and lymphoid hyperplasia but also mantle cell lymphoma, follicular lymphoma, and chronic lymphocytic leukemia/small lymphocytic lymphoma. Adherence to strict morphologic criteria is the standard for diagnosis, but these criteria should be augmented by immunologic studies together with judicious use of molecular techniques to determine clonality. In establishing a diagnosis of gastric marginal zone lymphoma of MALT type, determination of t(11;18)(q21;q21) status may be required since this translocation has clinical ramifications.
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Affiliation(s)
- Jerome S Burke
- Department of Pathology, Alta Bates Summit Medical Center, Berkeley, California 94705, USA.
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20
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Primary colorectal lymphoma: case series and literature review. Asian J Surg 2011; 34:111-4. [PMID: 22208685 DOI: 10.1016/j.asjsur.2011.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Revised: 02/11/2011] [Accepted: 04/14/2011] [Indexed: 01/10/2023] Open
Abstract
Primary colorectal lymphoma is a rare disease that accounts for 0.16% of colorectal malignancies. Treatments include surgical intervention with or without chemotherapy. Outcome of this intervention among the Chinese population are lacking. Perforation resulting from chemotherapy may need further exploration. A retrospective review of patient records was performed among those who were diagnosed with colorectal malignancy in a single center from January 1998 to June 2009. Ten patients met Dawson's diagnostic criteria for primary colorectal lymphoma [0.66% (10/1516) of all colorectal malignancies]. The male-to-female ratio was 9:1, and median age at diagnosis was 76 years. The most common site was the cecum (n = 5). B-cell lymphoma was present in eight patients. Seven patients underwent surgical intervention. The median follow-up of all patients was 16.5 months. Median survival was 17 months and 13 months in the surgical and chemotherapy group, respectively. Primary colonic lymphoma is a rare disease. Surgical intervention appeared to be superior to chemotherapy alone, but the findings were limited by the small number of patients in this study. Whether surgery or chemotherapy should be offered first remains unknown and requires further research.
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Abstract
AIM To perform case series from one centre over 9 years, and review of the literature. The synchronous diagnosis of colorectal malignancy and lymphoma is rare. METHOD Case note review of patients identified from clinical databases. RESULTS Five patients were identified and findings discussed. In two patients colorectal malignancy staging CT scans identified pathological lymphadenopathy consistent with lymphoma. A further two patients had an incidental lymphoma on histological examination of the colorectal malignancy specimen. The fifth patient was found to have suspicious superior mesenteric lymph nodes at laparotomy. Histology confirmed two nodular lymphocyte-predominant Hodgkin's lymphomas, a lymphocytic-rich classical Hodgkin's lymphoma, a diffuse large B-cell lymphoma and a B-cell follicular lymphoma. CONCLUSION There is a need for vigilance for the possibility of dual pathologies in all specialties.
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Affiliation(s)
- L R Kidd
- Department of Colorectal Surgery, Singleton Hospital, Wales, UK.
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22
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Gou HF, Zang J, Jiang M, Yang Y, Cao D, Chen XC. Clinical prognostic analysis of 116 patients with primary intestinal non-Hodgkin lymphoma. Med Oncol 2010; 29:227-34. [PMID: 21193968 DOI: 10.1007/s12032-010-9783-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 12/10/2010] [Indexed: 02/05/2023]
Abstract
The gastrointestinal tract is the most common extranodal invasion site of non-Hodgkin lymphoma (NHL). Primary gastrointestinal NHL is often discussed together in most survival analyses. Primary intestinal NHL is significantly different from primary gastric NHL with regard to clinical features, pathological subtype, treatment, and prognosis. In this article, we analyzed clinical and pathological characteristics of primary intestinal NHL, and we also explored prognostic factors for primary intestinal NHL. A retrospective analysis was carried out on clinical data from 116 cases of confirmed primary intestinal NHL. The Kaplan-Meier method was used for the survival analysis. A Cox model was used for a multivariate analysis. In 116 patients with primary intestinal NHL, 79 patients were men (68.1%) and 37 patients were women (31.9%). In the cases used in this study, 68 were B-cell NHL and 48 were T-cell NHL. The age, incidence of intestinal obstruction, B symptom and performance status (PS) were closely related with pathological subtype. One-year and two-year survival rates were 76.7 and 58.3%, respectively. The log-rank univariate analysis showed male patients, PS score greater than or equal to two, hypoproteinemia, intestinal perforation, T-cell type, late stage (III/IV), no radical surgery, and no chemotherapy had relatively poor prognoses. Cox multivariate analysis shown that gender (95.0% CI 0.218-0.721), pathological subtype (95.0% CI 1.484-4.179), and radical surgery (95.0% CI 0.110-0.394) were independent prognostic risk factor for primary intestinal NHL. Male patients, T-cell intestinal lymphoma, and no radical surgery had rapid clinical processes and poor prognoses.
