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Colonic Lymphoma

Lymphoma of the Colon


Presentation

  • This study was undertaken to identify risk factors, presentation, treatment, and prognosis for primary colonic lymphoma (PCL) through review of a large tertiary care hospital system experience.[ncbi.nlm.nih.gov]
Inguinal Hernia
  • The patient also complained of constipation, fatigue, weight loss and melena.The patient’s history included repaired right sided inguinal hernia, pulmonary fibrosis, hypertension and angina pectoris which was treated using coronary stents 5 months ago[bmcsurg.biomedcentral.com]
Palpable Spleen
  • Physical exam was significant for a palpable spleen that extended below the level of the umbilicus. There was no palpable peripheral lymphadenopathy.[omicsonline.org]
Nasal Discharge
  • Typically, nasal/paranasal disease presents with nasal congestion, fever, purulent/bloody nasal discharge and headache[ 22 ].Systemic symptoms such as fever, weight loss and anaemia may be present.[npplweb.com]
Nasal Congestion
  • Only when the histology suggested a nasal-type tumour and when a previous history of nasal congestion was elicited, did the patient undergo internal examination of the nasal area.[npplweb.com]
Abdominal Pain
  • Patients' frequently present with non-specific abdominal pain, this leads to lengthy delays in diagnosis. Most of these tumors are located in the cecal area. Surgery is the most widely utilized form of therapy.[ncbi.nlm.nih.gov]
  • Colonic Lymphoma Nodular, ulcerated, constricting neoplasm found in the proximal ascending colon of an 83 year-old woman who had presented with weight loss, abdominal pain and blood in the stool.[endoatlas.com]
  • A colonic lymphoma presents with non-specific abdominal pain, weight loss, a change in bowel habits, bleeding, intestinal obstruction, intussusception and a palpable mass.[e-ce.org]
Chronic Abdominal Pain
  • CASE REPORT A 65-year-old Caucasian male with a history of hepatitis C virus (HCV) infection, chronic kidney disease, hypertension, on anticoagulation presented to his primary care physician with chronic abdominal pain.[edoriumjournals.com]
Abdominal Tenderness
  • Vital signs were normal and physical examination was unremarkable, with no peripheral lymphadenopathy, abdominal tenderness, or hepatosplenomegaly. Laboratory testing was notable for thrombocytopenia with platelets 122,000/uL and AST 51 U/L.[acgcasereports.gi.org]
Lower Abdominal Pain
  • Figure 1 Multifocal irregular ulcers distributed transversely in the ascending colon, with diameters ranging from 0.6 cm to 1.5 cm Two months later, however, the patient complained of repeated fever, bloody diarrhea and right lower abdominal pain.[cjcr.amegroups.com]

Workup

  • These previous reports described inflammatory mucosal changes typical of ulcerative colitis as being present in superficial biopsies, leading to the initial diagnosis of ulcerative colitis ; however, further workup resulted in a diagnosis of primary colonic[journals.lww.com]
  • Serum carcinoembryonic antigen and carbohydrate antigen 19-9 values were not measured during his initial workup.[edoriumjournals.com]
  • The workup for Mantle cell lymphoma is similar to the workup for many indolent lymphomas and certain aggressive lymphomas.[en.wikipedia.org]
  • Although a variety of laboratory and imaging studies are used in the evaluation and staging of suspected NHL (see Workup ), a well-processed hematoxylin and eosin (H&E)–stained section of an excised lymph node is the mainstay of pathologic diagnosis.[emedicine.medscape.com]
Right Pleural Effusion
  • We report a case of primary colonic non-Hodgkin's lymphoma with peritoneal carcinomatosis and a right pleural effusion.[e-ce.org]
Normal Chest X-Ray
  • DISCUSSION To distinguish between primary and secondary gastrointestinal lymphoma, the definition of primary gastrointestinal lymphoma 5 ) is quite applicable, which consists of no palpable superficial lymphadenopathy at presentation, a normal chest X-ray[kjim.org]

