Primary multifocal non-Hodgkin lymphoma of the colon successfully treated with chemotherapy - 23/08/11
Doi : 10.1016/j.gie.2008.04.002
| Commentary It is not unusual when doing screening colonoscopy in an asymptomatic person that we encounter polyps. The surprise here was that the polyps were shown to be lymphoma. Of all the scenarios imaginable for this patient, however, I consider her lucky to have had the procedure. In adults, only 10% to 20% of primary GI lymphomas occur in the colon, and most present at advanced stages with GI symptoms. Almost all primary colorectal lymphomas are of B-cell lineage in Western countries, whereas primary colorectal T-cell lymphomas are more common in the East. B-cell lymphomas present in older people than do T-cell lymphomas, and with abdominal pain and a fungating mass, perhaps with intussusception. T-cell lymphomas manifest hematochezia and ulcero-infiltrative lesions, perhaps with perforation, and with a worse prognosis. Lymphomatous polyposis comprises follicular cell and mantle cell lymphoma. Follicular lymphoma represents about 20% to 25% of non-Hodgkin lymphomas in the United States and Europe, and is the most frequent type of indolent lymphoma. It usually presents with superficial lymph node enlargement and no systemic manifestations, but can arise in the GI tract, usually the duodenum or small intestine. A colon presentation is rare, but the appearance as polypoid lesions is not uncommon. In the colon, the ileocecal region and cecum are the most frequently involved. Details aside, continue to advocate for routine colorectal cancer screening, but if you hear the hoof beats of polyps, place your bet on an adenomatous/hyperplastic horse and not a lymphomatous zebra. Lawrence J. Brandt, MD Associate Editor for Focal Points |
© 2008
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 68 - N° 5
P. 1005-1006 - novembre 2008 Retour au numéro
Article précédent
- Peutz-Jeghers syndrome: are “shaggy” villi part of the pathology?
- Richard J. Noel, Steven L. Werlin
- The “cecal patch” in patients with ulcerative colitis
- Kleanthis Dendrinos, Sandra Cerda, Francis A. Farraye
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?