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Affiliation(s)
- Hong-Feng Gou
- Center of Medical Oncology, West China Hospital, Sichuan University, Chengdu, China.
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23
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Sasaki S, Hatanaka K, Sahara N, Uekusa T, Hirayama K, Shirahata A, Ishimaru M. Collision tumor of primary malignant lymphoma and adenocarcinoma in the colon: report of a case. Surg Today 2010; 40:975-81. [PMID: 20872204 DOI: 10.1007/s00595-009-4166-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Accepted: 10/05/2009] [Indexed: 12/19/2022]
Abstract
This report presents the case of a 62-year-old man with a collision tumor of primary malignant lymphoma and adenocarcinoma in the cecum. All regional mesenteric lymph nodes that were removed surgically were found to be occupied by lymphoma cells and no lymph nodes contained any cancer cells, although the primary carcinomas did exhibit lymphatic invasion. Malignant lymphoma was also seen in the duodenum. Systemic chemotherapy was administered for the malignant lymphoma, and a complete response was thus obtained. However, just after chemotherapy multiple liver metastases of adenocarcinoma emerged, and chemotherapy against adenocarcinoma was therefore continued. The occurrence of synchronous lymphoma and adenocarcinoma of the colorectum is rare. Furthermore, collisions of these different entities are also extremely unusual; so far only five such case reports have been published. The accurate clinical determination of the dominant tumor and a close follow-up is required for proper treatment in these cases.
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Affiliation(s)
- Shin Sasaki
- Department of Surgery, Omori Red Cross Hospital, 4-30-11 Chuo, Ota-ku, Tokyo 143-8527, Japan
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24
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Park JH, Lee JH. [MALT (Mucosa-Associated Lymphoid Tissue) Lymphoma of the colon]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2010; 55:213-6. [PMID: 20389173 DOI: 10.4166/kjg.2010.55.4.213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Jong Hyeok Park
- Department of Internal Medicine, Seoul Paik Hospital, Inje Univercity College of Medicine, Seoul, Korea
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25
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Samee A, Rukin N, Siddiqui I, Halliday M, Farmer M. A solitary rectal mucosa-associated lymphoid tissue (MALT) lymphoma. BMJ Case Rep 2010; 2010:2010/jul16_2/bcr0120102649. [PMID: 22767556 DOI: 10.1136/bcr.01.2010.2649] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Mucosa-associated lymphoid tissue (MALT) is a type of extra nodal malignant lymphoma seen in organs such as the stomach, thyroid and salivary glands. Furthermore, occurrence of colorectal MALT lymphoma is extremely rare. We report a case of a solitary rectal MALT lymphoma treated by surgical resection and radiotherapy. Lymphoma should be considered as a rare differential diagnosis when dealing with large bowel pathology. We would advocate the use of surgery as a primary treatment option for a medically fit patient.
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Affiliation(s)
- A Samee
- Surgical Directorate, Princess Royal Hospital, Telford, UK.
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26
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Rare anorectal neoplasms: gastrointestinal stromal tumor, carcinoid, and lymphoma. Clin Colon Rectal Surg 2010; 22:107-14. [PMID: 20436835 DOI: 10.1055/s-0029-1223842] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Several uncommon tumors occur in the anal canal such as gastrointestinal stromal tumors, carcinoids, and lymphoma. Increased clinical experience and advancements in molecular biology have improved the accuracy of pathologic diagnosis and guided treatment recommendations, which the author addresses in this article.
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27
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Ismaili N, Bensouda Y, Mellas N, Errihani H. Role of chemotherapy in the management of primary rectal lymphoma: a case report and review of the literature. CASES JOURNAL 2009; 2:9373. [PMID: 20062547 PMCID: PMC2804016 DOI: 10.1186/1757-1626-2-9373] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Accepted: 12/22/2009] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Primary rectal lymphoma is a rare disease. In this paper we present an unusual case of primary rectal lymphoma which was managed with chemotherapy and discussed by a thorough review of the related literature. CASES PRESENTATION An 85-years-male patient was diagnosed in Sidi Mohammed Ben Abdellah Hospital as having diffuse large B-cell lymphoma of the rectum at a bulky stage two. This patient was managed successfully with 8 treatment cycles of Cyclophosphamide 750 mg/m2 at day 1 of each cycle, Doxorubicin (50 mg/m2 in the first 4 cycles and 25 mg/m2 in the subsequent cycles) at day 1 of each cycle, Vincristine 1.4 mg/m(2 )at day 1 of each cycle, and prednisone 50 mg/m(2 )at day 1 to 5 of each cycle. CONCLUSION The optimal treatment of primary rectal lymphoma needs more research studying to be achieved.
