Endoscopic features of colorectal lymphoma according to histological type

Tatsuo Yachida; Takahisa Matsuda; Taku Sakamoto; Takeshi Nakajima; Yasuo Kakugawa; Akiko Miyagi Maeshima; Hirokazu Taniguchi; Ryoji Kushima; Kensei Tobinai; Hideki Kobara; Hisashi Masugata; Tsutomu Masaki; Yutaka Saito

doi:10.1002/jgh3.12738

Endoscopic features of colorectal lymphoma according to histological type

JGH Open. 2022 Apr 6;6(4):257-262. doi: 10.1002/jgh3.12738. eCollection 2022 Apr.

Authors

Tatsuo Yachida^{1

2

3}, Takahisa Matsuda¹, Taku Sakamoto¹, Takeshi Nakajima¹, Yasuo Kakugawa¹, Akiko Miyagi Maeshima⁴, Hirokazu Taniguchi^{4

5}, Ryoji Kushima^{4

6}, Kensei Tobinai⁷, Hideki Kobara², Hisashi Masugata³, Tsutomu Masaki², Yutaka Saito¹

Affiliations

¹ Endoscopy Division National Cancer Center Hospital Chuo City Tokyo Japan.
² Department of Gastroenterology and Neurology, Faculty of Medicine Kagawa University Kita-gun Kagawa Japan.
³ Department of General Internal Medicine, Faculty of Medicine Kagawa University Kita-gun Kagawa Japan.
⁴ Department of Pathology National Cancer Center Hospital Chuo City Tokyo Japan.
⁵ Pathology and Clinical Laboratory Division JR Tokyo General Hospital Shibuya City Tokyo Japan.
⁶ Department of Clinical Laboratory Medicine and Diagnostic Pathology Shiga University of Medical Science Otsu Shiga Japan.
⁷ Department of Hematology National Cancer Center Hospital Chuo City Tokyo Japan.

Abstract

Background and aim: This study aimed to investigate the relationship between the histological type of colorectal lymphoma and its endoscopic features.

Methods: We retrospectively analyzed patients with primary colorectal lymphoma who were diagnosed using colonoscopy and biopsy specimens at the National Cancer Center Hospital, Tokyo, Japan. The lesions were macroscopically classified into the following types via colonoscopy: polypoid, ulcerative, multiple lymphomatous polyposis, diffuse, and mixed.

Results: A total of 117 lesions were identified in 90 patients enrolled in this study. Of these, 59 (50%) were located in the ileocecal region, 23 (20%) in the rectum, 9 (8%) in the transverse colon, 8 (7%) in the sigmoid colon, 7 (6%) in the descending colon, and 4 (3%) in the ascending colon. Moreover, the most common histological subtypes were diffuse large B-cell lymphoma (DLBCL) in 39 patients (43%) and mantle cell lymphoma (MCL) in 23 patients (26%), followed by follicular lymphoma (FL; 17%), mucosa-associated lymphoid tissue (MALT) lymphoma (9%), peripheral T-cell lymphoma-NOS (2%), monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL; 2%), and Burkitt lymphoma (1%). More than half of the DLBCL (52%), MCL (52%), and MALT (56%) lymphomas were macroscopically classified as polypoid types. In contrast, FL lesions showed various macroscopic types. The majority of DLBCL (62%) and FL (78%) lesions were distributed in the ileocecal region. MCL lesions tended to be widely spread in various sites of the large intestine.

Conclusions: Colorectal lymphomas showed macroscopically distinctive features depending on the histological type. Understanding the macroscopic classification of the lesions by colonoscopy and its distribution may be helpful in diagnosing the type of lymphoma and determining the malignant grade based on the histological types.

Keywords: colon; colonoscopy; lymphoma.