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Hasturk D, Akturk Esen S, Buyukaksoy M, Civelek B, Seven I, Uncu D. Primary colon lymphomas: An analysis of our experience over the last 18 years. Medicine (Baltimore) 2024; 103:e38013. [PMID: 38728507 PMCID: PMC11081556 DOI: 10.1097/md.0000000000038013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/04/2024] [Indexed: 05/12/2024] Open
Abstract
Colon lymphoma is a rare type of gastrointestinal lymphoma and represents 0.2% to -1.2% of all primary colon cancers. This study aimed to retrospectively examine the general characteristics, treatment methods, and survival characteristics of patients with colon lymphoma who were followed-up at our center. This retrospective study included patients diagnosed with colon lymphoma who were followed up at Ankara Numune Training and Research Hospital and Ankara Bilkent City Hospital between December 2005 and June 2023. Clinicopathological features, radiological findings, treatments, and modalities of patients were obtained from their medical records. Fourteen patients with primary colon lymphoma were included in the study. Thirteen patients (92.9%) were diagnosed with diffuse large B-cell lymphoma. The median age of the patients was 55 (28-84) years. The tumor location was the terminal ileum/cecum in 50% of the patients. At the time of diagnosis, 10 patients (7 with stage 1E-2E disease, 2 with stage 3E disease, and 1 with stage 4E disease due to tumor obstruction) underwent surgery. Twelve patients received chemotherapy (6 patients as adjuvant and 6 patients as first-line treatment). The median overall survival (OS) was 10 years (0.1-21.5) years, the 5-year median OS was 71%, and the 10-year median OS was 53%. Primary colon lymphoma is a rare disease and its optimal treatment is not clearly defined. The primary treatment for primary colon lymphoma is a combination of surgery and chemotherapy. A clear consensus on the treatment can be established through prospective studies.
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MESH Headings
- Humans
- Middle Aged
- Male
- Aged
- Female
- Retrospective Studies
- Colonic Neoplasms/therapy
- Colonic Neoplasms/pathology
- Colonic Neoplasms/mortality
- Adult
- Aged, 80 and over
- Lymphoma/therapy
- Lymphoma/epidemiology
- Lymphoma/diagnosis
- Lymphoma/mortality
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Neoplasm Staging
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Affiliation(s)
- Denizcan Hasturk
- Clinic of Internal Medicine, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Selin Akturk Esen
- Clinic of Medical Oncology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Muge Buyukaksoy
- Clinic of Internal Medicine, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Burak Civelek
- Clinic of Medical Oncology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Ismet Seven
- Clinic of Medical Oncology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Dogan Uncu
- Clinic of Medical Oncology, Ankara Bilkent City Hospital, Ankara, Turkey
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Pather V, Chen MZ, Ellis‐Clark J. Rectal malignant tumours may have an unexpected histology. ANZ J Surg 2022; 93:1070-1071. [PMID: 36300711 DOI: 10.1111/ans.18106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 09/24/2022] [Accepted: 10/02/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Vijay Pather
- Department of General Surgery Nepean Hospital Kingswood New South Wales Australia
| | - Michelle Zhiyun Chen
- Department of Colorectal Surgery Nepean Hospital Kingswood New South Wales Australia
| | - Jodie Ellis‐Clark
- Department of Colorectal Surgery Nepean Hospital Kingswood New South Wales Australia
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Rectal plasmablastic lymphoma in Ebstein Barr virus positive and human immunodeficiency virus negative subject after external radiation therapy for prostatic cancer. Acta Gastroenterol Belg 2021; 84:663-665. [PMID: 34965049 DOI: 10.51821/84.4.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Plasmablastic lymphoma (PBL) represents a rare and aggressive subtype of diffuse large B cells lymphoma (DLBCL) most associated with the human immunodeficiency virus (HIV). Prognosis remains poor despite various treatment approaches. We describe an evolution at six months of HIV negative PBL and Ebstein Barr virus (EBV) positive PBL with chemotherapy. Role of radiotherapy is still unclear.
