Non-Hodgkin's lymphomas with primary localization in large bowel and rectum

Area of Science:

• Oncology
• Gastroenterology
• Hematology

Background:

• Primary non-Hodgkin lymphoma (NHL) of the large bowel and rectum is rare.
• Literature suggests a poor prognosis for these malignancies.

Observation:

• Seven patients with primary colorectal NHL were treated between 1989 and present.
• Diagnostic procedures varied, with some patients undergoing immediate laparotomy.
• Histological subtypes included centroblastic, lymphoplasmocytic, Burkitt, Burkitt-like, and diffuse centrocytic.

Findings:

• Five patients had localized disease in the cecum/ascending colon, one in the transverse colon, and one in the rectum.
• Two patients with rectal/transverse colon NHL achieved long-term disease-free survival with surgery alone.
• Two patients with cecum/ascending colon NHL and Burkitt/Burkitt-like histology experienced early mortality due to advanced disease.
• Three patients with stage II disease underwent chemotherapy with the ProMACE regimen, achieving complete responses lasting over 36 months.
• Median survival in the observed group was 41+ months, exceeding previously reported outcomes.

Implications:

• Primary colorectal NHL may have a better prognosis than previously suggested.
• Treatment strategies involving surgery and chemotherapy can lead to long-term survival.
• Disease stage and topographic localization appear to be critical prognostic factors.