Large bowel (colorectal) lymphoma is a very rare tumor, 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 tumors, 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. With other less common types including mucosa-associated lymphoid tissue (MALT) lymphoma and mantle cell lymphoma (MCL) 5.
The underlying etiology is unknown but an infective/inflammatory pathogenesis is suspected as there 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, mostly characterized by circumferential wall thickening.
- 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
- 5. Colorectal Lymphoma. (2006) Clinics in Colon and Rectal Surgery. 19 (02): 049. doi:10.1055/s-2006-942344 - Pubmed
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