A CASE OF PRIMARY MALIGNANT LYMPHOMA OF THE RECTUM

Abstract

A 65-year-old woman was seen at the hospital because of bleeding on defecation. An elevated lesion of 4cm in diameter was found in the posterior wall of the rectum. Possible malignancy was suspected. Clamp biopsy, however, revealed no malignant findings, endoscopic findings changed rapidly, and it was difficult to make a diagnosis. Finally, transanal partial excision of the rectum was performed under lumber anestesia, and a malignant lymphoma was found. No other lesions were detected. A diagnosis of malignant lymphoma arising in the rectum was made. Abdominoperineal excision of the rectum (R3) was performed. There were two lesions, 35×33mm and 10×8mm in size, were noted in the excised specimen. Histopathologically lymphocytic infiltration of medium sized-type, lacking in atypia and being confined to proper muscle layer, was confirmed but no lymph node metastasis was found. It was in Stage I according to Naqvi's classification and was of folicular medium cell type (B cell type) according to LSG classification. After the operation 2 courses of CHOP regimen were conducted. There has been no recurrence as of 1 year and 4 months after the operation and the patient is followed on an ambulant basis.