• colon lymphomas
• gastrointestinal lymphoma
• primary colon cancers
• rare disease

• Humans
• Middle Aged
• Male
• Aged
• Female
• Retrospective Studies
• Colonic Neoplasms/therapy
• Colonic Neoplasms/pathology
• Colonic Neoplasms/mortality
• Adult
• Aged, 80 and over
• Lymphoma/therapy
• Lymphoma/epidemiology
• Lymphoma/diagnosis
• Lymphoma/mortality
• Lymphoma, Large B-Cell, Diffuse/therapy
• Lymphoma, Large B-Cell, Diffuse/epidemiology
• Lymphoma, Large B-Cell, Diffuse/diagnosis
• Lymphoma, Large B-Cell, Diffuse/mortality
• Lymphoma, Large B-Cell, Diffuse/pathology
• Neoplasm Staging

• Humans
• Anus Neoplasms/pathology
• Anus Neoplasms/therapy
• Rectal Neoplasms/pathology
• Rectal Neoplasms/therapy
• Rectal Neoplasms/diagnosis
• Colonic Neoplasms/pathology

• Cancer intervention
• Colon cancer
• Endoscopy
• Gastroenterology
• Renal transplantation

• Male
• Humans
• Lymphoma, Large B-Cell, Diffuse/diagnosis
• Intestine, Small
• Gastrointestinal Tract
• Lymphoma, Non-Hodgkin
• Biopsy

• Ascending colon
• Colonoscopy
• Endoscopic submucosal dissection
• Mucosa-associated lymphoid tissue lymphoma

Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) occurs in approximately 9% of non-Hodgkin B-cell lymphomas. The gastrointestinal tract is the most commonly affected site of the extranodal forms of primary non-Hodgkin’s lymphomas. However, it rarely occurs within the rectum, and at present, there is no consensus on its diagnosis and treatment at this site.

We report a rare laterally spreading tumour-like rectal MALT lymphoma case in which the diagnosis and the depth of infiltration were determined by magnifying endoscopy and ultrasonic endoscopy. Then, the lesion was en bloc resected by endoscopic submucosal dissection (ESD) alone. The lesion was confirmed as MALT lymphoma by haematoxylin and eosin staining, immunohistochemical staining and gene arrangement analysis. Surveillance exams have indicated a 2-year disease-free survival for this patient.

We report a rare primary rectal MALT lymphoma that was curable with resection by ESD. ESD is a safe and effective therapeutic option for rectal MALT lymphoma.

• Rectum
• Mucosa-associated lymphoid tissue lymphoma
• Endoscopic submucosal dissection
• En bloc resection
• Case report

Helicobacter pylori (H. pylori) has infected approximately fifty percent of humans for a long period of time. However, improvements in the public health environment have led to a decreased chance of H. pylori infection. However, a high infection rate is noted in populations with a high incidence rate of gastric cancer (GC). The worldwide fraction of GC attributable to H. pylori is greater than 85%, and a high H. pylori prevalence is noted in gastric mucosa-associated lymphoid tissue lymphoma patients. These results indicate that the majority of GC cases can be prevented if H. pylori infection is eliminated. Because H. pylori exhibits oral-oral or fecal-oral transmission, the relationship between this microorganism and other digestive tract malignant diseases has also attracted attention. This review article provides an overview of H. pylori and the condition of the whole gastrointestinal tract environment to further understand the correlation between the pathogen and the host, thus allowing improved realization of disease presentation.

• Helicobacter pylori
• Gastrointestinal tract
• Malignant disease

Diffuse large B cell lymphoma of the sigmoid colon and rectum is relatively uncommon and aggressive. Due to its nonspecific symptomatology, patients are often diagnosed late into the disease and present with life-threatening complications, such as hemorrhage, obstruction, or perforation, requiring emergent surgical intervention. Patients with colorectal lymphoma typically have inflammatory bowel disease or immunosuppression. We present a case of a 79-year-old male with no known inflammatory bowel disease or immunosuppression, who had significant weight loss, diarrhea, and abdominal fullness, found by CT to have irregular wall thickening of the recto-sigmoid colon along with a colo-colonic fistula, concerning for bowel perforation. Endoscopic evaluation and biopsy confirmed the diagnosis of recto-sigmoid Diffuse large B cell lymphoma, with a PET/CT scan revealing stage IV disease. He had a partial response to six cycles of palliative reduced dose R-CHOP and is currently receiving palliative radiation to the sigmoid colon and rectum. Surgery and/or chemoradiation remain the mainstay therapy for this condition. Clinicians, however, must consider patient’s functional, nutritional, and clinical status prior to choosing an optimal therapeutic regimen. This case illustrates a unique clinical presentation of this condition and the associated diagnostic and therapeutic challenges that arise in order to prevent life-threatening complications.

