Diffuse Large B-Cell Lymphoma of the Colon in an Asymptomatic Patient

Abstract

Extranodal lymphomas of the gastrointestinal (GI) tract are known entities, but primary lymphoma of the colon is extremely rare. Symptoms are non-specific, such as abdominal pain, bloody diarrhea, unintentional weight loss, night sweats, and changes in bowel habits. Some patients do not have any specific symptoms, which makes diagnosis extremely difficult. We present a 69-year-old asymptomatic male who was incidentally found to have an inflammatory mass in the descending colon on screening colonoscopy; the initial biopsy was inconclusive. However, due to high suspicion of any underlying malignancy, a repeat colonoscopy with biopsy was done, which revealed diffuse large B-cell lymphoma (DLBCL). Prompt and early diagnosis is extremely crucial for timely management. Management includes chemotherapy, radiotherapy, and surgery.

Primary Diffuse large B-cell Lymphoma of the colon presenting as Idiopathic thrombocytopenia : A case report

“…The most common translocation seen in colonic lymphomas is t (14; 18), leading to BCL2 overexpression and unchecked growth of B-cells in germinal centers. 5 While successful treatment of colonic lymphomas with H.pylori eradication has been observed, the relationship between colonic lymphomas and H. Pylori infection remains unclear. On the other hand, gastric mucosa-associated Lymphoid tissue (MALT) lymphomas are strongly associated with H. Pylori .…”

“…Serological testing for Hepatitis B virus (HBV), HCV, HIV, and EBV is also necessary, as these viruses can be possible etiologies. 5 …”

“…The combined use of monoclonal antibodies with anthracyclines has been shown to improve outcomes and prolong the survival of these patients. 5 …”

“…However, due to the non-specific nature of these symptoms, diagnosis may be delayed, as was the case with this patient. 5 It is important for healthcare providers to consider the possibility of primary colorectal lymphoma in patients presenting with these symptoms and those with risk factors such as IBD, viral infections, and the use of immunosuppressant agents. When proctitis or colitis is observed during a colonoscopy, a broader differential diagnosis should always be considered.…”