Primary small cell type of non-Hodgkin lymphoma of the colon: a case report

Eyal Meir,Chovav Handler,Uri Kaplan,Ossama A Hatoum,Doron Kopelman

doi:10.1186/s13256-020-02500-y

Eyal Meir, Chovav Handler + Show 3 more

Open Access

https://doi.org/10.1186/s13256-020-02500-y

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Abstract

IntroductionPrimary lymphoma of the colon is exceedingly rare and comprises 0.2–1% of all colon tumors. The most common subtype of lymphoma in the colon is non-Hodgkin lymphoma. Symptoms are often nonspecific, and treatment varies between chemotherapy alone and a combination of surgery and chemotherapy.Case presentationWe describe a case of a Ashkenazi Jew patient who presented in the typical way that carcinoma of the colon might present but turned out to have a very rare type of tumor in both its histology and its location.ConclusionThere was apparent discordance between the relative bulkiness and gross appearance of the tumor with the unrevealing result of the biopsies, demanding a high level of suspicion as to the actual presence and possible type of such a tumor in the future.

Highlights

Primary lymphoma of the colon is exceedingly rare and comprises 0.2–1% of all colon tumors
Symptoms described in the literature are varied and include abdominal pain, weight loss, hematochezia, abdominal mass, intussusception, intestinal obstruction, and even perforation and peritonitis [1, 3, 5, 10], and it is estimated that 20% of patients require emergent surgery [11]
The lower stages of disease are treated with surgery and complemented by adjuvant polychemotherapy, whereas the more advanced stages are treated with multidrug chemotherapy, or other combinations of chemotherapy and rituximab (R-CHOP [cyclophosphamide, doxorubicin, vincristine, prednisone, rituximab]) [10, 11, 15]

Summary

Introduction

Primary lymphoma of the colon is exceedingly rare and comprises 0.2–1% of all colon tumors [1,2,3,4]. Pathology of the surgical specimen showed findings consistent with small B cell lymphoproliferative disorders (LPDs) with plasmacytoid differentiation. At this point, though primary lymphoma of the colon was considered in the differential diagnosis, the disease was thought to be part of systemic dissemination of lymphoma. The result of a test for Epstein-Barr virus infection as a possible predisposing factor for lymphoma was negative. These results support the diagnosis of a primary colonic NHL small B-cell LPD with plasmacytoid differentiation, an exceedingly rare disease with only two such reports in the current literature [2, 9]

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