• Colorectal lymphoma
• colon cancer
• colonic fistula
• colorectal cancer
• diffuse large B-cell lymphoma

Colorectal mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease, and only a few cases have been reported to date. It has no specific clinical presentations and shows various endoscopic appearances. There is no uniform consensus on its treatment. With the advancement of endoscopic technology, endoscopic treatment has achieved better results in individual case reports of early-stage patients.

We report a case of rectal MALT in a 57-year-old Chinese man with no symptoms who received endoscopy as part of a routine physical examination, which incidentally found a 25 mm × 20 mm, laterally spreading tumor (LST)-like elevated lesion in the rectum. Therefore, he was referred to our hospital for further endoscopic treatment. Complete and curable removal of the tumor was performed by endoscopic submucosal dissection. We observed enlarged and dilated branch-like vessels similar to those of gastric MALT lymphoma on magnifying endoscopy with narrow-band imaging. And immunopathological staining showed hyperplastic capillaries in the mucosa. Histopathological findings revealed diffusely hyperplastic lymphoid tissue in the lamina propria, with a visible lymphoid follicle structure surrounded by a large number of diffusely infiltrated lymphoid cells that had a relatively simple morphology and clear cytoplasm. In addition, immunohistochemical analysis suggested strongly positive expression for CD20 and Bcl-2. Gene rearrangement results showed positivity for IGH-A, IGH-C, IGK-B, and IGL. Taking all the above findings together, we arrived at a diagnosis of extranodal marginal zone B-cell lymphoma of MALT lymphoma. Positron emission tomography-computed tomography examination showed no other lesions involved. The patient will be followed by periodic endoscopic observation.

In conclusion, we report a case of rectal MALT with an LST-like appearance treated by endoscopic submucosal dissection. Further studies will be needed to explore the clinical behavior, endoscopic appearance, and treatment of rectal MALT.

• Primary rectal mucosa-associated lymphoid tissue lymphoma
• Laterally spreading tumor
• Endoscopic submucosal dissection
• Mucosa-associated lymphoid tissue
• Case report

• Chemotherapy
• Lymphoma
• Non-Hodgkin's lymphoma
• Primary
• Radiotherapy
• Rectum

Ileocecal thickening (ICT) is a common finding on radiological imaging. It can be caused by a variety of inflammatory, infectious, or neoplastic conditions, and evaluating a patient of ICT can be a challenging task. Intestinal tuberculosis (ITB), Crohn's disease (CD), and adenocarcinoma are the most common causes. Enteric bacterial infections, cytomegalovirus, histoplasmosis, amebiasis, systemic vasculitis, lymphoma, etc. should be suspected in appropriate clinical settings. However, it could often be a spurious or nonspecific finding. A thickness of more than 3 mm in a normally distended small bowel is usually considered abnormal. Detailed evaluation of imaging of the site and extent of thickening; the degree and pattern of thickening; and the associated findings, such as degree of fat stranding, fibrofatty proliferation, adjacent lymph nodes, and solid organ involvement, should be performed. Ileocolonoscopy is an important tool for diagnosing and obtaining samples for tissue diagnosis. Histopathology is usually the gold standard for diagnosis, although—not uncommonly—findings could be nonspecific, and reaching a definitive diagnosis is difficult. As such, a systematic approach with the integration of clinical, biochemical, radiological, endoscopic, histological, and other laboratory tests is the key to reaching a diagnosis. In this article, we review the causes of ICT and present a clinical approach for the management of ICT.

• Amebiasis
• Crohn's disease
• computed tomography
• ileocecal thickening
• intestinal tuberculosis

Primary colorectal lymphoma (PCL) is a rare colorectal malignancy. The standard treatment and prognostic factors of PCL remain unexplored. Therefore, a large population-based study should be conducted to provide a detailed review of this disease.

We extracted the data of eligible patients with PCL registered in the SEER database from 1973 to 2011. All statistical analyses were performed using SPSS 19.0.

A total of 2050 (61.3%) of the 3342 patients with PCL underwent surgical intervention, and 1292 (38.7%) patients received no surgical treatment. The median overall survival was 95 months, and patients receiving surgery exhibited significantly prolonged survival (adjusted HR =0.69, P <0.001). Young age, early tumor stage, and indolent lymphoma were independent predictors of improved survival. Further survival analyses demonstrated the potential benefit of surgery in patients with early tumor stage, right-sided lesions, or diffuse large B-cell PCL. Conversely, surgical intervention did not improve the survival of patients with advanced-stage, left-sided, or indolent PCL.

