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Colonic Lymphoma

Nodular, ulcerated, constricting neoplasm found in the proximal ascending colon of an 83 year-old woman who had presented with weight loss, abdominal pain and blood in the stool. At surgery there was a second smaller lesion in the terminal ileum, as well as involvement of nearby lymph nodes. Biopsy revealed this to be a malignant lymphoma, large cell (B cell) type.

Proximal ascending colon lesion in a 78 year-old woman, with features similar to the lesion above (nodularity and ulceration). Symptoms included abdominal pain and and wieght loss. At surgery, the lesion was focally invasive into mesentery and lymph nodes. Biopsy revealed this to be a large cell lymphoma.

Nodular, polypoid, neoplastic appearing tissue infiltrating the ileocecal valve (photo at left), terminal ileum (center photo) with metastases to transverse colon (photo at right), discovered in a 66 year-old man referred for colonoscopy in view of a history of colon polyps 5 years earlier. Histology revealed follicular lymphoma.

Asymptomatic 68 year-old woman undergoing average risk colon screening. Colonoscopy revealed diffuse polypoid nodularity thorughout the colon. The gross appearance suggested a hyperplastic or lymphoid-hyperplastic process. On biopsy, the lesions proved to be grade 1 follicular lymphoma. Primary follicular lymphomas of the GI tract may present in a pattern of lymphomatous polyposis in 50% of cases.

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