Diagnosis and treatment of primary colonic malignant lymphoma / 国际外科学杂志

ABSTRACT

Objective To investigate the diagnosis and treatment procedures of primary colonic malignant lymphoma(PCML). Methods Data of clinical and pathological findings, surgical treatment and prognosis of 12 cases with PCML verified by pathology were retrospectively analyzed, workups of barium clysma,colon-scopic examination and multislice spiral computed tomography(MSCT) were compared to evaluate their role in diagnosis. Results The classic presentation of PCML included abdominal pain, abdominal bulge, bowel obstruction, gastrointestinal bleeding, and serum levels of tumor markers were within the normal ran-ges. Six cases underwent procedure of barium clysma, and anomaly appeared in 2 cases, however, there were no indications of lymphoma, 6 cases underwent colon-scopic examination, anomaly in 3 cases, of which 1 revealed possibility of lymphoma, 10 cases underwent MSCT; 9 cases demonstrated tumor origin by CT scan of which diagnosis was established in 5 cases. All the patients underwent surgery. No incidence of peri-opreative death happened. Non-Hodgkin' s lymphoma was confirmed in all of cases. For all of the cases a T-cell origin was in 1 case and a B-cell origin in other cases. Ten cases were administrated postoperative chem-otherapy. 11 cases were followed up, and the overall 1-year and 3-year survival rates were 81.9% (9/11) and 54.5% (6/11), respectively. Conclusions Typical presentation is still lacking for PCML, workups of barium clysma and colon-seopic examination are little sensitive and specific to make the diagnosis. However, MSCT is useful in diagnosing PCML with its characteristic information as well as clinical findings. Surgical management and postoperative adjuvant-chemotherapy would be likely the optimal therapeutic maneuver of this disease in early period.