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Affiliation(s)
- Nabil Ismaili
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco
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28
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Jung CK, Lee JH, Lee CM, Won JJ, Baek YH, Lee JM, Lee SA. [A case of primary sigmoid colon mucosa-associated lymphoid tissue lymphoma]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2009; 54:126-9. [PMID: 19696541 DOI: 10.4166/kjg.2009.54.2.126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The gastrointestinal (GI) tract is the most frequently involved site of mucosa-associated lymphoid tissue (MALT) lymphoma. Stomach is the most common site of involvement among the GI tract. However, MALT lymphoma of the large intestine is rare. A diagnosis is established by pathological examination of the surgical or endoscopic specimens. A 72-year-old man with low abdominal pain was diagnosed as a sigmoid MALT lymphoma, which was noted as an obstructing mass in a colonoscopic examination. A left hemicolectomy was performed, and the patient has had no recurrence postoperatively without any chemotherapy.
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Affiliation(s)
- Chang Kil Jung
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
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29
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30
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Bessa X, De Juan C, Bombí JA. [Fever, anemia and weight loss in the last 2 months in a woman of 21 years old]. Med Clin (Barc) 2009; 132:591-8. [PMID: 19285317 DOI: 10.1016/j.medcli.2008.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2008] [Accepted: 05/22/2008] [Indexed: 11/28/2022]
Affiliation(s)
- Xavier Bessa
- Sección Gastroenterología, Servicio de Digestivo, Hospital del Mar, Barcelona, España.
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31
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Primary CD56+ NK/T-cell lymphoma of the rectum accompanied with refractory ulcerative colitis. J Gastroenterol 2008; 43:576-80. [PMID: 18648746 DOI: 10.1007/s00535-008-2192-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Accepted: 03/16/2008] [Indexed: 02/04/2023]
Abstract
A case of primary NK/T-cell lymphoma of the rectum accompanied with ulcerative colitis (UC) in a 73-year-old man is reported. He had a 6-year history of repeated admission to our hospital for UC. Total colonoscopy performed 4 months after resolution of refractory UC complicated by cytomegalovirus colitis showed a markedly submucosal tumor in the rectum, which was histologically diagnosed as malignant lymphoma. The findings of computed tomography of the chest and abdomen, gallium scintigraphy, abdominal ultrasonography, and upper gastrointestinal endoscopy showed no abnormal lesions. Therefore, based on a diagnosis of localized rectal lymphoma with UC, proctocolectomy was performed. The resected specimen showed three submucosal tumors in the rectum with local nodal involvement. Histologically, the tumors were characterized by diffusely infiltrating sheets of large atypical lymphoid cells, which were negative for CD4, CD8, and CD20 but were positive for CD56, CD3, and granzyme B. The presence of Epstein-Barr virus (EBV) infection in neoplastic cells was shown by in situ hybridization for EBV-encoded early small RNA1 (EBER-1). Based on these findings, the patient was diagnosed with primary CD56+ NK/T-cell lymphoma of the rectum (stage IIE). This is the first case report of primary rectal NK/T-cell lymphoma accompanied with UC.
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32
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Foo M, Chao MWT, Gibbs P, Guiney M, Jacobs R. Successful treatment of mucosa-associated lymphoid tissue lymphoma of the rectum with radiation therapy: report of a case. Dis Colon Rectum 2008; 51:1719-23. [PMID: 18633678 DOI: 10.1007/s10350-008-9379-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2006] [Accepted: 12/27/2006] [Indexed: 02/08/2023]
Abstract
We report a case of Stage IE mucosa-associated lymphoid tissue lymphoma arising in the rectum, which was successfully treated with radiotherapy. A 60-year-old man had several months of altered bowel habit with rectal bleeding and was found to have a large rectal tumor with no evidence of distant spread. Histologic studies showed this to be a mucosa-associated lymphoid tissue lymphoma. The patient received 45 Gy in 25 fractions with external beam radiotherapy during 5 weeks. The treatment was well tolerated and review at 41 months revealed no evidence of recurrence.
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Affiliation(s)
- Marcus Foo
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrew's Place, East Melbourne, Victoria, 3002, Australia.
