Tevlin R, Larkin J O, Hyland J M P, O'Connell P R, Winter D C
Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland.
Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland.
Surgeon. 2015 Jun;13(3):151-5. doi: 10.1016/j.surge.2014.01.002. Epub 2014 Mar 30.
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.
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.
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).
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.
原发性结直肠淋巴瘤（PCL）的发病率很低（占大肠恶性肿瘤的0.2 - 0.6%）。高达三分之一的非霍奇金淋巴瘤仅表现为结外表现。结外淋巴瘤起源于淋巴结以外的组织，甚至起源于不含淋巴组织的部位。在过去五十年中，非霍奇金淋巴瘤的发病率有所上升。本研究的目的是探讨我们对PCL的诊治经验。
对一个前瞻性汇编的结直肠癌患者数据库（1988 - 2012年）进行回顾性研究，以查找结直肠淋巴瘤病例。通过回顾病历，根据道森标准确定PCL病例。从病例记录中获取临床信息。
共确定了11例患者（占4219例患者的0.3%）（6例男性，5例女性）。诊断时的中位年龄为63岁。临床表现各异；腹痛、可触及肿块和直肠出血最为常见。盲肠是最常受累的部位（5/11）。9例患者接受了手术治疗，1例仅接受化疗，1例仅接受放疗。所有病例均为非霍奇金淋巴瘤，大多数为弥漫性大B细胞淋巴瘤。接受手术及术后化疗患者的中位无事件生存期为10个月（范围5 - 120个月）。
原发性结直肠淋巴瘤很罕见。其治疗需要多学科协作，且取决于淋巴瘤的亚型。由于诊断罕见，随机对照试验较少。已发表的大多数信息基于个别病例报告，因此，对于这些病例尚无明确的治疗方案。