PCL is a rare tumor that can be effectively treated. Surgical intervention may play an important role in the treatment of PCL. Early tumor stage, a right-sided lesion, and diffuse large B-cell histological PCL seem to be the clinical characteristics of optimal surgical candidates.

• SEER
• primary colorectal lymphoma
• prognosis
• surgical intervention
• survival

• Anti-TNF-α
• Inflammatory bowel disease
• Lymphoma
• Lymphoproliferative disorders
• Thiopurines

• Clinical features
• Intestinal lymphoma
• Prognosis
• Treatment

• Antineoplastic Combined Chemotherapy Protocols
• Female
• Humans
• Intestinal Neoplasms
• Lymphoma
• Male
• Middle Aged
• Prognosis
• Retrospective Studies

• colonic lymphoma
• double hit
• drug-induced lupus
• gastrointestinal vasculitis
• immunodeficiency
• non-hodgkin lymphoma
• segmental colitis

• colorectal cancer
• diffuse large B-cell lymphoma
• rectal adenocarcinoma
• rituximab
• second primary malignancy

• Anus Neoplasms/genetics
• Anus Neoplasms/pathology
• Colonic Neoplasms/genetics
• Colonic Neoplasms/pathology
• Gastrointestinal Stromal Tumors/pathology
• Humans
• Lymphoma/pathology
• Microsatellite Instability
• Neuroendocrine Tumors/pathology
• Rectal Neoplasms/genetics
• Rectal Neoplasms/pathology

• Helicobacter pylori
• diagnosis
• gastrointestinal tract
• lymphoma
• non-Hodgkin lymphoma
• therapy

This pictorial essay briefly discusses methods for optimizing bowel imaging with magnetic resonance imaging (MRI) and illustrates the MRI appearance of a variety of unusual lesions involving or related specifically to the large bowel.

• Imaging
• large bowel
• magnetic resonance imaging

We report a case of primary colonic lymphoma incidentally diagnosed in a patient presenting a gallbladder attack making particular attention on the diagnostic findings at ultrasound (US) and total body computed tomography (CT) exams that allowed us to make the correct final diagnosis. A 85-year-old Caucasian male patient was referred to our department due to acute pain at the upper right quadrant, spreaded to the right shoulder blade. Patient had nausea and mild fever and Murphy’s maneuver was positive. At physical examination a large bulky mass was found in the right flank. Patient underwent to US exam that detected a big stone in the lumen of the gallbladder and in correspondence of the palpable mass, an extended concentric thickening of the colic wall. CT scan was performed and confirmed a widespread and concentric thickening of the wall of the ascending colon and cecum. In addition, revealed signs of microperforation of the colic wall. Numerous large lymphadenopathies were found in the abdominal, pelvic and thoracic cavity and there was a condition of splenomegaly, with some ischemic outcomes in the context of the spleen. No metastasis in the parenchimatous organs were found. These imaging findings suggest us the diagnosis of lymphoma. Patient underwent to surgery, and right hemicolectomy and cholecystectomy was performed. Histological examination confirmed our diagnosis, revealing a diffuse large B-cell lymphoma. The patient underwent to Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone chemotherapy showing only a partial regression of the lymphadenopathies, being in advanced stage at the time of diagnosis.

• Primary colonic lymphoma
• Gastrointestinal lymphoma
• Diffuse large B-cell lymphoma
• Gallstone attack
• Computed tomography

• Colorectal lymphoma
• Extra-nodal lymphoma
• Non-Hodgkin's lymphoma
• Primary colorectal lymphoma

Colorectal lymphomas represent only 5% to 10% of gastrointestinal lymphomas, after the stomach and small intestine. Primary lymphoma of the colon and rectum is an unusual observation, constituting only 0.2% to 0.5% of all malignant tumors arising from the colorectal region. Very little is known about the correlation between adenoma and lymphoma in the colorectal tract. We report here a rare case of diffuse large B-cell lymphoma developing within a solitary tubular adenoma with low-grade dysplasia of the rectum.

An 83-year-old Caucasian man was referred to our hospital intermittent anal bleeding and irregular bowel. Colonoscopy revealed a 1cm solitary rectal polyp, which was completely removed by endoscopic resection. Histologic studies revealed low-grade intraepithelial dysplasia; the stroma of adenoma showed focal localization by highly proliferative lymphoid cells. Immunohistochemical analyses demonstrated that lymphoid cells were positive for CD20 and bcl2, whereas they were negative for CD3, CD5, CD10, CD23, CD30, CD138 and cyclin D1. Approximately 90% of the neoplastic cells reacted positively when stained with an antibody to Ki-67. Molecular studies showed the presence of a monoclonal immunoglobulin heavy chain gene rearrangement.