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33
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Kojima M, Iijima M, Shimizu K, Hoshi K. Localized lymphoid hyperplasia of the rectum representing progressive transformation of the germinal center. A report of two cases. APMIS 2008; 115:1432-6. [PMID: 18184416 DOI: 10.1111/j.1600-0463.2007.00815.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Histologically, benign lymphoid hyperplasia (BLH) of the rectum is usually characterized by large lymphoid follicles with active germinal centers, and a narrow surrounding mantle zone and marginal zone. We present two cases of BLH of the rectum demonstrating progressive transformation of the germinal center (PTGC). The patients were 50- and 71-year-old Japanese women. Colonoscopy demonstrated small sessile polyps in both cases. The resected specimen contained numerous lymphoid follicles with active germinal centers and a portion of the lymphoid follicles exhibited PTGC. The area showing PTGC contained a few large lymphoid cells resembling lymphocytic and histiocytic Reed-Sternberg cells of nodular lymphocyte-predominant Hodgkin lymphoma. These PTGC contained small- to-medium clusters of epithelioid cells in both cases. In situ hybridization studies demonstrated scattered Epstein-Barr virus (EBV)-encoded small RNA-positive medium and large lymphoid cells and crypt epithelium in both lesions. EBV may be involved in the etiology of a subset of BLH of the rectum. However, reactivity of lymphoid cells for EBV has been reported in lymphoid tissues in a high percentage of "normal" individuals. The etiology of BLH of the rectum remains unclear.
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Affiliation(s)
- Masaru Kojima
- Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan.
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Sztarkier I, Levy I, Walfisch S, Delgado J, Benharroch D. Mantle cell lymphoma in a tubular adenoma: unusual presentation with synchronous colonic carcinoma. Ann Diagn Pathol 2007; 13:47-9. [PMID: 19118782 DOI: 10.1016/j.anndiagpath.2007.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
An 80-year-old man underwent sigmoidectomy for adenocarcinoma. Six months later, after a near-syncope incident, pancytopenia was detected in the absence of occult blood in the stools. A bone marrow biopsy showed malignant lymphoma, suggestive of mantle cell lymphoma (MCL). Colonoscopy at this time revealed 3 colonic tubular adenomas. Reassessment of the histology of the colonic polyps and appropriate immunohistochemical stains showed that the lamina propria of one of the tubular adenomas was infiltrated by MCL. Reexamination of the sections taken at the time of the original sigmoidectomy showed MCL in 2 of the regional lymph nodes removed at that time, but no evidence of lymphoma in the colon was found. To our knowledge, this is the fifth reported case of synchronous occurrence of intestinal MCL and colonic carcinoma and the first report of MCL presenting in a tubular adenoma of the colon.
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Affiliation(s)
- Ignacio Sztarkier
- Institute of Pathology, Soroka University Medical Center, Beer-Sheva, Israel
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35
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Ara C, Coban S, Kayaalp C, Yilmaz S, Kirimlioglu V. Spontaneous intestinal perforation due to non-Hodgkin's lymphoma: evaluation of eight cases. Dig Dis Sci 2007; 52:1752-6. [PMID: 17420936 DOI: 10.1007/s10620-006-9279-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Accepted: 03/01/2006] [Indexed: 12/09/2022]
Abstract
Primary intestinal lymphoma with spontaneous perforation and after systemic chemotherapy is rare. The present study summarizes retrospectively the outcome of eight free intestinal perforated patients diagnosed with intestinal non-Hodgkin's lymphoma. Two patients had a history of systemic chemotherapy before perforation. The most common symptoms of the patients were abdominal pain, nausea, vomiting, weight loss, and fever. Sites of perforation were ileum in four, jejunum in two, cecum in one, and sigmoid colon in one patient. Synchronous lymphoma was present in three patients. The perforation was closed by primary closure in three patients. Resection/anastomosis was performed in four patients and sigmoid colostomy was performed in one patient. Three patients were lost due to leakage or septicemia. Intestinal lymphoma might be kept in mind as a cause in free intestinal perforations. Because of the high mortality rate early diagnosis and treatment are important to improve the prognosis of bowel perforation in patients with non-Hodgkin's lymphoma.
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Affiliation(s)
- Cengiz Ara
- Department of General Surgery, Inonu University School of Medicine, Malatya, 44069, Turkey.
