colon Lymphoma – Surgery Superspeciality MCQs

Q) True about lymphoma of the colon?

a) More common in females

b) Most common in 3rd and 4th decade

c) Most common site is caecum

d) T cells are most commonly involved

Ans c

Lymphoma is uncommon in the colon/rectum occurring in 0.4% of patients; intestinal lymphoma and can present anywhere between the
second and eighth decades of life.

Most of these lesions are intermediate to high-grade B-cell lymphomas.

Affected men outnumber women about 1.5:1

The majority of colorectal lymphomas are found in the cecum or ascending colon. More than 70% of colorectal lymphomas are proximal to the hepatic flexure.

Colon Lymphoma Pathology Outlines

Extranodal Marginal Zone B-Cell Lymphoma

ENMZL, formerly known as marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)

Low-grade lymphoma involving cells that arise from the marginal zone surrounding lymphoid follicles.

23%–48% of all primary GI NHLs, second only to DLBCL in most series

ENMZLs are heterogeneous lymphomas, often containing monocytoid-like cells, plasma cells, and scattered large cells intermixed with marginal zone cells.

There are small cells with irregular cleaved nuclei and a moderate amount of clear cytoplasm

DLBCL

Microscopic Appearance diffuse sheets of large lymphoid cells infiltrate the lamina propria and submucosa, with frequent obliteration of the muscularis propria and ulceration of the overlying mucosa.

Irregular nuclei, prominent nucleoli, and basophilic cytoplasm and are more than twice as large as normal lymphocytes.