Primary colorectal lymphoma – A single centre experience

• Published in: The surgeon (Edinburgh) 2015-06, Vol.13 (3), p.151-155
• Main Authors: Tevlin, R, Larkin, J.O, Hyland, J.M.P, O'Connell, P.R, Winter, D.C
• Format: Article
• Language: English
• Subjects: Adult; Aged; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - therapy; Female; Humans; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - therapy; Lymphoma, Non-Hodgkin - diagnosis; Lymphoma, Non-Hodgkin - therapy; Male; Middle Aged; Retrospective Studies; Surgery
• ISSN: 1479-666X
• DOI: 10.1016/j.surge.2014.01.002

Abstract Purpose The incidence of primary colorectal lymphoma (PCL) is rare (0.2–0.6% of large bowel malignancy). Up to one third of Non-Hodgkin's lymphoma will present with extra-nodal manifestations only. Extra-nodal lymphomas arise from tissues other than the lymph nodes and even from sites, which contain no lymphoid tissue. The incidence of Non-Hodgkin's lymphoma has increased over the past fifty years. The objective of this study was to examine our experience of PCL. Methods A prospectively-compiled database (1988–2012) of patients with colorectal cancer was retrospectively examined for cases of colorectal lymphoma. A retrospective chart review identified cases of PCL based on Dawson's criteria. Clinical information was obtained from case notes. Results Eleven patients (0.3% of 4219 patients) were identified (6 male, 5 female). The median age at diagnosis was 63 years. Mode of presentation varied; abdominal pain, a palpable mass and per rectal bleeding being the most frequent. The caecum was the most frequently involved site (5/11). Nine patients underwent surgical management, one had chemotherapy alone and one had radiotherapy alone. All cases were non-Hodgkin's lymphoma, with diffuse large B-cell lymphoma in majority. The median event-free survival of those treated with surgery and post-operative chemotherapy was 10 months (range 5–120 months). Conclusion Primary colorectal lymphoma is rare. Management is multidisciplinary and dependent on the subtype of lymphoma. Due to the rarity of diagnosis, there is a paucity of randomised control trials. Most information published is based on individual case reports and there is, thus, no clear treatment algorithm for these cases.