T. Kishida et al., ENDOSCOPIC DIAGNOSIS OF LOWER INTESTINAL LESIONS OF LEUKEMIA AND MALIGNANT-LYMPHOMA, Journal of gastroenterology and hepatology, 13(9), 1998, pp. 961-967
There have been only a few endoscopic studies with respect to lower in
testinal lesions of leukaemia and malignant lymphoma, although there h
ave been many autopsy studies of these lesions. The aim of this study
was to clarify these lesions using endoscopy. Colonoscopy was performe
d on 11 of 341 patients with leukaemia and on 32 of 105 patients with
malignant lymphoma for frequent diarrhoea, anal bleeding or abnormal f
indings on barium enema examination, between April 1984 and September
1994. In eight of the 11 patients with leukaemia on whom endoscopy was
performed, nine lesions were found; aphthoid ulcers, small ulcers or
large tumours due to leukaemic infiltration were found in five, and co
lorectal adenoma was found in only one patient. Antibiotic-associated
haemorrhagic colitis or pseudomembranous colitis was found in one pati
ent each. In 10 of the 32 patients with malignant lymphoma, 11 lesions
were found. The following were found in one patient each: large lymph
omatous tumours, a large lymphomatous ulcer, multiple small polypoid l
esions, multiple lymphomatous polyposis; and colorectal cancer or aden
oma in six patients. However, the autopsy findings in patients with bo
th diseases were mostly pseudomembrane formation or ulcers due to fung
al and/or bacterial infection. It is concluded that accurate endoscopi
c diagnosis of lower intestinal lesions in patients with leukaemia or
malignant lymphoma is essential for staging and treatment of these dis
eases and for determining their prognosis. Most lesions in leukaemia a
re aphthoid and small ulcers are due to leukaemic infiltration or anti
biotics; most lesions in malignant lymphoma are elevated lesions such
as cancer, adenoma or lymphomatous lesions as determined by endoscopy.
This is in contrast to pseudomembrane formation or ulcers due to fung
al and/or bacterial infection which are detected at autopsy.