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Rahman MA, Chowdhury Q, Begum FA, Hassan Arup MM, Habib S. Primary Rectal Non-Hodgkin's Lymphoma Treated with Urgent Radiotherapy and Chemotherapy: A Case Report and Literature Review. Gastrointest Tumors 2020; 7:93-102. [PMID: 32903936 DOI: 10.1159/000505648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 12/29/2019] [Indexed: 11/19/2022] Open
Abstract
Rectal malignancy is usually symptomatic due to its location, and most of the time presents with pain and bleeding due to its growth and ulceration. It is difficult to identify the primary as carcinoma or lymphoma based on symptoms only, as both have a similar presentation. As it presents the rarest form of histology, non-Hodgkin's lymphoma in the rectum is still difficult to diagnose initially, and its treatment is debatable. We describe the case of a 49-year-old male from Bangladesh with the same presentation. His treatment was delayed for more than a month as immunohistochemistry and staging delayed the final diagnosis. The disease was diagnosed as stage IE with the help of a positron emission tomography (PET)-CT scan, and due to the local progression the patient had a massive rectal bleeding that needed an urgent intervention. Radiotherapy was applied to stop the bleeding. Hypofraction followed by a conventional fraction of external beam radiotherapy (EBRT) with a total of 40 Gy was applied. Post-EBRT digital rectal examination showed no residual except scaring, and a PET scan was also negative for residual disease. Due to uncertainties and lack of any precious guideline, 6 cycles of adjuvant chemotherapy with the R-CHOP schedule were also completed. Without surgery, the combination of EBRT and chemotherapy helped to preserve the organ, and the patient has been disease free for more than 2.5 years since his treatment.
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Affiliation(s)
- Md Arifur Rahman
- Department of Oncology, Bangladesh Specialized Hospital, Dhaka, Bangladesh
| | - Qamruzzaman Chowdhury
- Department of Radiation Oncology, Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh
| | - Ferdous Ara Begum
- Department of Oncology, Bangladesh Specialized Hospital, Dhaka, Bangladesh
| | | | - Saequa Habib
- Department of Histopathology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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KAYA T, DEMİRLİ ATICI S, ÇALIK B, GUL G. A Cause of Rectal Mass: Diffuse Large B-Cell Lymphoma. DÜZCE TIP FAKÜLTESI DERGISI 2020. [DOI: 10.18678/dtfd.687478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Rastogi K, Jain S, Sharma S, Jindal A. Primary Rectal Lymphoma with Synchronous Liver Involvement: An Extremely Rare Case Report. Indian J Med Paediatr Oncol 2020. [DOI: 10.4103/ijmpo.ijmpo_103_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractBoth primary rectal lymphoma (PRL) and primary hepatic lymphoma are rare entities, concomitant NHL in rectum and liver is an extremely rare coincidence. Cases of primary colonic lymphoma however can be found in literature. We report an extremely rare case of PRL with synchronous liver involvement after obtaining written informed consent, with a review of available literature. The case was provisionally diagnosed to be an adenocarcinoma of rectum with liver metastasis, with final confirmation on immunohistochemistry. PRL with synchronous liver involvement is an extremely rare coincidence. It is usually confused with more common adenocarcinoma of rectum with liver metastasis posing diagnostic challenges. The optimal management of PRL has never been validated through randomized trials. The treatment options include chemotherapy, radiation, surgical treatment, or a combination of these. Chemotherapeutic agents of choice are the cyclophosphamide, doxorubicin, vincristine, and prednisone regimen, with or without monoclonal antibody rituximab.