To determine primary or secondary lymphoma localization, Dawson’s criteria were applied to the case. A diagnosis of primary diffuse large B- lymphoma Ann Arbor stage 1A was established. Subsequently, the patient was referred to oncology to establish the stage and to select appropriate treatment.

The case of diffuse large B-cell lymphoma developing within a tubular adenoma, as reported here, is considered a rare event. Little about the prognosis of primary colorectal lymphomas is available and therapeutic treatment protocol is unclear. This case report provides more information on the history and macroscopic appearance of lymphomas presenting in an unusual location. To report additional cases in the future would be helpful in redefining the diagnostic, prognostic and therapeutic approach.

• Carcinoid tumor
• Carcinoma de células escamosas
• Cáncer de recto
• Gastrointestinal stromal tumors
• Linfoma
• Lymphoma
• Neuroendocrine tumors
• Rectal neoplasms
• Review literature
• Revisión de la literatura
• Sarcoma
• Squamous cell carcinoma
• Tumor carcinoide
• Tumor del estroma gastrointestinal
• Tumores neuroendocrinos

Primary colonic lymphomas represent a rare minority among the colonic neoplasms. Their correct pre-operative identification is crucial for the design of treatment. We herein describe a case of a colonic lymphoma presenting as a necrotic colonic mass and we discuss the current evidence about the presentation, diagnosis and treatment of lymphomas isolated to the colon.

• Colonic lymphoma
• Necrotic colonic mass

Rectal submucosal lesions encompass a wide variety of benign and malignant tumors involving the rectum. With optical colonoscopy, any mass-like protrusion covered by normal mucosa, whether the underlying process is intramural or extramural in origin, may be reported as a submucosal lesion. Whereas the assessment of submucosal lesions may be limited with performing optical colonoscopy, cross-sectional imaging such as CT, transrectal ultrasonography and MRI allows the evaluation of perirectal tissues and pelvic organs in addition to the entire thickness of the rectum, and so this is advantageous for the assessment of rectal submucosal tumors. Among these, MRI is the best investigative modality for soft tissue characterization. Therefore, knowledge of the MRI features of rectal submucosal tumors can help achieve accurate preoperative diagnoses and facilitate the appropriate management.

• MRI
• Rectal cancer
• Rectal submucosal tumor

Gastrointestinal tract is the most common extranodal site involved by lymphoma with the majority being non-Hodgkin type. Although lymphoma can involve any part of the gastrointestinal tract, the most frequent sites in order of its occurrence are the stomach followed by small intestine and ileocecal region. Gastrointestinal tract lymphoma is usually secondary to the widespread nodal diseases and primary gastrointestinal tract lymphoma is relatively rare. Gastrointestinal lymphomas are usually not clinically specific and indistinguishable from other benign and malignant conditions. Diffuse large B-cell lymphoma is the most common pathological type of gastrointestinal lymphoma in essentially all sites of the gastrointestinal tract, although recently the frequency of other forms has also increased in certain regions of the world. Although some radiological features such as bulky lymph nodes and maintenance of fat plane are more suggestive of lymphoma, they are not specific, thus mandating histopathological analysis for its definitive diagnosis. There has been a tremendous leap in the diagnosis, staging and management of gastrointestinal lymphoma in the last two decades attributed to a better insight into its etiology and molecular aspect as well as the knowledge about its critical signaling pathways.

• Gastrointestinal lymphoma
• Epstein-Barr virus
• Helicobacter pylori
• Celiac disease
• Diffuse large B-cell lymphoma

• Adenocarcinoma/diagnosis
• Adenocarcinoma/pathology
• Aged
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Colonoscopy
• Cyclophosphamide/therapeutic use
• Diagnosis, Differential
• Doxorubicin/therapeutic use
• Humans
• Immunohistochemistry
• Lymphoma, Large B-Cell, Diffuse/diagnosis
• Lymphoma, Large B-Cell, Diffuse/drug therapy
• Lymphoma, Large B-Cell, Diffuse/mortality
• Lymphoma, Large B-Cell, Diffuse/pathology
• Lymphoma, Large B-Cell, Diffuse/surgery
• Male
• Meta-Analysis as Topic
• Middle Aged
• Neoplasm Staging
• Prednisone/therapeutic use
• Prognosis
• Radiography, Abdominal
• Rectal Neoplasms/diagnosis
• Rectal Neoplasms/drug therapy
• Rectal Neoplasms/mortality
• Rectal Neoplasms/pathology
• Rectal Neoplasms/surgery
• Rectum/pathology
• Tomography, X-Ray Computed
• Vincristine/therapeutic use