title: Primary colonic lymphoma. Clinical presentation, histopathologic features, and outcome with combination chemotherapy.
abstract: Primary colonic lymphomas are rare, but we identified 15 cases at our institution between 1973 and 1992. They comprised 5.8% of all cases of gastrointestinal lymphoma (15 of 259) and 0.16% of all cases of colon cancer (15 of 9,193) during the last 20 years. The most common presenting symptoms were abdominal pain and weight loss (40% each). In seven patients (47%), a palpable abdominal mass was noted on the initial physical examination. The most frequent site of involvement was the cecum (73%). Histologically, six (40%) were classified as high-grade and nine (60%) as intermediate-grade non-Hodgkin's lymphoma. The tumors usually presented at an advanced stage: in 13 of 15 patients (87%), the lymphoma had spread to the adjacent mesentery, the regional lymph nodes, or both when first diagnosed. The 5-year survival rate was 27% for all patients and 33% (4 of 12) for patients treated with combination chemotherapy. Two patients relapsed after 8 years of complete remission. Primary colonic lymphomas have an aggressive behavior and only a marginal response to surgery and combination chemotherapy.
authors.affiliation: Division of Gastroenterology, Mayo Clinic and Foundation, Rochester, Minnesota 55905.
authors.forename: J
authors.initials: J
authors.lastname: Zighelboim
authors.forename: M V
authors.initials: MV
authors.lastname: Larson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone