Symptoms and treatment of intestinal lymphoma. Intestinal lymphoma symptoms Lymphoma in the intestine symptoms and treatment

Areas of granulation tissue alternate with areas of sclerosis and thinning of the intestinal wall, as a result of which a series of narrowings and ampul-shaped expansions are formed in the intestine, and with multiple circular growths it has a distinct appearance. The disintegration of granulomatous tissue leads to the formation of transversely located ulcers with a dense bottom and raised ridge-like edges, in the area of ​​which perforation of the intestinal wall sometimes occurs.

Symptoms of intestinal lymphoma

There is compaction and enlargement of the mesenteric and retroperitoneal lymph nodes, which are usually not fused with the surrounding tissues and are therefore mobile. With intestinal lymphoma, there may not be typical changes in the inguinal, axillary, cervical and other palpable lymph nodes. The disease occurs with febrile symptoms characteristic of lymphoma, which are usually very pronounced here; Sometimes there is skin itching.

Intestinal manifestations are reduced either to attacks of obstruction or to intestinal bleeding, foul-smelling diarrhea, which are accompanied by constant or periodic abdominal pain. Sometimes attacks of obstruction alternate with intestinal bleeding and diarrhea. When the intestines are damaged, an acute course of the disease is observed with rapid exhaustion and the development of cachexia, leading to death. The cause of death can sometimes be profuse intestinal bleeding or peritonitis due to perforation.

The diagnosis of intestinal lymphoma is difficult due to the lack of specific changes. Severe febrile symptoms with moderate intestinal signs lead to incorrect diagnoses - typhoid fever, brucellosis. In most patients, the picture is essentially indistinguishable from that of a malignant tumor of the intestine.

X-ray examination gives a typical picture in the case where there are multiple granulomatous foci, manifesting as strictures and filling defects. Their localization in the upper part of the small intestine allows us to exclude tuberculosis and syphilis, which mainly affect the lower part of the ileum.

In doubtful cases, a trial transection with removal of individual lymph nodes for microscopic examination is indicated.

Treatment of intestinal lymphoma

Treatment is conservative and mainly radiation. Lymphogranulomatous infiltrates are very sensitive to X-rays, which also makes it possible to differentiate them from formations of a different nature.

Surgical treatment in these patients is useless, since the disease is systemic in nature. It is necessary to operate on such patients only if they develop one or another complication (formation of stricture, intestinal perforation, profuse bleeding). However, in some cases, a lymphogranulomatous node can be isolated (single), and then bowel resection radically cures the patient. The literature describes observations of complete recovery after such an operation.

The prognosis is unfavorable, most patients die within the first 2-5 years. The prognosis is especially unfavorable in acute cases, which quickly lead to the development of severe anemia; the latter does not make it possible to carry out the necessary active treatment (radiation therapy, Embiquin).

What is the survival prognosis for lymphoma?

• Features of the disease
• Existing types of lymphomas
• Stages of disease development
• Treatment of pathology
• Prognosis for cure of the disease

Many people are concerned about whether lymphoma has a prognosis for recovery. Lymphoma is a type of cancer, including many types and subtypes with different localizations of the process.

This problem is being solved by specialists in clinics in many leading countries (for example, in Israel). Several radical methods of treatment and prevention have been developed. Of course, when lymphoma develops, the prognosis for combating this disease depends entirely on timely diagnosis and initiation of treatment using effective measures.

Features of the disease

Lymphoma is an oncological disease when a malignant tumor destroys the human lymphatic system. This part of the human body consists of interconnected vessels, nodes, spleen and glands that ensure the movement and purification of lymph and lymphocytes (white blood particles); playing an important role in protecting the body from a variety of infections.

With lymphoma, rapid and chaotic cell division begins, leading to the formation of tumors. The main composition of the formations is B-lymphocytes and T-lymphocytes, which are types of white blood cells. These affected cells can be concentrated in the blood, but the most typical localization is solid malignant tumors in the nodes and vessels, and they also affect the spleen and other internal organs.

Lymphoma damage is quite versatile and is divided into subtypes. In general, the prognosis for treatment of the disease depends on the type of disease, stage of development, general condition of the human body, his age and other individual characteristics.

Existing types of lymphomas

It is possible to predict the course of the disease only after establishing the type of lymphoma, since each of them has its own characteristics, pathology and specific treatment. In total, there are 35 main types of the disease, incl. 5 types belong to the varieties of Hodgkin lymphoma, and 30 types are considered non-Hodgkin lymphoma.

The most common type of lymphoma is Hodgkin's lymphoma, which affects the lymphatic system. There are 5 main subtypes of this type of disease: the type enriched with lymphocytes; sclerosis of nodes (nodular sclerosis); mixed-cell type (accounts for up to half of all cases of disease); lymphoid depletion; sclerosis with lymphoid predominance. Until recently, the prognosis for this type of disease was disappointing, but treatment methods have now been developed that provide an optimistic outlook for recovery.

Non-Hodgkin's lymphomas constitute a long line of neoplastic diseases arising from lymphatic cells. They belong to the group of so-called lymphosarcoma. Very often this type of disease is explained by infection with the Epstein-Barr virus. In general, many subspecies are distinguished, which are grouped into slowly developing indolent variants; into progressive aggressive types and into a subgroup with moderate activity, but affecting internal organs (primarily the spleen) without damaging the nodes, called extranodal. Survival prognosis in this group has a different prognosis: for the indolent course of the disease it is quite optimistic.

The characteristic morphological types of non-Hodgkin lymphoma include: B-cell type in the marginal area; MALT lymphoma; follicular varieties, which have a very good prognosis for survival with timely treatment. At the same time, this large group includes subtypes with a rather negative prognosis: T-regional type and T-cell variants of a peripheral nature.

Typical extranodal forms of the disease include skin lymphoma, lymphoma of the stomach and gastrointestinal tract, and Burkitt's lymphoma. The latter type is characterized by the most active growth of a malignant tumor, affecting a number of organs, incl. spleen

Stages of disease development

One of the main factors shaping the prognosis for survival is the degree of development of the disease, which is classified into 4 stages:

• the first stage is caused by damage to only one group of lymph nodes or the presence of one small lesion of organ tissue;
• the second stage includes the growth of the tumor into two or more groups of nodes on one side of the diaphragm;
• the third stage is characterized by damage to nodes on both sides of the diaphragm; damage to individual tissues of the spleen, liver lymph nodes, celiac nodes; growth of the lesion into the abdominal cavity;
• the fourth stage determines diffuse damage to a number of internal organs.

1. Type A: the disease develops without the manifestation of obvious symptoms, there are no signs of intoxication of the body.
2. Type B: severe weight loss (10% or more), frequent temperature fluctuations above 38 degrees, fever, night sweats.

In addition, lymphoma is classified according to possible recurrences. There are two forms of relapse: the early type, which appears less than 1 year after the end of treatment; and late type with repetition at a later date. This classification is very important when assessing the prognosis for curing the disease.

Treatment of pathology

A prognosis for survival at any stage of lymphoma development can be made only after intensive treatment and determination of the effectiveness of its effect on the body. The following methods are used to treat lymphoma at different stages: chemotherapy, radiation therapy, biological therapy, bone marrow transplant.

The principles of chemotherapy and radiation exposure are most often used. For clearly localized tumors, preference is given to radiation therapy - radiotherapy, i.e. exposure to high-energy, highly targeted X-rays that destroy diseased cells.

In case of extensive damage or lack of clear localization, chemical drugs that suppress all rapidly dividing cells are more effective. To improve treatment results, a course of radiation therapy may be prescribed after chemotherapy. The following potent drugs are used: chlorbutin, cyclophosphamide, Mabthera, vincristine, fludarabine and some others. Chemotherapy allows you to suppress the development of pathogenic cells, which allows the patient to live normally until the next course of treatment, and in the first stages of lymphoma, to heal the body.

One of the effective methods of treatment is the use of chemicals with increased dosages. Such a radical remedy suppresses cancerous foci, but at the same time kills spinal cord cells. This necessitates a spinal cord transplant (your own, taken before chemotherapy, or a donor). The effectiveness of the method makes it possible to increase a positive prognosis even for patients at the fourth stage of lymphoma.

Biological therapy is an ultra-modern technique and is carried out only in the best clinics, for example, in Israel. Such therapy is based on immunotherapy, antigenesis inhibitors and therapy at the gene level.

Prognosis for cure of the disease

The prognosis for survival of patients with lymphoma depends on the type of disease, its stage and the effectiveness of treatment. Thus, the use of intensive radiation therapy for non-Hodgkin lymphomas in the early stages leads to long-term remission in almost 95% of cases. Moreover, with remission up to 5 years, survival is predicted to be within 80-82%, and with a relapse after 15 years - up to 98%.

Treatment using combination chemotherapy increases complete remission of patients with stage 2-3 Hodgkin lymphoma in more than 50% of cases, and the positive prognosis when remission is achieved tends to 90%.

An optimistically high prognosis for cure in patients with most types of non-Hodgkin's lymphoma, however, when the central nervous system, breast, ovaries, and bones are affected, the prognosis does not exceed 30%, which requires timely diagnosis and radical treatment methods.

In general, taking into account the presence of the fourth stage and other complications, the prognosis for survival for 5 years on average exceeds 67%, and for 15 years - 56%. At the same time, the disease at the first stage and in a slowly progressing form has a prognosis for cure close to 98%, and when treated in leading clinics - up to 100%.

Lymphoma is a very life-threatening disease. The survival prognosis for patients depends on many factors, but, above all, it is determined by the timeliness of diagnosis and the initiation of effective treatment. The prognosis will be optimistic if the patient has the appropriate psychological mood and faith in a cure, and modern medical techniques make life easier for such people.

Lymphoma

There are a lot of clinical studies and scientific works on the etiology and pathophysiological mechanisms of lymphoma, but the full picture of the disease still remains unexplored. This pathology is rightfully considered one of the most common and dangerous types of cancer of human lymph nodes.

Definition

Lymphoma is a cancerous pathology that develops in a person’s lymph nodes. This term combines a whole group of diseases that affect lymphatic tissue. Malignant lymphomas are quite common, and statistics indicate an increase in incidence.

Reasons for development

Modern medicine is not able to answer the question about the causes of the development and etiology of lymphoma. However, there is a list of factors that can act as provoking elements:

Classification

Lymphoma stages

Stage 1

Development of a tumor in the lymph nodes or in one internal organ.

Stage 2

Damage to several areas of regional lymph nodes, damage to the diaphragmatic plate on one side.

Stage 3

Involvement of lymph nodes on both sides of the diaphragm, damage to the spleen.

Stage 4

The development of tumor lesions of the upper floor of the abdominal cavity, lymph nodes and lymphatic structures that are located along the aorta. Stage 4 lymphoma is considered the most dangerous and has a poor prognosis.

Histological variants

marginal zone cell lymphoma

mantle cell lymphoma

Private views

Lymphoma of the intestine

This type of intestinal disease is diagnosed in approximately eighteen cases out of a hundred, among all malignant pathologies of the small intestine, and in one case out of a hundred, when it comes to the large intestine. Most often, the presence of B-cell non-Hodgkin lymphoma is determined in this part of the digestive tract.

In the photo: Sectional view of a removed intestinal lymphoma

There are such types of small intestinal lymphoma as posterior type lymphoma, as well as alpha heavy chain disease. The pathology mainly affects children under ten years of age, or men after fifty. The most common location (in eighty percent) is the small intestine. Precancerous diseases in this case are usually called celiac disease, hypogammaglobulinemia, and Crohn's disease.

Lymphoma of the small intestine

This is a rather dangerous pathology, the diagnosis of which should be treated with the utmost caution. The fact is that there are no specific symptoms that can distinguish small intestinal lymphoma from other tumors. In this regard, treatment must be comprehensive, including all available methods.

Photo of removed small intestinal lymphoma

Liver lymphoma

This is the development of a tumor from lymphatic tissues in the liver. Primary liver lymphoma is identified, which occurs in no more than fifteen percent of cases and is most often a solitary formation; usually this type develops in patients with immunodeficiency syndrome or against the background of a recent transplantation of this organ.

