CT of primary colonic lymphoma

Area of Science:

• Radiology
• Gastroenterology
• Oncology

Background:

• Primary colorectal lymphoma is a rare malignancy.
• Accurate diagnosis is crucial for appropriate treatment and patient outcomes.

Purpose of the Study:

• To evaluate the computed tomography (CT) findings in patients with primary colorectal lymphoma.
• To assess the utility of CT in characterizing colorectal lymphomas and differentiating them from adenocarcinoma.

Main Methods:

• Retrospective analysis of CT scans from 15 patients with histopathologically confirmed primary colorectal lymphoma.
• Categorization of lymphomas based on CT appearance: discrete bulky masses, focal mural infiltration, or diffuse colonic invasion.

Main Results:

• CT findings were categorized into three patterns: discrete bulky masses (n=6), focal mural infiltration (n=5), and diffuse colonic invasion (n=5).
• Mass lesions showed greater mural invasion depth (4.3 cm) compared to infiltrative lesions (2.7 cm, P < .05) and tended to present earlier.
• Specific CT features, such as cecal tumors extending into the terminal ileum, well-demarcated lesions, and perforation without desmoplastic reaction, suggest lymphoma.

Conclusions:

• CT is invaluable for characterizing primary colorectal lymphomas, assessing tumor invasion, and spread.
• CT findings can help distinguish primary colonic lymphoma from adenocarcinoma, especially in cases of solitary mass lesions without adenopathy.
• Clinical history, including human immunodeficiency virus infection, should prompt consideration of colonic lymphoma.