Diffuse large B-cell lymphoma of the colon with synchronous liver metastasis: A rare case report mimicking metastatic colorectal adenocarcinoma

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Abstract

Background: Primary colorectal lymphoma represents a rare minority among the colonic neoplasms. Early diagnosis is often difficult because of unspecific symptoms, with subsequent delays in diagnosis and management. We describe a rare case of colonic lymphoma presenting with synchronous liver metastasis. Case presentation. A 70-year-old male with a 6-mo history of vague abdominal pain, constipation and melena was referred to our hospital. Computed tomography scan of abdomen revealed the presence of a mass along the proximal ascending colon. Colonoscopy biopsy showed external compression of the cecum with two ulcerations of mucosa, but it was not consistent for a definitive diagnosis. Because the difficulties in the preoperative pathological diagnosis, the high risk of bowel obstruction and the correlated hemorrhagic risk, the patient underwent a right hemicolectomy associated with locoregional lymphadenectomy and liver resection.The surgically resected right colon and liver tumors were all immunohistochemically diagnosed as diffuse large B-cell lymphomas (DLBCL). The patient refused any other antineoplastic treatment; he is alive and free of disease at 3 years after initial diagnosis. Conclusions: Primary colonic lymphomas represent a rare minority among the colonic neoplasms. Their correct pre-operative identification is crucial for the design of treatment. This case highlights the difficulty in diagnosing of primary colonic lymphoma. To our knowledge, this is the first report of a colonic lymphoma presenting with a colonic mass and a synchronous liver metastasis.

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Risio, D., Percario, R., Legnini, M., Caldaralo, F., Angelucci, D., Marinelli, C., … Innocenti, P. (2014). Diffuse large B-cell lymphoma of the colon with synchronous liver metastasis: A rare case report mimicking metastatic colorectal adenocarcinoma. BMC Surgery, 14(1). https://doi.org/10.1186/1471-2482-14-75

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