Abstract
Background: The gastrointestinal tract is the most common site of extranodal involvement in non-Hodgkin's lymphoma (NHL). Primary colorectal NHL comprises 13–18% of all gastrointestinal NHL but is not commonly reported as a separate entity.
Methods: This was a retrospective review of the medical records of 19 patients over a 16-year period to evaluate the clinical features and behavior of colorectal NHL.
Results: A pediatric group of seven male patients presented at an early stage with acute symptomatology. The primary tumor was located in the ileocecum in all cases and intussusception was common. An adult group of 12 patients presented at a later stage with chronic symptomatology. Staging study results were positive by bone marrow biopsy in four of 16 patients (25%), by lymphangiography in six of 11 patients (54.5%), and by gallium scan in eight of 10 patients (80%). Seven patients relapsed a median of 8 months after treatment. Three other patients died during treatment, one died of other causes, and one died without receiving treatment. The remaining seven patients are alive from 41 to 231 months without evidence of disease. Five of these patients are in the pediatric group, where the median survival was >72 months. The overall median survival was 45 months.
Conclusion: Colorectal NHL is a disease that affects both the pediatric and adult population. Although pediatric patients have an excellent prognosis with anticipated long-term survival after treatment, long-term survival can be expected in ∼50% of adult patients. In both groups of patients, multimodality therapy with surgery, chemotherapy, and radiation is the treatment of choice.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Weingrad DN, DeCosse JJ, Sherlock P, Straus D, Lieberman PH, Filippa DA. Primary gastrointestinal lymphoma: a 30 year review.Cancer 1982;46:1258–65.
Herrmann R, Panahon AM, Barcos MP, Walsh D, Stutzman L. Gastrointestinal involvement in non-Hodgkin's lymphoma.Cancer 1980;46:215–22.
Franssila KO, Heiskala MK, Rapola J. Non-Hodgkin's lymphoma in childhood: a clinicopathologic and epidemiologic study in Finland.Cancer 1987;59:1837–46.
Fleming ID, Turk PS, Murphy SB, Crist WM, Santana VM, Rao BN. Surgical implications of primary gastrointestinal lymphoma of childhood.Arch Surg 1990;125:252–6.
Lewin KJ, Ranchod M, Dorfman RF. Lymphomas of the gastrointestinal tract: a study of 117 patients presenting with gastrointestinal disease.Cancer 1978;42:693–707.
The Non-Hodgkin's Lymphoma Pathologic Classification Project. National Cancer Institute sponsored study of classifications of non-Hodgkin's lymphoma: summary and description of a working formulation for clinical usage.Cancer 1982;49:2112–35.
Carbone PP, Kaplan HS, Musshoff K, Smithers IW, Tubiana M. Report of the Hodgkin's disease staging classification committee. Conference on staging in Hodgkin's disease.Cancer Res 1971;31:1860–1.
Musshoff K. Kleinsche stadieneinteilung der Nicht-Hodgkin-Lymphome.Strahlentherapie 1977;153:218–21.
Contreary K, Nance FC, Becker WF. Primary lymphoma of the gastrointestinal tract.Ann Surg 1980;191:593–8.
Novak S, Caraveo J, Trowbridge AA, Peterson RF, White RR. Primary lymphomas of the gastrointestinal tract.South Med J 1979;72:1154–8.
Auger MJ, Allan NC. Primary ileocecal lymphoma: a study of 22 patients.Cancer 1990;65:358–61.
Hwang W-S, Yao JCT, Cheng S-S, Tseng H-H. Primary colorectal lymphoma in Taiwan.Cancer 1992;70:575–80.
Sweetenham JW, Mead GM, Wright DH, et al. Involvement of the ileocecal region by non-Hodgkin's lymphoma in adults: clinical features and results of treatment.Br J Cancer 1989;60:366–9.
Glick DD, Soule EH. Primary malignant lymphoma of colon or appendix: report of 27 cases.Arch Surg 1966;92:144–51.
Jinnai D, Iwasa Z, Watanuki T. Malignant lymphoma of the large intestine: operative results in Japan.Jpn J Surg 1983;13:331–6.
Dawson IMP, Cornes JS, Morson BC. Primary malignant lymphoid tumours of the intestinal tract: report of 37 cases with a study of factors influencing prognosis.Br J Surg 1961;49:80–9.
Dragosics B, Bauer P, Radaszkiewicz T. Primary gastrointestinal non-Hodgkin's lymphomas: a retrospective clinicopathologic study of 150 cases.Cancer 1985;55:1060–73.
Jenkin RDT, Sonley MJ, Stephens CA, Darte JMM, Peters MV. Primary gastrointestinal tract lymphoma in childhood.Radiology 1969;92:763–7.
Rao AR, Kagan AR, Potyk D, et al. Management of gastro-intestinal lymphoma.Am J Clin Oncol 1984;7:213–9.
Shepherd NA, Hall PA, Coates PJ, Levison DA. Primary malignant lymphoma of the colon and rectum. A histopathological and immunohistochemical analysis of 45 cases with clinicopathological correlations.Histopathology 1988;12:235–52.
Nelson DF, Cassady JR, Traggis D, et al. The role of radiation therapy in localized resectable intestinal non-Hodgkin's lymphoma in children.Cancer 1977;39:89–97.
Hande KR, Fisher RI, DeVita VT, Chabner BA, Young RC. Diffuse histiocytic lymphoma involving the gastrointestinal tract.Cancer 1978;41:1984–9.
DeVine RM, Beart RW, Wolff BG. Malignant lymphoma of the rectum.Dis Colon Rectum 1986;29:821–4.
Salles G, Herbrecht R, Tilly H, et al. Aggressive primary gastrointestinal lymphomas: review of 91 patients treated with the LNH-84 regimen. A study of the Groupe d'Etude des Lymphomes Agressifs.Am J Med 1991;90:77–84.
Herndier BG, Friedman SL. Neoplasms of the gastrointestinal tract and hepatobiliary system in acquired immunodeficiency syndrome.Semin Liver Dis 1992:12:128–41.
Danzig JB, Brandt LJ, Reinus JF, Klein RS. Gastrointestinal malignancy in patients with AIDS.Am J Gastroenterol 1991;86:715–8.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Busch, E., Rodriguez-Bigas, M., Mamounas, E. et al. Primary colorectal non-Hodgkin's lymphoma. Annals of Surgical Oncology 1, 222–228 (1994). https://doi.org/10.1007/BF02303527
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02303527