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Thread: Colonic Lymphoma Pictures - Atlas of Colon and Ileum

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    Default Colonic Lymphoma Pictures - Atlas of Colon and Ileum

    The Multidisciplinary Approach (For effective solutions in cancer treatment)
    The most effective solutions in the treatment of cancer are obtained under a multidisciplinary approach because oncology is an area that requires the collaboration and co-decision of many branches of science. The consultation of physicians in different branches is extremely important in the diagnosis and treatment of cancer and requires close teamwork. In multidisciplinary structures, specialists in different branches come together, reach a joint decision and share the responsibility. As a result, centers working under a multidisciplinary structure obtain more successful results in the treatment and follow-up of cancer that is in the field of oncology.Multidisciplinary-Approach

    The Multidisciplinary approach in Acibadem Hospitals The diagnosis and treatment of all cancers is evaluated under a multidisciplinary approach in Acibadem Cancer Centers. The services offered in the centers include scanning programs for the early diagnosis of cancer, identifying people who are healthy but at risk of cancer and informing these people and their relatives about cancer prevention.

    Acibadem Hospitals – serving cancer patients with world class technology.
    Acibadem Healthcare Group has brought the latest technology to Turkey. With its developed technology, its technological devices and wealth of knowledge and experience, Acibadem Hospitals offers its patients state-of-the-art technologies the world has reached on the diagnosis and treatment of cancer.
    Colonic Lymphoma Pictures Atlas Colon attachment.php?s=bb29beeecc1c89ba2a1b9a4ebfee4458&attachmentid=2058&d=1442181663

    Acibadem Healthcare Group carries radiation oncology treatment in 5 hospitals. These hospitals are as follows: Maslak and Kozyatağı Hospitals in Istanbul, Bursa, Adana and Kayseri Hospitals outside of Istanbul.

    gamma-knife-deviceThe Gamma Knife device, used for the treatment of brain tumors, offers service in Acibadem Kozyatağı Hospital and the CyberKnife device, used for the treatment of tumors in the brain and in other parts of the body, offers service in Acibadem Maslak Hospital. In addition, cancer patients are treated with the first and only Rapidarc device, which reduces the treatment duration to 1-2 minutes, again in Acibadem Maslak Hospital.
    Colonic Lymphoma Pictures Atlas Colon attachment.php?s=bb29beeecc1c89ba2a1b9a4ebfee4458&attachmentid=2061&d=1442181706

    Case 1
    A 45 year-old male patient presented with dull-aching abdominal pain and a lump in the left flank of three months' duration. He showed loss of appetite and weight, and altered bowel habits. A general physical examination revealed that the patient was anemic. Abdominal examination revealed a tender, firm, irregular mass of 9 × 6 cm in the left hypochondrium and left lumbar region with restricted intrinsic mobility and no movement with respiration. Rectal examination did not reveal any abnormalities. His routine blood investigations were normal except hemoglobin which was 8.6g% and ESR which was 46 mm/1st h. Sputum was negative for acid-fast bacilli (AFB). A peripheral smear showed i) microcytic to normocytic, hypochromic RBCs, ii) mild anisopoikilocytosis of RBCs, iii) a total WBC count and cell distribution within the normal range, iv) adequate number of platelets. Stool was negative for occult blood. Liver function tests (LFTs) including levels of liver enzymes, serum bilirubin, serum proteins, and alkaline phospatase were within normal limits. Bone marrow biopsy revealed no abnormalities; a chest X-ray was also normal. Abdominal ultrasonography (USG) detected a hypoechoic mass with pseudo-kidney signs suggestive of a bowel mass noted in the left hypochondrium, measuring about 9 × 6 cm with bowel wall thickening, and a possibility of carcinoma of the left colon. A barium enema study depicted a circumferential growth involving the proximal part of the descending colon, producing a long segment stricture with mucosal irregularity and shouldering, suggestive of malignant growth but with a normal Ileocecal junction. Colonoscopy and biopsy were inconclusive.