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36
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Guney N, Basaran M, Aksakalli N, Bavbek S, Erseven G. Primary Non-Hodgkin’s Lymphoma of the Rectum. Oncol Res Treat 2007; 30:385-7. [PMID: 17596749 DOI: 10.1159/000103590] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Primary rectal lymphoma is a very uncommon disease, therefore, it has received little attention in the literature. Because of their rarity, rectal lymphomas are generally included in the group of large intestine lymphomas. CASE REPORT We report here a case of primary rectal B-cell lymphoma in a 67-year-old woman. The tumor was originally located in the rectum without evidence of any other lymphoma-involved organ. Histological findings revealed diffuse large B-cell lymphoma. The clinical stage was IE according to the Ann Arbor system. International prognostic index (IPI) was I (low-intermediate risk). We preferred a non-surgical, organ-sparing treatment which started with chemotherapy followed by radiation. 12 months after the end of therapy, there is no sign of tumor recurrence in our patient. CONCLUSION We suggest that histology-specific multidrug chemotherapy followed by radiotherapy seems to be a therapeutic approach that is appropriate fort this rare tumor.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biopsy
- Combined Modality Therapy
- Dose Fractionation, Radiation
- Drug Administration Schedule
- Female
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/radiotherapy
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/radiotherapy
- Neoplasm Staging
- Radiotherapy, Adjuvant
- Rectal Neoplasms/diagnosis
- Rectal Neoplasms/drug therapy
- Rectal Neoplasms/pathology
- Rectal Neoplasms/radiotherapy
- Rectum/pathology
- Sigmoidoscopy
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Affiliation(s)
- Nese Guney
- Department of Medical Oncology, Institute of Oncology, Istanbul University, Turkey
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37
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Lee J, Kim WS, Kim K, Ahn JS, Jung CW, Lim HY, Kang WK, Park K, Ko YH, Kim YH, Park C, Yoon SH, Lee WY, Chun HK. Prospective clinical study of surgical resection followed by CHOP in localized intestinal diffuse large B cell lymphoma. Leuk Res 2007; 31:359-64. [PMID: 16930692 DOI: 10.1016/j.leukres.2006.06.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Revised: 06/18/2006] [Accepted: 06/20/2006] [Indexed: 10/24/2022]
Abstract
This study aimed to assess the efficacy of surgical treatment followed by post-surgical CHOP chemotherapy and to analyze the impact of T and N stage on survival in localized intestinal diffuse large B cell lymphoma (DLBL) patients. A prospective non-randomized study was conducted and 40 patients received primary surgical resection with lymph node dissection and post-operative CHOP chemotherapy. After a median follow-up duration of 33.3 months (range, 5.1-75.9 months), an estimated 5-year overall survival rate was 88.9% and a 5-year disease-free survival rate was 83.1%. Primary surgical resection followed by post-operative CHOP chemotherapy showed high efficacy in intestinal DLBL patients.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Combined Modality Therapy
- Cyclophosphamide/therapeutic use
- Disease-Free Survival
- Doxorubicin/therapeutic use
- Female
- Follow-Up Studies
- Humans
- Intestinal Neoplasms/diagnosis
- Intestinal Neoplasms/drug therapy
- Intestinal Neoplasms/surgery
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/surgery
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/surgery
- Male
- Middle Aged
- Neoplasm Staging
- Predictive Value of Tests
- Prednisolone/therapeutic use
- Prognosis
- Prospective Studies
- Survival Rate
- Treatment Outcome
- Vincristine/therapeutic use
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Affiliation(s)
- Jeeyun Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Republic of Korea
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Kang H, O'Connell JB, Leonardi MJ, Maggard MA, McGory ML, Ko CY. Rare tumors of the colon and rectum: a national review. Int J Colorectal Dis 2007; 22:183-9. [PMID: 16845516 DOI: 10.1007/s00384-006-0145-2] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2006] [Indexed: 02/04/2023]
Abstract
BACKGROUND Most literature available on rare colorectal cancer (CRC) is from case series reports. This population-based evaluation is the first comprehensive look at four rare histologic types of CRC, allowing comparisons with the more common adenocarcinoma for clinical and pathological features and survival rates. MATERIALS AND METHODS All patients diagnosed with carcinoid (n=2,565), malignant lymphoma (n=955), non-carcinoid neuroendocrine (n=455), squamous cell (n=437), and adenocarcinoma (n=164,638) in SEER cancer database (1991-2000) were analyzed. Evaluation of age-adjusted incidence rate, stage at presentation, and 5-year relative survival were determined for each histologic subtype. RESULTS All rare histologic subtypes had younger mean age than adenocarcinomas (70 years; p<0.05). Lymphoma was more common in males (65.1%; P<0.01). Incidence rates in 2000 per million were: carcinoid 10.6, lymphoma 3.5, neuroendocrine 2.0, squamous 1.9, and adenocarcinoma 496.3. The annual percent change in incidence for each rare tumor increased significantly during the 10 years (range: 3.1-9.4%, p<0.05), except squamous cell carcinoma (5.9%, p>0.05). Squamous (93.4%) and carcinoid (73.7%) tumors occurred more often in the rectum; lymphoma (79.0%), neuroendocrine (70.8%), and adenocarcinoma (70.1%) occurred more often in the colon (P<0.01). Carcinoids presented at earlier stage (localized/regional, 90.5%) more often than adenocarcinoma (80.6%; p<0.01), but squamous cell (82.1%; p=0.50), lymphoma(70.6%; p<0.01), and neuroendocrine (37.8%; p<0.01) presented at earlier stage similarly or less often than adenocarcinoma. Relative 5-year survival rate was highest for carcinoid (91.3%), and lowest for neuroendocrine tumors (21.4%). CONCLUSION This study provides the first population-based analysis of the epidemiology, tumor characteristics, and survival rates for rare CRC.
