Title: Primary NHL (Non Hodgkin Lymphoma) Colon: A Rare Case Presentation
Authors: Dr Kapil Mohan Pal, Dr Shabnum Thakur, Dr Anup Negi, Dr Lalit Chandrakant, Dr Manju Rao, Dr Shivani Sharma, Dr Manish Gupta
DOI: https://dx.doi.org/10.18535/jmscr/v8i7.90
Abstract
The incidence of primary lymphoma of colon is only 0.2-1.2 % of all colonic malignancies. Non-Hodgkin’s lymphoma (NHL) is the the most common among primary colonic lymphoma. The gastrointestinal (GI) tract accounting for 30-40% of all extra nodal lymphomas and approximately 4-20% of which are NHL. Most common site for GI lymphoma is stomach followed by the small intestine. The treatment depends upon the stage of the disease. Early stage disease can be managed by radical tumor resection (hemicolectomy) plus multi-agent chemotherapy (polychemotherapy). Advanced stage can be managed by biopsy plus multidrug chemotherapy. Surgery alone can be considered as an adequate treatment for patients with low-grade NHL disease that does not infiltrate beyond the sub-mucosa. Here, we have described a case, who presented with acute intestinal intussusception and vomiting in emergency, later on we found an intraluminal growth in ascending colon and on detailed histopathological examination (HPE) confirms that it was an NHL (diffuse large B-cell type).
Keywords: Non –Hodgkin lymphoma, chemotherapy, hemicolectomy.
References
- World Cancer Research Fund International, http://www.wcrf.org/cancer_statistics/world_cancer_statistics.php
- Wong MT, Eu KW. Primary colorectal lymphomas. Colorectal Dis 2006;8:586-91.
- Bairey O, Ruchlemer R, Shpilberg O. Non-Hodgkin’s lymphomas of the colon. Isr Med Assoc J 2006;8:832-5.
- Zinzani PL, Magagnoli M, Pagliani G, Bendandi M, Gherlinzoni F, Merla E, et al. Primary intestinal lymphoma: Clinical and therapeutic features of 32 patients. Haematologica1997;82:305-8.
- Doolabh N, Anthony T, Simmang C, Bieligk S, Lee E, Huber P, et al. Primary colonic lymphoma. J Surg Oncol 2000;74:257-62.
- Doolabh N, Anthony T, Simmang C, Bieligk S, Lee E, Huber P, et al. Primary colonic lymphoma. J SurgOncol. 2000; 74:257–62.
- Gonzalez QH, Heslin MJ, Davila-Cervantes A, Alvarez –Tostado J, de los Monteros AE, Shore G, et al. Primary colonic lymphoma. Am Surg. 2008; 74:214–6.
- Eser B, Kaplan B, Unal A, Canoz O, Altuntas F, Sari HI, et al. Clinicopathologic characteristics and therapeutic outcomes of primary gastroint-estinal non-Hodgkin’s lymphomas in central anatolia, in Turkey. Yonsei Med J 2006;47:22-33.
- Fatin M. Al-Sayes. Gastrointestinal Non-Hodgkin’s lymphoma: A clinico- pathological study. The Saudi journal of gastroenterology 2006 12(3):118-122.
- Lewis, J.D., Bilker, W.B., Brensinger, C. et al., 2001. Inflammatory Bowel Diseases Not associated with an increased. Risk of lymphoma Gastroenterology; 121:1080–1087.
- Lewis, J.D., Deren, J.J., Li chtensteen, G.R., 1999. Cancer risk in patients with inflammatory bowel disease. Gastroentero-logy Clin. North Am., 28:459–477.
- Tondini C, Giardini R, Bozzetti F, Valagussa P, Santoro A, Bertulli R, et al. Combined modality treatment for primary gastrointestinal non- Hodgkin's lymphoma: The Milan cancer Institute experience. Ann Oncol.1993; 4:831–7.