A case series presentation Colorectal Lymphoma , A case series presentation * Dr Monem Alshok * Dr Akeel Muhail , GIT Center

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Follicular cell lymphoma Mantle cell lymphoma Large B cell lymphoma Non-Hodgkins lymphoma accounts for about 0.5 percent of all colorectal cancers and has many forms. These include MALT lymphoma Follicular cell lymphoma Mantle cell lymphoma Large B cell lymphoma Anaplastic large cell lymphoma Enteropathy-associated T cell lymphoma Peripheral T cell lymphoma Burkitt's lymphoma

CRL The colon is a rare location for gastrointestinal non-Hodgkin's lymphoma )) Half of colorectal lymphomas are discovered at an advanced stage & have spread to other organs or to the bone marrow

Colorectal Lymphoma , Case Series 5 cases of primary colorectal lymphomas were identified in our department during the period of 2008 to 2010 . They were 4 males and one woman. Their age at presentation was 11 to 32 years

CRL The common presentations included a combination of abdominal pain ,anorexia and loss of weight , and an abdominal mass ,and bleeding per rectum. The two most common sites of involvement were the caecum and the rectum/sigmoid colon.

CRL The lesions manifested in a variety of ways, ranging from solitary fungating masses to multiple polypoid lesions which were seen on colonoscopy . All cases were non-Hodgkin's B-cell lymphomas, with a majority being diffuse large B-cell lymphomas of intermediate grade .

CRL The diagnoses were confirmed through laparotomy in all cases. All cases presented with evidence of spread to regional lymph nodes or beyond seen at the time of resection All but one patient underwent attempted curative surgical resection .

CRL Four patients received postoperative chemotherapy, with a regimen that included cyclophosphamide, vincristine, doxorubicin and prednisone. One patient died during postoperative day after he presents with perforation of transverse colon .

In CONCLUSION: Primary colorectal lymphoma is a rare condition In CONCLUSION: Primary colorectal lymphoma is a rare condition. It predominantly affects males and most commonly occurs in the caecum. It often presents with abdominal pain and loss of weight and due to the nonspecific nature of these symptoms, patients frequently present late with advanced loco-regional disease. The histology is usually B cell and of intermediate grade. Therapy usually involves resection of the affected colon and regional lymphovascular structures, followed by adjuvant chemotherapy,

J Surg Oncol 2000. Aug;74(4):257-62 Primary colonic lymphoma 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 taking steroids chronically for Addison disease ( IC : were no evidence of extraperitoneal disease, no leukemic or lymphomatous abnormalities in the blood, and disease confined to the colon )

In this study on CRL : 1 . The most common presentation was nonspecific abdominal pain 2. All patients underwent laparotomy with resection. The most common tumor location was the cecum (5/7, 71%). Regional lymph nodes were affected in all patients . 3 . All tumors were B-cell lymphomas (5 small noncleaved cell, 2 large cell )

Study on CRL Six of 7 patients received adjuvant chemotherapy. Of the 6 patients available for follow-up four remain alive (12, 19, 23, and 25 months after diagnosis). In both patients who died the disease recurred diffusely .

Bowel When hazards are this obvious, it’s much easier to assess the risks LINK to next slide: Many different assessment tools For example…. Qualitative Boston Square Semi-Qualitative TBRA Quantitative Modeling to assess major hazard scenarios Only look a the first two – otherwise here all day

CT scan Abdomen

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