Primary Intestinal Hodgkin's Disease Complicating Ileal Crohn's Disease

Kelly, Michael D.; Stuart, Malcolm; Tschuchnigg, Mark; Turner, J.; Tydd, T.

doi:10.1111/j.1445-2197.1997.tb02020.x

Cited by 25 publications

(10 citation statements)

References 23 publications

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“…Heterogeneity in the type, the dose and duration of immunomodulatory therapy may be responsible for this discrepancy (Xie & Itzkowitxz, 2008). The association between Crohn's disease and lymphoma is confirmed by numerous case reports (Perosio et al, 1992;Brown et al, 1992;Vazquez et al, 1993;Vanbockrijck et al, 1993;Larvol et al, 1994;Veldman et al, 1996;Kelly et al, 1997;Woodley et al, 1997;Charlotte et al, 1998;Kashyap et al, 1998;Parasher et al, 1999;Musso et al, 2000;Li et al, 2001;Martinez Tirado et al, 2001;Calvo-Villas et al, 2003;Hall et al, 2003;Sivarajasingham et al, 2003;Losco et al, 2004;Garcia-Sanchez et al, 2006;). In 60% of cases, lymphomas occur in the small and large intestine ( Figure 5, 6).…”

Section: Lymphomas and Leukemiasmentioning

confidence: 78%

Crohn’s Disease and Colorectal Cancer

Denegri¹,

Paparo²,

Fornaro³

2011

Rectal Cancer - A Multidisciplinary Approach to Management

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Section: Lymphomas and Leukemiasmentioning

confidence: 78%

Crohn’s Disease and Colorectal Cancer

Denegri¹,

Paparo²,

Fornaro³

2011

Rectal Cancer - A Multidisciplinary Approach to Management

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“…The location of the lymphomas cited in case reports and series appears to correspond to the frequency with which Crohn’s disease occurs in different areas of the alimentary tract 13 , . 15 Among 21 cases of lymphoma associated with Crohn’s disease reviewed by Perosio et al ., seven were in the ileum, eight in the large bowel, four in the small bowel, one ileo‐colonic, and one in the stomach 16 .…”

Section: Case Reports and Case Seriesmentioning

confidence: 93%

“…The association of lymphoma of the small intestine with coeliac disease has been well‐recognized for many years 12 . Potential pathogenic mechanisms proposed for the development of malignancy include increased exposure to carcinogens secondary to the disturbed mucosal barrier, accelerated cell turnover with the increased genetic mutations, and reduced immune surveillance secondary to immune suppression 13 , . 14 Exposure to radiation during diagnostic radiology is another potential carcinogenic factor; 3 however, this is even more difficult to quantify than exposure to immunosuppressive treatment.…”

Section: Introductionmentioning

confidence: 99%

Review article: the risk of lymphoma associated with inflammatory bowel disease and immunosuppressive treatment

Aithal

Mansfield

2001

Aliment Pharmacol Ther

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Lymphoma complicating inflammatory bowel disease is well described. Whether the risk of lymphoma is incre‐ ased by immunosuppressive treatment with azathiop‐ rine, 6‐mercaptopurine or infliximab is a common concern among patients and physicians considering using these agents. This review aims to quantify the lymphoma risk in inflammatory bowel disease and the added risk attributable to these treatments. The evidence from published cases is that lymphomas occur at sites of active inflammatory bowel disease more often than expected for this to be a chance association. Studies on inflammatory bowel disease populations are conflicting, with some follow‐up studies from large inflammatory bowel disease clinics showing an increase in lymphoma incidence, while other population‐based studies show little or no increase in risk of lymphoma. A small increase in lymphoma risk in inflammatory bowel disease, perhaps 2–3‐fold, may be compatible with both sets of data. Studies of the risks associated with immuno‐ suppression are less satisfactory, with smaller numbers of patients and relatively short follow‐up. The available evidence would support a further increase in lymphoma risk associated with immunosuppressive treatment in inflammatory bowel disease of around fivefold compared to no immunosuppressive use, and tenfold compared to the general population. The risks appear to be less than that associated with renal and hepatic transplant‐related immunosuppression. Infliximab treatment is still too new to make a full assessment of its long‐term safety, but post‐marketing surveillance currently suggests that lymphoma risk may not be any greater than that associated with azathioprine and 6‐mercaptopurine. Population‐wide surveillance for lymphoma in inflammatory bowel disease would be required to narrow the confidence intervals on these estimates of lymphoma risk in inflammatory bowel disease and immunosuppressive treatment.

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“…Indeed, almost 80 years ago a case of “lymphosarcoma” was noted in the first published case series of colorectal cancer occurring in the setting of UC 35. Over the years, numerous case reports and case series have been published that describe the development of lymphoma in the setting of IBD 36–38. As none of these reports were prospective in nature, no causal inferences can be made.…”

Section: Ibd and The Risk Of Lymphomamentioning

confidence: 99%

“…Observational studies evaluating the relationship between IBD and lymphoma come in the form of case reports or case series,36, 38–41 hospital‐based,42, 43 or larger population‐based cohort studies 44–51. One of the largest population‐based studies (Table 1)47 utilized the General Practice Research Database (GPRD), which is comprised of the computerized medical records of 2000 general practitioners and 8 million patients (6% of the population of the UK).…”

Section: Ibd and The Risk Of Lymphomamentioning

confidence: 99%

Lymphoma risk in inflammatory bowel disease: Is it the disease or its treatment?

Jones

Loftus

2007

Inflammatory Bowel Diseases

111

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With the increasingly widespread use of immunosuppressive and biologic agents for the treatment of Crohn's disease and ulcerative colitis come concerns about potential long-term consequences of such therapies. Disentangling the potential confounding effects of the underlying disease, its extent, severity, duration, and behavior, and concomitant medical therapy has proven to be exceedingly difficult. Unlike the case in rheumatoid arthritis, the overwhelming preponderance of population-based evidence suggests that a diagnosis of inflammatory bowel disease (IBD) is not associated with an increased relative risk of lymphoma. However, well-designed studies that evaluate the potential modifying effect of IBD severity have yet to be performed. Although the results from hospital- and population-based studies have conflicted, the results of a recent meta-analysis suggest that patients receiving purine analogs for the treatment of IBD have a lymphoma risk approximately 4-fold higher than expected. Analyses of lymphoma risk in patients receiving biologic agents directed against tumor necrosis factor-alpha are confounded by concomitant use of immunosuppressive agents in most of these patients. Nevertheless, there may be a small but real risk of lymphoma associated with these therapies. Although the relative risk of lymphoma may be elevated in association with some of the medical therapies used in the treatment of IBD, this absolute risk is low. Weighing the potential risk of lymphoma associated with select medical therapies against the risk of undertreating IBD will help physicians and patients to make more informed decisions pertaining to the medical management of IBD.

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Primary Intestinal Hodgkin's Disease Complicating Ileal Crohn's Disease

Cited by 25 publications

References 23 publications

Crohn’s Disease and Colorectal Cancer

Crohn’s Disease and Colorectal Cancer

Review article: the risk of lymphoma associated with inflammatory bowel disease and immunosuppressive treatment

Lymphoma risk in inflammatory bowel disease: Is it the disease or its treatment?

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