Primary colonic lymphoma

Background and Objectives: The colon is a rare location for gastrointestina l non-Hodgkin's lymphoma (NHL). This study was undertaken to identify risk factors, presentation, treatment, and prognosis for primary colonic lymphom a (PCL) through review of a large tertiary care hospital system experience. Methods: A retrospective review of all patients with colonic malignancy and NHL was performed using pathology and cancer registry databases from Janua ry 1989 to December 1998. Criteria for inclusion were no evidence of extrap eritoneal disease, no leukemic or lymphomatous abnormalities in the blood, and disease confined to the colon. Results: Seven patients met the inclusion criteria (4 male, 3 female; 33-72 years). They represented 1.4% of all NHL, 14% of gastrointestinal NHL and 0.9% of all colonic malignancies diagnosed during this period. Three of the patients had positive serology for human immunodeficiency virus; one was t aking steroids chronically for Addison disease. The most common presentatio n was nonspecific abdominal pain. The lack of specific symptoms delayed dia gnosis from 1-12 months. All patients underwent laparotomy with resection. The most common tumor location was the cecum (5/7, 71%). Regional lymph nod es were affected in all but 1 patient. All tumors were B-cell lymphomas (5 small noncleaved cell, 2 large cell). Six of 7 patients received adjuvant c hemotherapy. Of the 6 patients available for follow-up four remain alive (1 2, 19, 23, and 25 months after diagnosis). In both patients who died the di sease recurred diffusely. Conclusions: The colon is a rare location for NHL. Immunosupression is the most common risk factor. Patients' frequently present with nonspecific abdo minal pain, this leads to lengthy delays in diagnosis. Most of these tumors are located in the cecal area. Surgery is the most widely utilized form of therapy. Although adjuvant therapy is frequently utilized, its' impact on survival is unclear. (C) 2000 Wiley-Liss, Inc.