Large bowel lymphoma
Large bowel (colorectal) lymphoma is a very rare tumour, accounting for < 0.5% of primary colorectal malignancies, ~1.5% of all lymphomas, and ~15% of gastrointestinal lymphoma. Large bowel lymphoma differs from gastric and small bowel lymphoma in clinical presentation, management and prognosis.
Most commonly occurs in patients in their forties to sixties, with increasing incidence with age. There is a slight male predominance (M:F = 1.5:1) 2.
As with other colorectal tumours, primary symptoms are weight loss, pain and less commonly per rectal bleeding 2. Large bowel obstruction and perforation are rare.
Diffuse large B-cell lymphoma is the most common subtype (~65%) of large bowel lymphoma. The underlying aetiology 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.
The majority (~70%) of large bowel lymphomas occurs in the right colon 2.
Compared to colorectal adenocarcinoma, lymphoma affects longer and multiple colonic segments 4.
- overview of lymphoma
WHO classification of tumours of haematopoietic and lymphoid tissues
- Hodgkin lymphoma
mature B-cell lymphoma
- Burkitt lymphoma
- follicular lymphoma
- lymphoplasmacytic lymphoma (Waldenström's macroglobulinaemia)
- lymphomatoid granulomatosis
- mantle cell lymphoma
- mature T-cell and NK-cell lymphoma
- post-transplant lymphoproliferative/lymphoproliferation disorders
- mature B-cell lymphoma
- location-specific lymphomas
- central nervous system
- head and neck lymphoma
- thoracic lymphoma
- gastrointestinal lymphoma
- hepatobiliary lymphoma
- genitourinary lymphoma
- musculoskeletal lymphoma
- cutaneous lymphoma
- lymphoma staging
- 1. Stanojevic GZ, Nestorovic MD, Brankovic BR et-al. Primary colorectal lymphoma: An overview. World J Gastrointest Oncol. 2011;3 (1): 14-8. doi:10.4251/wjgo.v3.i1.14 - Free text at pubmed - Pubmed citation
- 2. Quayle FJ, Lowney JK. Colorectal lymphoma. Clin Colon Rectal Surg. 2006;19 (2): 49-53. doi:10.1055/s-2006-942344 - Free text at pubmed - Pubmed citation
- 3. Cho MJ, Ha CS, Allen PK et-al. Primary non-Hodgkin lymphoma of the large bowel. Radiology. 1997;205 (2): 535-9. doi:10.1148/radiology.205.2.9356641 - Pubmed citation
- 4. Lee WK, Lau EW, Duddalwar VA et-al. Abdominal manifestations of extranodal lymphoma: spectrum of imaging findings. AJR Am J Roentgenol. 2008;191 (1): 198-206. AJR Am J Roentgenol (full text) - doi:10.2214/AJR.07.3146 - Pubmed citation