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Affiliation(s)
- Kartick Rastogi
- Department of Radiotherapy, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
| | - Sandeep Jain
- Department of Radiotherapy, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
| | - Shantanu Sharma
- Department of Radiotherapy, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
| | - Arpita Jindal
- Department of Pathology, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
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Rao P, Kaniyarakkal P, Kamalesh NP, Prasanna BK, Kulshrestha K, Deepak GT, Ponnambathayil S, Iype S. Starry Rectum: a Rare Case of Adult Primary Rectal Burkitt’s Lymphoma in the Setting of Crohn’s Disease with Literature Review. Indian J Surg 2019. [DOI: 10.1007/s12262-019-01868-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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8
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Saad-Hossne R, De Sibia CDF, Baima JP, Sassaki LY. Non-Hodgkin's Lymphoma: An Important Differential Diagnosis in Inflammatory Bowel Disease. Chin Med J (Engl) 2018; 131:1377-1378. [PMID: 29786058 PMCID: PMC5987516 DOI: 10.4103/0366-6999.232794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Rogerio Saad-Hossne
- Department of Surgery, Division of Coloproctology, Botucatu Medical School, Sao Paulo State University-UNESP, Botucatu, SP 18618-687, Brazil
| | - Carina De Fatima De Sibia
- Department of Surgery, Division of Coloproctology, Botucatu Medical School, Sao Paulo State University-UNESP, Botucatu, SP 18618-687, Brazil
| | - Julio Pinheiro Baima
- Department of Internal Medicine (Gastroenterology), Botucatu Medical School, Sao Paulo State University-UNESP, Botucatu, SP 18618-687, Brazil
| | - Ligia Yukie Sassaki
- Department of Internal Medicine (Gastroenterology), Botucatu Medical School, Sao Paulo State University-UNESP, Botucatu, SP 18618-687, Brazil
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Jeong JH, Kim S, Kim JE, Yoon DH, Lee SW, Huh J, Suh C. Clinical characteristics, treatment, and outcome of primary rectal lymphoma: a single center experience of 16 patients. Blood Res 2017; 52:125-129. [PMID: 28698849 PMCID: PMC5503890 DOI: 10.5045/br.2017.52.2.125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/09/2017] [Accepted: 04/18/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The rectum is a relatively uncommon site for lymphoma compared with other gastrointestinal sites; no consensus regarding management of primary rectal lymphoma (PRL) has been formed due to its limited frequency. We aimed to investigate clinical characteristics and treatment outcomes in patients with PRL in a single center patient cohort. METHODS We retrospectively analyzed the results of 16 consecutive patients with PRL, identified and treated at the Asan Medical Center, Seoul, Korea between January 1993 and December 2014. RESULTS These 16 patients with PRL constituted 0.8% of all non-Hodgkin's lymphoma patients (N=1,984). B-cell lymphomas (N=14) made up the majority of the series, and half of these were extranodal marginal zone lymphomas (ENMZL, N=7). Ten patients received systemic chemotherapy with (N=3) or without rituximab (N=7), and 4 of these received additional local therapy. The others received radiotherapy (N=3) or endoscopic mucosal resection (N=3). Twelve patients (75%) achieved complete response (CR) after first-line treatment. Event-free survival (EFS) and overall survival (OS) in stages IE and IIE were significantly longer compared with stages IVE (P=0.001 and P=0.001, respectively). All patients with ENMZL (N=7) achieved CR during or after initial treatment. CONCLUSION PRL is very rare and seems to present mostly as B-cell type. Stage is the most important prognostic factor, with significantly better survival associated with localized diseases. ENMZL may be one of the most common types of PRL with favorable treatment outcomes.
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Affiliation(s)
- Jae Ho Jeong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Shin Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Eun Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Wook Lee
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jooryung Huh
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Cheolwon Suh
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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10
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Sudworth O, Hameed A. Delayed diagnosis of a high-grade B-cell non-Hodgkin's lymphoma presenting as an obstructing rectal mass. BMJ Case Rep 2015; 2015:bcr-2015-213146. [PMID: 26698207 DOI: 10.1136/bcr-2015-213146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This case describes a 54-year-old man who presented to the surgical triage unit and was found to have a rare underlying rectal lymphoma. The patient had previously sought medical advice on multiple occasions, reporting a chronic inability to open his bowels. This case report aims to highlight the importance of thorough history taking and examination, in order to reduce delaying the diagnosis of significant pathology.
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11
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Jiang C, Gu L, Luo M, Xu Q, Zhou H. Primary rectal lymphoma: A case report and literature review. Oncol Lett 2015; 10:43-44. [PMID: 26170974 DOI: 10.3892/ol.2015.3164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 02/19/2015] [Indexed: 11/06/2022] Open
Abstract
One-third of non-Hodgkin's lymphoma cases are extranodal lymphomas. The gastrointestinal tract is the most common of the extranodal sites. The incidence of primary rectal lymphoma in the gastrointestinal tract is very rare, and its clinical presentation is difficult to distinguish from that of rectal carcinoma. In the treatment of primary rectal lymphomas, surgery options have been controversial. Considering this, we report a case of primary rectal lymphoma (diffuse large B-cell lymphoma) which disappeared completely following cyclophosphamide, hydroxydaunomycin, oncovin and prednisolone chemotherapy. This case demonstrates that systemic chemotherapy may be successful for the primary treatment of rectal lymphoma.
