title: The management of primary small bowel and colon lymphoma--a review.
abstract: OBJECTIVE
  The management of primary small bowel and colon lymphoma is controversial. A review of the literature was therefore undertaken to evaluate the evidence for the classification, staging, diagnosis, and treatment of primary small bowel and colon lymphoma and guide management.
  
  
  METHODS
  A literature search was performed utilising Embase, Medline, and Pubmed and papers were evaluated on an individual basis.
  
  
  RESULTS
  Consensus opinion favours the WHO classification scheme and the TNM staging systems for primary small bowel and colon lymphoma. CT enteroclysis and barium enterolysis are recommended for the diagnosis of primary small bowel lymphoma and capsule endoscopy and double-balloon enteroscopy maybe useful diagnostic tools. In terms of the diagnosis and staging of primary colonic lymphoma, the evidence is scarce and CT is to be recommended.                         The mainstay of treatment for primary GI lymphoma is surgery and/or chemotherapy. For primary small bowel and colonic lymphoma, there was no definitive evidence regarding the benefits of either strategy; however, chemotherapy seemed to give a survival benefit over surgery alone for primary small bowel lymphoma and colonic lymphoma was skewed towards surgery plus chemotherapy due to the large number of patients presenting as an emergency.
  
  
  CONCLUSIONS
  Published data regarding the management of primary small bowel and colon lymphoma is very limited. Classification and staging should be standardised to enable accurate evaluation of investigations and treatments and a large RCT undertaken to compare chemotherapy and surgery. Currently, we would recommend that management should involve chemotherapy with surgery reserved for those with clinical indication.
authors.affiliation: Department of Colorectal Surgery, Singleton Hospital, School of Medicine, Swansea University, Sketty, Swansea SA2 8QA, UK. c_beaton@hotmail.com
authors.forename: Ceri
authors.initials: C
authors.lastname: Beaton
authors.forename: Mark
authors.initials: M
authors.lastname: Davies
authors.forename: John
authors.initials: J
authors.lastname: Beynon
mesh_terms: D003106:Colon / Q000473:pathology; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000628:therapy*; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery; D008223:Lymphoma / Q000175:diagnosis / Q000628:therapy*; D009367:Neoplasm Staging