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Affiliation(s)
- Hakjung Kang
- Department of Surgery, Daehang Hospital, Seoul, South Korea
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39
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Daum S, Thiel E, Zeitz M. Is intestinal diffuse large b cell lymphoma a relatively benign disease? Leuk Res 2006; 31:287-9. [PMID: 17010434 DOI: 10.1016/j.leukres.2006.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Revised: 08/17/2006] [Accepted: 08/18/2006] [Indexed: 11/15/2022]
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40
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Kodama T, Ohshima K, Nomura K, Taniwaki M, Nakamura N, Nakamura S, Kohno S, Yamamoto J, Karube K, Yamasita Y, Shirakusa T, Kikuchi M. Lymphomatous polyposis of the gastrointestinal tract, including mantle cell lymphoma, follicular lymphoma and mucosa-associated lymphoid tissue lymphoma. Histopathology 2005; 47:467-78. [PMID: 16241994 DOI: 10.1111/j.1365-2559.2005.02225.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIMS Lymphomatous polyposis (LP) is considered to represent mantle cell lymphoma (MCL) of the gastrointestinal (GI) tract. However, a few reports have suggested that some are follicular lymphoma (FL) or mucosa-associated lymphoid tissue (MALT) lymphomas. In this study, we analysed 35 patients and clarified the clinicopathological features of LP. METHODS AND RESULTS Paraffin-embedded tissue samples were stained immunohistochemically and analysed by tissue-fluorescence in situ hybridization (T-FISH) for IGH/CCND1 (cyclin D1) and IGH/BCL2. The average age of the patients was 58.3 years. Over half of the cases showed gastric, duodenal, small intestinal, ileocaecal and sigmoid colonic lesions (15, 19, 15, 16 and 16 cases, respectively). Phenotypically, cases were classified into three types of MCL (cyclin D1+ CD5+ CD10-) (n=12), FL (cyclin D1- CD5- CD10+) (n=14) and MALT (cyclin D1- CD5- CD10-) (n=9). T-FISH identified 11 of the 11 examined cases with MCLs to have IGH/CCND1, while seven of 10 cases with FL had IGH/BCL2, and none of the MALT cases were positive for IGH/CCND1 or IGH/BCL2. At the study endpoint, five of 12 patients with MCL were dead, two of 14 with FL and one of nine with MALT were dead of other disease. Event-free survival analysis showed significantly poorest outcome in MCL, followed by FL, while MALT was associated with a favourable outcome (P=0.0040). CONCLUSIONS Our study emphasizes the importance of differentiating MCL, FL and MALT of LP in evaluating prognosis and hence the most suitable therapeutic regimen.
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MESH Headings
- Aged
- Aged, 80 and over
- Diagnosis, Differential
- Female
- Gastrointestinal Neoplasms/diagnosis
- Gastrointestinal Neoplasms/pathology
- Humans
- Immunohistochemistry
- In Situ Hybridization
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, Follicular/diagnosis
- Lymphoma, Follicular/pathology
- Lymphoma, Mantle-Cell/diagnosis
- Lymphoma, Mantle-Cell/pathology
- Male
- Middle Aged
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Affiliation(s)
- T Kodama
- Department of Pathology, School of Medicine, Fukuoka University, Fukuoka, Japan.
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41
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Kim YH, Lee JH, Yang SK, Kim TI, Kim JS, Kim HJ, Kim JI, Kim SW, Kim JO, Jung IK, Jung SA, Jung MK, Kim HS, Myung SJ, Kim WH, Rhee JC, Choi KY, Song IS, Hyun JH, Min YI. Primary colon lymphoma in Korea: a KASID (Korean Association for the Study of Intestinal Diseases) Study. Dig Dis Sci 2005; 50:2243-7. [PMID: 16416168 DOI: 10.1007/s10620-005-3041-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2005] [Accepted: 03/22/2005] [Indexed: 12/16/2022]
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.
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Affiliation(s)
- Y-H Kim
- Sungkyunkwan University, Korea
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42
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Esteban JM, Gutiérrez del Olmo A, Baki W, Fernández S, Soria MT, Díaz Mediavilla J, Ramírez Armengol JA. Colonic mucosa-associated lymphoid tissue lymphoma presenting as multiple polyposis. Gastrointest Endosc 2005; 61:928-30. [PMID: 15933708 DOI: 10.1016/s0016-5107(04)02841-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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43
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Lee YG, Lee S, Han SW, Lee JS. A case of multiple mucosa-associated lymphoid tissue (MALT) lymphoma of the colon identified as simple mucosal discoloration. J Korean Med Sci 2005; 20:325-8. [PMID: 15832010 PMCID: PMC2808615 DOI: 10.3346/jkms.2005.20.2.325] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Most colonic multiple mucosa-associated lymphoid tissue (MALT) lymphomas are confirmed with a histologic and immunohistochemical staining of the mucosal biopsy specimen obtained during colonoscopic examinations. Endoscopically, colonic MALT lymphomas frequently appear as protruding and/or ulcerative lesions, and there are not so many reports of colonic MALT lymphoma as compared to the frequent reports of MALT lymphoma of stomach. We report a unique case of colonic MALT lymphoma presenting as a simple reddish discoloration of mucosa; this presentation has never been describe before. Our patient was a 47-yr-old male who suffered from tenesmus and mucoid stool. A colonoscopy was accomplished, followed by a histologic examination and we diagnosed a colonic MALT lymphoma. Staging of the disease was done because this was necessary for choosing the modality of treatments. The patient was then treated with polychemotherapy in conjunction with radiation therapy.
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Affiliation(s)
- Yong Guk Lee
- Department of Internal Medicine, Seonam University School of Medicine, Korea
| | - Soong Lee
- Department of Internal Medicine, Seonam University School of Medicine, Korea
| | | | - Ji Shin Lee
- Department of Anatomic Pathology, Seonam University School of Medicine, Korea
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Yamamoto R, Kato S, Shimazaki K, Yoshizumi T, Uefuji K, Seo M, Matsuura T, Kikuchi M, Itoh K, Miura S. A case of primary rectal mucosa-associated lymphoid tissue lymphoma treated by endoscopic mucosal resection. Dig Endosc 2005. [DOI: 10.1111/j.1443-1661.2005.00487.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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45
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Affiliation(s)
- Vanessa M Shami
- Department of Endoscopy and Therapeutics, The University of Chicago, Illinois 60637, USA
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46
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Yoshida N, Nomura K, Matsumoto Y, Nishida K, Wakabayashi N, Konishi H, Mitsufuji S, Kataoka K, Okanoue T, Taniwaki M. Detection of BCL2-IGH rearrangement on paraffin-embedded tissue sections obtained from a small submucosal tumor of the rectum in a patient with recurrent follicular lymphoma. World J Gastroenterol 2004; 10:2602-4. [PMID: 15300917 PMCID: PMC4572174 DOI: 10.3748/wjg.v10.i17.2602] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
A 59-year-old woman was admitted to our hospital because of recurrent follicular lymphoma (FL). Colonoscopic examination revealed a rectal submucosal tumor (SMT) without any erosions and ulcers. In this patient, it was difficult to distinguish non-Hodgkin’s lymphoma (NHL) invasion from other disorders of the colon including carcinoid tumor merely based on endoscopic findings. Histopathologic and immunohistochemical studies on biopsy specimens showed an infiltration of atypical lymphocytes that were positive for CD20 and BCL2 but negative for UCHL-1. Fluorescence in situ hybridization on paraffin-embedded tissue sections (T-FISH) identified a translocation of BCL2 with IGH gene. Based on these findings, the tumor was defined as an invasion of FL. T-FISH method is useful for the detection of a monoclonality of atypical lymphocytes in an SMT of the gastrointestinal tract, and particularly for the detection of chromosomal translocations specific to lymphoma subtypes.
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Affiliation(s)
- Naohisa Yoshida
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto 602-8566, Japan
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Daum S, Ullrich R, Heise W, Dederke B, Foss HD, Stein H, Thiel E, Zeitz M, Riecken EO. Intestinal non-Hodgkin's lymphoma: a multicenter prospective clinical study from the German Study Group on Intestinal non-Hodgkin's Lymphoma. J Clin Oncol 2003; 21:2740-6. [PMID: 12860953 DOI: 10.1200/jco.2003.06.026] [Citation(s) in RCA: 198] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Intestinal non-Hodgkin's lymphomas are not well characterized. We therefore studied prospectively their clinical features and response to standardized therapy. PATIENTS AND METHODS Fifty-six patients with primary intestinal lymphoma were included in a prospective, nonrandomized multicenter study. Lymphoma resection was recommended and staging was performed according to the Ann Arbor classification. Patients were scheduled to receive six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy, and at stages EIII to EIV, they received additional involved-field radiotherapy. Corticosteroids were used in patients who could not receive chemotherapy. RESULTS Thirty-five patients had intestinal T-cell lymphoma (ITCL), 21 patients had intestinal B-cell lymphoma (IBCL; 18 diffuse large-cell lymphomas, two marginal-cell lymphomas, and one follicle-center lymphoma). Thirty-four patients at stages EI to EII (14 ITCL and 20 IBCL) and nine patients at stages EIII to EIV (all ITCL) received chemotherapy. No patient in stages EIII to EIV received radiotherapy, because death occurred in 12 of 14 patients. Two-year cumulative survival in patients with IBCL was 94% (95% CI, 82% to 100%) and higher than in patients with ITCL (28% [95% CI, 13% to 43%]; P <.0001), even when only stages EI to EII were considered (ITCL, 37.5% [95% CI, 16.5% to 58.5%]; P <.0001). IBCL patients compared with ITCL patients were at lower lymphoma stages (P <.01), had higher Karnofsky status (P <.005), had intestinal perforation less often (P <.05), required emergency operation less often (P <.05), received CHOP (P <.05) more often, and reached complete remission (P <.0005) more frequently. CONCLUSION IBCL patients at stages EI and EII respond well to chemotherapy, but the prognosis and treatment of ITCL patients is unsatisfactory.