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Affiliation(s)
- Chunhui Jiang
- Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Pudong, Shanghai 200001, P.R. China
| | - Lei Gu
- Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Pudong, Shanghai 200001, P.R. China
| | - Meng Luo
- Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Pudong, Shanghai 200001, P.R. China
| | - Qing Xu
- Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Pudong, Shanghai 200001, P.R. China
| | - Hong Zhou
- Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Pudong, Shanghai 200001, P.R. China
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12
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Peng JX, Wang LZ, Tan ZJ, Zhong XS, Huang YX, Diao JF, He JM. Concomitant non-Hodgkin's lymphoma in colon and liver: report of a rare case and review of literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:3257-3261. [PMID: 26045849 PMCID: PMC4440158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 02/22/2015] [Indexed: 06/04/2023]
Abstract
A 58-year-old male patient was admitted with right upper abdominal pain. Initial hematologic evaluation revealed mildly elevated serum carcinoembryonic antigen and carbohydrate antigen (CA) 19-9 tests, while an abdominal CT-scan showed a circumferential mass along the distal ascending colon and the right flexure of colon, simultaneously a liver lesion in segment 8 is considered metastases from colorectal. colonoscopic examination revealed a circumferential growth tumor in the right flexure of colon and the colonoscopy can not reach the proximal of the tumor. We performed a right hemihepatoectomy and a right hemicolectomy associated with loco-regional lymphadenectomy. Histological examination showed diffuse large B-cell lymphomas in resected right colon as well as liver tumors. The patient received six courses of chemotherapy with CHOP-based regimens. At 14-month follow-up before this report, the patient is still alive and free of disease.
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Affiliation(s)
- Jian-Xin Peng
- Department of Hepatobiliary Surgery, Guangdong Province Traditional Chinese Medical HospitalGuangzhou 510120, People’s Republic of China
| | - Ling-Zhi Wang
- Department of Anesthesia, The Second Affiliated Hospital, Guangzhou Medical UniversityGuangzhou 510260, People’s Republic of China
| | - Zhi-Jian Tan
- Department of Hepatobiliary Surgery, Guangdong Province Traditional Chinese Medical HospitalGuangzhou 510120, People’s Republic of China
| | - Xiao-Sheng Zhong
- Department of Hepatobiliary Surgery, Guangdong Province Traditional Chinese Medical HospitalGuangzhou 510120, People’s Republic of China
| | - You-Xing Huang
- Department of Hepatobiliary Surgery, Guangdong Province Traditional Chinese Medical HospitalGuangzhou 510120, People’s Republic of China
| | - Jing-Fang Diao
- Department of Hepatobiliary Surgery, Guangdong Province Traditional Chinese Medical HospitalGuangzhou 510120, People’s Republic of China
| | - Jun-Ming He
- Department of Hepatobiliary Surgery, Guangdong Province Traditional Chinese Medical HospitalGuangzhou 510120, People’s Republic of China
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Abbott S, Nikolousis E, Badger I. Intestinal lymphoma--a review of the management of emergency presentations to the general surgeon. Int J Colorectal Dis 2015; 30:151-7. [PMID: 25374417 DOI: 10.1007/s00384-014-2061-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2014] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Intestinal non-Hodgkin's lymphoma (NHL) is uncommon but not rare. This paper aims to review the recent evidence for the management of perforated NHL of the intestine, consider when chemotherapy should be commenced and examine the likely outcomes and prognosis for patients presenting as surgical emergencies with this condition. METHODS MEDLINE and Cochrane databases were searched using intestinal lymphoma, clinical presentation, perforation, management and prognosis. The full text of relevant articles was retrieved and reference lists checked for additional articles. FINDINGS Emergency surgery was required at disease presentation for between 11 and 64% of intestinal NHL cases. Perforation occurs in 1-25% of cases, and also occurs whilst on chemotherapy for NHL. Intestinal bleeding occurs in 2-22% of cases. Obstruction occurs more commonly in small bowel (5-39%) than large bowel NHL and intussusceptions occur in up to 46%. Prognosis is generally poor, especially for T cell lymphomas. CONCLUSIONS There is a lack of quality evidence for the elective and emergency treatment of NHL involving the small and large intestine. There is a lack of information regarding the impact an emergency presentation has on the timing of postoperative chemotherapy and overall prognosis. It is proposed that in order to develop evidence-based treatment protocols, there should be an intestinal NHL registry.
