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Primary colonic lymphoma.

N Doolabh¹, T Anthony, C Simmang

¹Department of Surgery, University of Texas Southwestern Medical School, Dallas, Texas 75235, USA.

Journal of Surgical Oncology

|August 30, 2000

Summary

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Primary colonic lymphoma (PCL) is rare, often presenting with non-specific abdominal pain and delayed diagnosis. Immunosuppression is a key risk factor, with surgery as the primary treatment.

Area of Science:

Gastroenterology
Oncology
Hematology

Background:

Gastrointestinal non-Hodgkin's lymphoma (NHL) is uncommon in the colon.
Primary colonic lymphoma (PCL) represents a small fraction of all NHL and colonic malignancies.

Purpose of the Study:

To identify risk factors, clinical presentation, treatment strategies, and prognosis of primary colonic lymphoma (PCL).
To analyze the experience with PCL at a large tertiary care hospital system.

Main Methods:

Retrospective review of patients diagnosed with colonic malignancy and NHL between January 1989 and December 1998.
Inclusion criteria: disease confined to the colon, no extraperitoneal disease, and no leukemic/lymphomatous blood abnormalities.

Main Results:

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Seven patients (4 male, 3 female) met criteria, representing 1.4% of all NHL and 14% of GI NHL.
Common presentation: non-specific abdominal pain, leading to diagnostic delays (1-12 months). Immunosuppression (HIV, steroids) noted in 4 patients.
Cecum was the most common site (71%). All were B-cell lymphomas. Surgery was primary treatment; adjuvant chemotherapy was given to 6/7 patients. Four of six followed patients survived.

Conclusions:

PCL is a rare entity, with immunosuppression as a significant risk factor.
Non-specific symptoms contribute to delayed diagnosis; cecal location is frequent.
Surgery is standard, but the impact of adjuvant therapy on survival remains uncertain.