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MESH Headings
- Adult
- Age Distribution
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols
- Combined Modality Therapy
- Cyclophosphamide
- Doxorubicin
- Female
- Follow-Up Studies
- Germany
- Humans
- Intestinal Neoplasms/diagnosis
- Intestinal Neoplasms/epidemiology
- Intestinal Neoplasms/therapy
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/therapy
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/mortality
- Lymphoma, Non-Hodgkin/therapy
- Lymphoma, T-Cell/diagnosis
- Lymphoma, T-Cell/mortality
- Lymphoma, T-Cell/therapy
- Male
- Middle Aged
- Neoplasm Staging
- Predictive Value of Tests
- Prednisolone
- Probability
- Proportional Hazards Models
- Prospective Studies
- Radiotherapy, Adjuvant
- Risk Assessment
- Sex Distribution
- Survival Analysis
- Survival Rate
- Treatment Outcome
- Vincristine
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Affiliation(s)
- Severin Daum
- Department of Medicine I, Universitätsklinikum Benjamin Franklin, Hindenburgdamm 30, D-12200 Berlin, Germany;
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Hirasaki S, Endo H, Nishina T, Masumoto T, Tanimizu M, Hyodo I, Tajiri H. Mucosa-associated lymphoid tissue lymphoma occurring in the transverse colon. Dig Endosc 2003. [DOI: 10.1046/j.1443-1661.2003.00250.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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49
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Tanaka S, Ohta T, Kaji E, Kosaka T, Murakami I. EMR of mucosa-associated lymphoid tissue lymphoma of the rectum. Gastrointest Endosc 2003; 57:956-9. [PMID: 12776055 DOI: 10.1016/s0016-5107(03)70039-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Shouichi Tanaka
- Department of Gastroenterology, Iwakuni National Hospital, Iwakuni, Japan
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50
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Byun JH, Ha HK, Kim AY, Kim TK, Ko EY, Lee JK, Yu ES, Myung SJ, Yang SK, Jung HY, Kim JH. CT findings in peripheral T-cell lymphoma involving the gastrointestinal tract. Radiology 2003; 227:59-67. [PMID: 12601189 DOI: 10.1148/radiol.2271012129] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate whether computed tomography (CT) accurately depicted gastrointestinal tract involvement in peripheral T-cell lymphoma (PTCL). MATERIALS AND METHODS CT scans were retrospectively reviewed in 14 patients with pathologically proved PTCLs of the gastrointestinal tract for the following considerations: sites, patterns of involvement (ie, morphologic features, bowel wall thickness or mass size, and contrast enhancement pattern), and ancillary findings at other sites (ie, lymphadenopathy, bowel perforation, and involvement of other organs). RESULTS PTCL involved the stomach in three patients, the small intestine in eight, both the stomach and the small intestine in one, and the sigmoid colon in two; multifocal involvement was seen in three (21%) patients. CT failed to demonstrate the bowel lesions in three of 14 patients. At CT, 11 patients had gastric or bowel wall thickening (n = 10) and a polypoid mass (n = 1). In 10 patients, the gastric or bowel wall thickening was mild (<1 cm) in six, moderate (1-2 cm) in three, and severe (>2 cm) in one. Lymphadenopathy was noted in nine (64%) patients, with the nonbulky type in eight and the bulky type in one. Bowel perforation occurred in four (29%) patients. Other organs were involved in eight (57%) patients. CONCLUSION CT can depict PTCL involving the gastrointestinal tract if it is not confined to the mucosa. There is a tendency toward preferential jejunal or duodenal involvement, as well as bowel perforation.
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Affiliation(s)
- Jae Ho Byun
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea
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