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Affiliation(s)
- S Abbott
- Department of Colorectal Surgery, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, WV10 0QP, UK,
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14
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Tevlin R, Larkin JO, Hyland JMP, O'Connell PR, Winter DC. Primary colorectal lymphoma - A single centre experience. Surgeon 2014; 13:151-5. [PMID: 24694573 DOI: 10.1016/j.surge.2014.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/22/2013] [Accepted: 01/01/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE The incidence of primary colorectal lymphoma (PCL) is rare (0.2-0.6% of large bowel malignancy). Up to one third of Non-Hodgkin's lymphoma will present with extra-nodal manifestations only. Extra-nodal lymphomas arise from tissues other than the lymph nodes and even from sites, which contain no lymphoid tissue. The incidence of Non-Hodgkin's lymphoma has increased over the past fifty years. The objective of this study was to examine our experience of PCL. METHODS A prospectively-compiled database (1988-2012) of patients with colorectal cancer was retrospectively examined for cases of colorectal lymphoma. A retrospective chart review identified cases of PCL based on Dawson's criteria. Clinical information was obtained from case notes. RESULTS Eleven patients (0.3% of 4219 patients) were identified (6 male, 5 female). The median age at diagnosis was 63 years. Mode of presentation varied; abdominal pain, a palpable mass and per rectal bleeding being the most frequent. The caecum was the most frequently involved site (5/11). Nine patients underwent surgical management, one had chemotherapy alone and one had radiotherapy alone. All cases were non-Hodgkin's lymphoma, with diffuse large B-cell lymphoma in majority. The median event-free survival of those treated with surgery and post-operative chemotherapy was 10 months (range 5-120 months). CONCLUSION Primary colorectal lymphoma is rare. Management is multidisciplinary and dependent on the subtype of lymphoma. Due to the rarity of diagnosis, there is a paucity of randomised control trials. Most information published is based on individual case reports and there is, thus, no clear treatment algorithm for these cases.
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Affiliation(s)
- R Tevlin
- Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland
| | - J O Larkin
- Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland
| | - J M P Hyland
- Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland
| | - P R O'Connell
- Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland
| | - D C Winter
- Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland.
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15
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Rare tumors of the rectum. Narrative review. Cir Esp 2014; 92:579-88. [PMID: 24629769 DOI: 10.1016/j.ciresp.2013.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 05/23/2013] [Accepted: 06/02/2013] [Indexed: 02/06/2023]
Abstract
Most rectal neoplasms are adenocarcinomas, but there is a small percentage of tumors which are of other histological cell lines such as neuroendocrine tumors, sarcomas, lymphomas and squamous cell carcinomas, which have special characteristics and different treatments. We have reviewed these rare tumors of the rectum from a clinical and surgical point of view.
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16
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Khan A, Lloyd GM, Ihedioha U, Hemingway D. Rectovesical fistula secondary to B-cell lymphoma of the rectum: a unique presentation of a rare disease. Colorectal Dis 2012; 14:e358-9. [PMID: 22022922 DOI: 10.1111/j.1463-1318.2011.02868.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- A Khan
- Department of Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester, UK
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17
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Stanojevic GZ, Nestorovic MD, Brankovic BR, Stojanovic MP, Jovanovic MM, Radojkovic MD. Primary colorectal lymphoma: An overview. World J Gastrointest Oncol 2011; 3:14-8. [PMID: 21267399 PMCID: PMC3026053 DOI: 10.4251/wjgo.v3.i1.14] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 12/20/2010] [Accepted: 12/27/2010] [Indexed: 02/05/2023] Open
Abstract
Lymphomas represent common hematological malignancies with increasing incidence in recent years. The major site of extranodal non-Hodgkin lymphoma is the gastrointestinal tract. Involvement of the large intestine is rare in comparison to the stomach or small bowel. The disease appears later in life, predominantly in the male population. Complaints are nonspecific, requiring a high index of suspicion in order to establish the diagnosis. The treatment varies from chemotherapy alone to multimodal therapies combining surgery, chemotherapy and radiotherapy. The small number of patients with various histological subtypes and different stage at presentation results in unclear protocol for the treatment of primary colorectal lymphoma. The purpose of this paper is to review current data on primary lymphoma of the colon and rectum while analyzing reported case series and published material on the subject.