    The patient was subjected to laparotomy through an infraumbilical midline incision (with supraumbilical extension). This revealed a huge growth at the splenic flexure and proximal descending colon with lymph nodes at the origin of the inferior mesenteric artery. There was no ascitis and detectable secondary deposits in the pelvis, liver, spleen, or peritoneum. Left hemicolectomy was performed with transverse-sigmoid, end-to-end anastomosis. Histopathological investigation revealed diffuse, large cell type, intermediate grade NHL of the left colon. The resected margins were free of tumor but the lymph nodes showed reactive hyperplasia. The postoperative period was uneventful and the patient received six cycles of chemotherapy following surgery (CHOP regimen). The patient was on regular follow-up for two years without any recurrence.
    Colonic Lymphoma Pictures Atlas Colon attachment.php?s=bb29beeecc1c89ba2a1b9a4ebfee4458&attachmentid=2059&d=1442181674

    Case 2
    A 60 year-old male patient presented with dull-aching, abdominal pain and a lump in the right lower abdomen of four months' duration. He showed loss of appetite and weight, an evening rise of temperature, and altered bowel habits. He had a cough with hemoptysis for four days. A general physical examination revealed clubbing and anemia. Abdominal examination revealed a tender, soft, irregular, freely mobile mass of 7 × 4 cm size in the right iliac fossa (RIF). Rectal examination results were normal. The patient's routine blood investigations were normal except hemoglobin which was 6.3 g%, and ESR which was 90 mm/1st h. Sputum was negative for AFB and showed no malignant cells. Results of other blood investigations including assays for liver function tests were within normal limits. A peripheral smear revealed microcytic, hypochromic anemia and a chest X-ray showed features of chronic bronchitis. Bone marrow biopsy revealed no abnormality but abdominal USG detected multiple bowel masses with lymphadenopathy in RIF. A barium enema study revealed cecal narrowing, mucosal irregularity, shouldering, and a normal Ileo-cecal junction. USG-guided FNAC of the mass suggested the possibility of lymphoma, which was confirmed by colonoscopy and biopsy.

    The patient was subjected to laparotomy through an infraumbilical midline incision which revealed a fleshy growth arising from the cecal wall with lymph nodes in the mesentery. There were no detectable secondary deposits in the liver, spleen, pelvis, or peritoneum. Right hemicolectomy [Figure 1] was performed with ileo-transverse anastomosis. Histopathological investigation revealed diffuse NHL [Figure 2] with no lymph node metastasis and resected margins free of tumor. The patient received six cycles of chemotherapy (CHOP regimen) following surgery. The patient did not show any signs of recurrence at the end of eight months of follow-up.
    Colonic Lymphoma Pictures Atlas Colon attachment.php?s=bb29beeecc1c89ba2a1b9a4ebfee4458&attachmentid=2060&d=1442181684

    Incidence
    Lymphomas of the GI tract are the most common type of primary extranodal lymphomas, accounting for 5-10% of all non-Hodgkin's lymphomas. In particular, primary intestinal lymphomas represent about 15-20% of GI lymphomas. Primary lymphoma of the colon is a rare tumor of the gastrointestinal (GI) tract that comprises only 0.2-1.2% of all colonic malignancies. GI lymphomas are predominantly located in the stomach (50-60%), whereas intestinal lymphomas are more infrequent and appear in the small bowel (20-30%), the colon, and the rectum (10-20%).[2–5] Colon lymphomas are more frequent in men, but are rarely seen in children.


    Pathology
    Intestinal lymphomas differ from gastric lymphomas not only in pathology, but also in their clinical features, treatment, and prognosis. The gross appearance of the tumor may be annular or just a thickened bowel wall. The majority of the colon lymphomas are single (86%), but can be multiple or diffuse in nature. The term, “primary intestinal lymphoma” includes some particular entities: The western type, immunoproliperative small intestinal disease (IPSID or Mediterranean lymphoma), the enteropathy- associated T-cell lymphoma, and the childhood type. The western type is an uncommon malignancy with a challenging differential diagnosis and an urgent need for therapy. In Western countries, almost all primary colorectal lymphomas are of B-cell lineage whereas they tend to be of T-cell lineage in the East. B-cell lymphomas are more common in older people than are T-cell lymphomas.

    References:
    Primary Lymphoma of the Colon
    Cancer Treatment (Oncology) | Acibadem Hospitals Group











    Last edited by Medical Photos; 09-13-2015 at 10:01 PM.

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