Primary Colon Lymphoma: A Rare Cause of Small-Bowel Obstruction

Primary colonic lymphoma is rare and accounts for 0.2-1.2% of colonic malignancies. The non-Hodgkin B-cell variety is the most common type with a predilection for the ileocecal region. The disease may mimic adenocarcinoma of the colon and gastrointestinal tuberculosis. Intestinal obstruction rarely occurs; however, spontaneous perforation of the colon is reported in up to 45% of cases. Diagnostic work-up includes colonoscopy, contrast enemas, CT and PET-CT scans; however, these tests are often non-specific and the diagnosis is commonly made on histopathology of hemicolectomy specimens. Surgery is the mainstay of therapy while cytotoxic chemotherapy (CHOP regime) is routinely employed in the adjuvant setting. Prognosis depends on the histological grade and stage of the disease at presentation.