Endoscopic manifestations of primary colorectal lymphoma.

BACKGROUND/AIMS: Little is known about the endoscopic manifestations of primary colorectal lymphoma. The study was designed to describe the features of colonoscopy and endoscopic ultrasonography of primary colorectal lymphoma.

METHODOLOGY

twenty-five patients with a definite diagnosis of primary colorectal lymphoma were recruited in this study. Their colonoscopic and endoscopic ultrasonography manifestations were retrospectively reviewed.

RESULTS

Based on colonoscopic features, primary colorectal lymphomas were classified into three subtypes: ulcerative type (n = 16, 64%), polypoid type (n = 4, 16%), and massive type (n = 5, 20%). Thirteen (92.9%) of the 14 patients with T-cell lymphomas presented as ulcerative lesions, and 3 (27.3%) of the 11 patients with B-cell lymphomas presented as ulcerative lesions (92.9% vs. 27.3%, p = 0.002). The initial diagnose accordance rate of colonoscopy was only 28% for primary colorectal lymphomas. The endosonography features of primary colorectal lymphomas included disappearance of normal colorectal layers, diffuse hypoechoic lesions instead, and thickening of intestinal wall.

CONCLUSIONS

Primary colorectal T-cell lymphoma presented as ulcerative lesions more frequently than B-cell lymphoma. It was difficult to differentiate primary colorectal lymphoma from other diseases merely based on colonoscopy. Endoscopic ultrasonography was useful in the diagnosis of primary colorectal lymphoma.