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.

Other less common type is Mantle cell lymphoma

Our Recommendations

BEST TEXTBOOKS FOR GENERAL SURGERY

Bailey & Love’s Short Practice of Surgery, 27th Edition

Sabiston’s Textbook of Surgery

Schwartz’s Principles Of Surgery

SRB’S Manual Of Surgery

BEST BOOKS FOR OPERATIVE SURGERY

Operative Techniques in Surgery by Michael W. Mulholland et al

Chassin’s Operative Strategy in General Surgery

Farquharson’s Textbook of Operative General Surgery, 10th Edition

Q) A 55-year-old male patient presents with chronic abdominal pain, weight loss, and intermittent diarrhea. Colonoscopy reveals a mass in the cecum, and biopsy confirms colonic lymphoma. Which of the following statements is most likely true regarding this condition?

A) Colonic lymphoma is predominantly of T-cell origin
B) It is more common in females
C) The cecum is the most common site of involvement
D) It typically presents in the 3rd and 4th decades of life

C) The cecum is the most common site of involvement

Explanation:

Colonic lymphoma is a rare form of lymphoma that primarily affects the gastrointestinal tract. Among the options provided:

A) Colonic lymphoma is predominantly of T-cell origin: This is incorrect. Colonic lymphoma is most commonly of B-cell origin, particularly extranodal marginal zone lymphoma (MALT lymphoma), rather than T-cell lymphoma.
B) It is more common in females: This is also incorrect. Colonic lymphoma does not have a strong gender predilection. The incidence is more balanced between males and females.
C) The cecum is the most common site of involvement: This is correct. The cecum is the most frequent site of involvement in colonic lymphoma, especially for extranodal B-cell lymphoma, such as MALT lymphoma. It tends to present as a mass-like lesion, often causing symptoms such as abdominal pain and weight loss.
D) It typically presents in the 3rd and 4th decades of life: This is incorrect. Colonic lymphoma is more commonly diagnosed in older adults, typically over the age of 50. It is relatively rare in younger individuals.