Treatment

  • BACKGROUND: Surgical resection is considered a crucial treatment in patients with primary colonic lymphoma, but combining surgery with chemotherapy has provided additional therapeutic benefits in some studies.[ncbi.nlm.nih.gov]
  • In combination with other treatment measures, these can help combat the symptoms of immunodeficiency Undertaking treatment of underlying conditions/disorders, as warranted If lymphoma of the large intestine is not fully responsive to treatment, or if[dovemed.com]
  • Treatment protocols for gastric MALT lymphoma are well established but are less clear for colonic MALT lymphoma owing to its rarity.[ekjm.org]

Prognosis

  • Nevertheless, resection followed by chemotherapy appears to offer the best prognosis.[ncbi.nlm.nih.gov]
  • Report of 37 cases with a study of factors influencing prognosis. Br J Surg 1961;49:80-9. 7. G Stanojević, M Stojanović, M Jovanović. [Primary colorectal lymphomas]. Vojnosanit Pregl 2009;66:295-301. [Article in Serbian]. 8.[pagepress.org]

Etiology

  • The underlying etiology is unknown but an infective/inflammatory pathogenesis is suspected as their is higher incidence in patients with HIV/AIDS , inflammatory bowel disease and post-transplantation immunosuppression 1 .[radiopaedia.org]
  • However, the results did not differentiate an infectious versus neoplastic etiology of the perforation.[edoriumjournals.com]
  • (Etiology) Lymphocytes are a type of white blood cells that are responsible for providing immunity in the human body. B-cells and T-cells are the two different types of lymphocytes.[dovemed.com]
  • The etiology of DLBCL is unknown, but some risk factors and predisposing conditions have been identified such as immunodeficienty and inflammatory bowel diseases [ 3 ].[bmcsurg.biomedcentral.com]
  • Any of the following may play a role in the etiology of non-Hodgkin lymphoma (NHL) in a particular patient: Genetic abnormalities Environmental factors Viral infections Immunodeficiency states Connective-tissue disorders Chromosomal translocations and[emedicine.medscape.com]

Epidemiology

  • […] non-Hodgkin lymphoma over a 10-year period in one study. 8 Sites of tumor growth have been reported to be the cecum (71.5%), rectum (16.9%), and ascending colon (6.2%); the sigmoid colon is only rarely affected. 9 HCV has been linked to MALT lymphoma by epidemiological[acgcasereports.gi.org]
  • The relationship between abdominal pain regions and specific diseases: An epidemiologic approach to clinical practice. J Epidemiol 1997 Mar;7(1):27–32. [ Pubmed ] Locker GY, Hamilton S, Harris J, et al.[edoriumjournals.com]
  • National Cancer Institute: Surveillance, Epidemiology, and End Results Program. Available at . Accessed: October 18, 2017. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al.[emedicine.medscape.com]
  • Surveillance Epidemiology and End Results (SEER). Bethesda, MD: National Cancer Institute. Archived from the original on 26 September 2009. Retrieved 3 November 2009. Table 1.4: Age-Adjusted SEER Incidence and U.S.[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • "Clinical categories of exaggerated skin reactions to mosquito bites and their pathophysiology". Journal of Dermatological Science. 82 (3): 145–52. doi : 10.1016/j.jdermsci.2016.04.010. PMID 27177994.[en.wikipedia.org]
  • […] disease Primary effusion lymphoma Burkitt lymphoma B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and Burkitt lymphoma B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and classical Hodgkin lymphoma Pathophysiology[emedicine.medscape.com]

Prevention

  • Although resection plays an important role in the local control of the disease and in preventing bleeding and/or perforation, it rarely eradicates the lymphoma by itself.[gastrointestinalatlas.com]
  • How can Lymphoma of Colon and Rectum be Prevented? Currently, it is not possible to prevent Lymphoma of Colon and Rectum. However, controlling certain factors may help lower one’s risk for the condition.[dovemed.com]
  • […] and early detection of cervical cancer: American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer.[nccn.org]
  • Chemotherapy drugs are injected directly into the spinal fluid to prevent the cancer from spreading to the central nervous system. This method of injection is referred to as “intrathecal.”[healthline.com]

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