Colonoscopic Manifestations of Primary Colorectal Lymphoma

Background and Study Aims: Little is known about the colonoscopic manifestation of colorectal lymphoma. This article describes the use of colonoscopy for diagnosis of primary colorectal lymphoma.

Patients and Methods: We analyzed colonoscopic findings in 13 retrospectively collected cases of primary colorectal lymphoma diagnosed between 1990 and 1999 at our hospital.

Results: The primary colorectal lymphomas were distinguished into three colonoscopic types: a) the mucosal type, which included six lymphomas (46 %), which were classified into two subtypes, erosive (two lymphomas) and ulcerative (four lymphomas); b) the polypoid type, which included three lymphomas (23 %); and c) the massive type, which included four (31 %). The proportion of patients with T-cell lineage lymphoma (5 of 12, 42 %) was higher than in previous studies. Three cases were diagnosed as enteropathy-associated T-cell (EAT)-like lymphoma: one presenting with multicentric ulcerations, one as a massive type and another as a polypoid type. Of those with B-cell lineage lymphoma (7 of 12, 58 %), three presented as massive type, two as polypoid type and two as erosive subtype.

Conclusions: Based on the analysis of colonoscopic records, we have proposed three main types of primary colorectal lymphoma. An unusually high proportion of T-cell lineage lymphomas was noted, but as the number of cases was low, further study is still needed for confirmation.

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