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Affiliation(s)
- Goran Z Stanojevic
- Goran Z Stanojevic, Milica D Nestorovic, Branko R Brankovic, Miroslav P Stojanovic, Milan M Jovanovic, Milan D Radojkovic, Clinic for General Surgery, Clinical Center Nis, Bul Zorana Djindjica 48, 18000 Nis, Serbia
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18
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Linfoma rectal primario: caso clínico y revisión de la literatura médica. Cir Esp 2010; 88:191-3. [DOI: 10.1016/j.ciresp.2009.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 10/06/2009] [Accepted: 10/10/2009] [Indexed: 12/11/2022]
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19
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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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20
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Abstract
The gastrointestinal (GI) tract contains the largest collection of lymphocytes anywhere in the body. GI lymphoma may arise at any site in the GI tract but typically involves the stomach and small bowel in cases of systemic disease. Most cases are non-Hodgkin B-cell type. Enteropathy-associated T cell lymphoma can complicate celiac disease. Less commonly, lymphoma may originate in the GI tract without systemic involvement. This sometimes occurs in response to chronic infections. This article discusses the role of imaging in detecting and staging GI tract lymphomas, using fluoroscopy and cross-sectional imaging, primarily CT.
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Affiliation(s)
- Marc J Gollub
- Weill Medical College of Cornell University, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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21
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Perspective on the Role of Transrectal and Transvaginal Sonography of Tumors of the Rectum and Anal Canal. AJR Am J Roentgenol 2008; 190:1495-504. [DOI: 10.2214/ajr.07.3188] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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22
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Cuffy M, Abir F, Longo WE. Management of Less Common Tumors of the Colon, Rectum, and Anus. Clin Colorectal Cancer 2006; 5:327-37. [PMID: 16512991 DOI: 10.3816/ccc.2006.n.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The majority of colorectal and anal malignancies are adenocarcinomas and squamous cell cancers, respectively. Despite the predominance of these neoplasms in these locations, rare histiotypes of the colon, rectum, and anus do occur. These histotypes include but are not limited to lymphoma, melanoma, diffuse cavernous hemangioma, and sarcomas, such as leiomyosarcoma or Kaposi's sarcoma. These tumors often present challenges to clinicians with respect to diagnosis, staging, management, and pathology because of their unfamiliarity. A Medline search using "colon," "rectum,""anus," "lymphoma," "melanoma," "diffuse cavernous hemangioma," "squamous cell carcinoma," "carcinoid," "sarcoma," "leiomyosarcoma," "Kaposi's sarcoma," "Paget's disease," "Bowen's disease," and "basal cell carcinoma" as key words was performed as well as a cross-referencing of the bibliography cited in each work. Rare tumors of the colon, rectum, and anus present diagnostic and management dilemmas for clinicians. Because of their infrequency and poor prognosis, the optimal management of these tumors is controversial. For some histotypes, such as squamous cell carcinoma and carcinoids of the rectum, treatment depends on location and size of the tumor. For uncommon anal lesions, such as Bowen's disease, Paget's disease, and basal cell carcinoma, wide local excision (WLE) with negative margins is the standard of care. For other lesions such as anorectal melanoma or leiomyosarcoma, abdominal perineal resection versus WLE is still being debated. Because the optimal treatment of these tumors is still unclear, we recommend a multidisciplinary approach including a surgeon, primary care physician, medical oncologist, radiation oncologist, and pathologist to offer the patient the best outcome.
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Affiliation(s)
- Madison Cuffy
- Yale University School of Medicine, Department of Surgery, New Haven, CT 06520-8062, USA
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