diffuse b cell lymphoma | Large B-cell diffuse lymphoma of the colon simulating metastatic carcinoma

Large B-cell diffuse lymphoma of the colon simulating metastatic carcinoma
Colony Diffuse large B-cell lymphoma mimicking metastatic carcinoma



Summary
Primitive colonic non-Hodgkin (NHL) lymphomas account for only 0.4% of colic cancers. They are usually isolated, from clinical stage I or II, from phenotype B, the treatment of choice remaining surgery followed by adjuvant chemotherapy. In the more advanced stages, the usual secondary locations of the NHL are ganglion, splenic and/or medullary. We report the unusual clinical presentation of a diffuse NHL with large B cells, whose mode of extension was of carcinomatous allure, with hepatic and ovarian secondary localization. This observation should alert clinicians to the fact that a colon tumor, even with such an extension mode, may be an NHL and that histological diagnosis must be obtained before any treatment. Indeed, the prognosis of a colonic NHL, even metastatic, will be better than that of a adenocarcinoma.

Summary
Primary Colony Nonhodgkin Lymphoma (NHL) accounts for only 0.4% of all GI malignant neoplasms [4]. NHL is usually locoregional, clinical stage I or II, Bcell lineage and surgical resection with adjuvant chemotherapy is the treatment of choice. Advanced NHL has lymphatic lymphomatous spread, with nodal, spleen and/or done marrow involvement. We report a case of diffuse large Bcell NHL with unusual clinical presentation. Metastatic spread was carcinomatouslike with liver and ovarian secondary nodules. Our observation must alert clinicians to colony tumors with this kind of dissemination spread. NHL can be a differential diagnosis and histological diagnosis must be performed before treatment. Prognosis of NHL, even with metastatic extension, will be better than Prognosis of adenocarcinoma.

Keywords
Metastatic diffusion colon lymphoma large cell B keywords
Colony lymphoma Diffuse large B-Cell lymphoma metastatic spread


Diffuse lymphoma/I large B cells of c61on simulating
M6tastatique carcinoma

Colony Diffuse large B-Cell lymphoma mimicking metastatic carcinoma
(1) Department of Pathological Anatomy, (2) Department of Digestive and Tropical Diseases,
(3) Visc surgery Service, and (4) Department of Radiology, Investigative hospital
Des Armies Robert Pataskar, Bordeaux (France)
(5) Department of Pathological Anatomy, tt6pital Haut-Ldv ~ that, Pessac (France)
RI ~ SUMI ~
C61on's Primitive non-Hodgkin (NHL) lymphomas reprOsentent only 0.4% of colic cancers. They are usually
isol6s, clinical stage I or II, of Ph6notype B, the treatment of choice remaining surgery followed by an adjuvant chimioth6rapie. In the
More avanc6s stages, the usual secondary locations of the NHL are ganglion, spl6niques and/or m6dullaires. We report the
Unusual clinical pr6sentation of a diffuse NHL ~ T large B cells, including carcinomatous-like 6tait extension mode, with
H6patiques and ovarian secondary locations. This observation should alert clinicians to the fact that a colonic tumor, DHW with
Such a mode of extension, can 8tre an NHL and that the histological diagnosis must absolutely 8tre obtained before any treatment. Indeed, the
Prognosis of a colonic NHL, DHW M6tastatique, will be better than that of a ad6nocarcinome.
SUMMARY
Primary colonic non-Hodgkin lymphoma (NHL) accounts for only 0.4% o fall Gl malignant neoplasms [4]. NHL is usually locoregional,
Clinical stage I or I1, B-cell lineage and surgical resection with adjuvant chemotherapy is the treatment of choice. Advanced NHL has lymphatic
Lymphomatous spread, with nodal, spleen and ~ or done marrow involvement. We report a case of diffuse large B-cell NHL with unusual clinical
Presentation. Metastatic spread was carcinomatous-like with liver and ovarian secondary nodules. Our observation must alert clinicians to
Colony tumors with this kind of dissemination spread. NHL can be a differential diagnosis and histological diagnosis must be performed before
Treatment. Prognosis of NHL, even with metastatic extension, will be better than Prognosis of adenocarcinoma.
Introd Introduction
Non-Hodgkin (NHL) Hypernodal lymphomas
are rare tumors. The gastrointestinal tractus
is the most common site, between 30 and 50%
Extra-nodal NHL related to the digestive system
[1-3]. N6anmoins, these digestive primitive NHL
Repr6sentent than 1 ~ 4% of digestive cancers [1]. The
The most fr6quentes locations remain the stomach and
gr61e intestine, colorectal damage does not repr6sentant
10 ~ 20% of cases [1].

Observation
A 60-year-old woman with family ant6c6dents
Breast cancer (her m6re and two other members of the
His family), consulted for flank pain
6voluant right for several months. The patient
Alt6ration of the 6tat g6n6ral, and the palpation of the
Of the right iliac pit objectively a mass
R6nitente. The abdominal scanner r6v61ait a voluminous
Mass of the R6gion il6o-C ~ East and three Macronodules
Hypodenses h6patiques (Fig. 1). The colonoscopy
Found a 16sion c ~ East St6nosante, but the
Pratiqu6es 6taient n6gatives biopsies. Three weeks
After the Premi6re consultation, the onset of a syndrome
Occlusive brought ~ a laparotomy. A
colectomy right 6tait r6alis6e, associ6e has a r6section
Partial h6patique, and ~ a right oophorectomy
(D6cision per op6ratoire for a tumor aspect
M6connu by Imaging).
The macroscopic aspect of Diff6rentes pi6ces
Op6ratoires 6tait all H done in favor of a carcinoma
(Fig. 2). The voluminous il6o-c ~ East tumor of 13 cm
On 6 out of 3, massively infiltrating the intestinal wall,
6tait associ6e H 3 ad6nopathies locor6gionales
of M6tastatique appearance. The right ovary 6tait almost