Photo of a liver affected by lymphomas

Secondary lymphoma is also isolated, which forms as a distant metastasis from other affected organs. This is due to the good blood supply to the liver and the fact that one of the main functions of this organ is filtering and purifying the blood. In this case, diffuse small-focal lesions are more typical.

Predisposing factors are pathologies such as:

• Cirrhosis of the liver.
• Diabetes mellitus of any type.
• Alcohol abuse.
• Biliary dyskinesia.

Thyroid lymphoma

Lymphoma of the thyroid gland is an oncological disease that originates from the lymphoid inclusions of the organ. Characteristic clinical symptoms develop, which are manifested by compression of the surrounding anatomical structures, which leads to an increase in the anterior surface of the neck, lymph nodes, as well as problems with the passage of the food bolus through the esophagus and hoarseness of the voice.

In the photo: a man with thyroid lymphoma

Diagnostic measures are limited to a blood test for thyroid hormones, as well as a fine-needle biopsy. Lymphoma of the thyroid gland is treated by using chemotherapy, and in the presence of limited forms of the disease, a radical ectomy of the organ is performed, followed by lymph node dissection. Thyroid lymphoma is more common in women after sixty years of age and has fairly good prognostic indicators.

Lymphoma of bone

Bone lymphoma usually develops in people over sixty years of age; this type of sarcoma can grow from absolutely any bone. In the case of secondary damage, most often the primary site is the liver, intestines or thyroid gland.

MRI image: bone lymphoma

Characteristic symptoms of the pathology are bone pain, which usually worsens at night, swelling, and the development of pathological fractures as a result of osteoporosis. Predisposing factors are considered to be congenital malformations, genetic conditions, and the presence of chronic exposure to radiation or chemical harmful factors.

Abdominal lymphoma

This is a type of blood cancer that causes abnormal lymphocytes to accumulate in the abdominal area. The characteristic clinical picture usually consists of the following symptoms:

• The presence of a palpable neoplasm in the abdomen, which leads to compression of the intestinal loops and the clinical picture of chronic intestinal obstruction.
• Frequent feeling of a full stomach as a result of eating the usual amount of food.
• Splenoid and hepatomegaly.
• Chronic abdominal pain and decreased appetite, even to the point of aversion to food.
• Accumulation of free fluid in the abdominal cavity.

An abdominopolar scan with enhanced contrast computed tomography showed a large soft tissue dense mass (white arrow) in the middle of the ascending colon and above the ileocecum. After extended scanning, heterogeneous enhancement was noted.

Diffuse lymphoma

Diffuse lymphoma (large B-cell) is a type of pathology in which lesions develop not only in the lymph nodes, but also in other internal organs. The risk group includes people with reduced immune reactivity, the presence of the Epstein-Barr virus, as well as those with infectious mononucleosis.

Histology of diffuse lymphoma

Lymphoma of the central nervous system

There are both primary and secondary types of this tumor. Secondary CNS lymphoma develops as a result of metastasis of lymphoma cells from other organs or tissues. Primary central nervous system lymphomas are considered to be quite rare types of non-Hodgkin lymphomas that arise in the area of ​​​​the structures of the central nervous system, but do not subsequently spread beyond its boundaries.

Magnetic resonance imaging of the brain showing B-cell non-Hodgkin's lymphoma of the sella turcica, hypothalamus, and tectum (intense white areas, middle).

Diagnosis is based on the presence of focal brain symptoms and invasive instrumental methods such as tumor resection or biopsy. A frequent clinical manifestation is an unbearable headache of a bursting nature, the appearance of damage to the spinal or optic nerves.

Lymphoma of the breast

This is an oncological tumor in the mammary gland, which occurs in five-tenths of one percent of all cases of pathological neoplasms in this anatomical structure. Usually it develops secondarily. As a result of metastasis from the primary tumor.

Mammography showed a round, 1.5 cm, well-described nodule, with uniform density, tiny lobular borders and no microcalcifications

Palpation reveals a round inclusion with clearly defined edges, which is combined with local thickening of the skin. Once the final diagnosis is determined by biopsy, the choice of treatment follows. Most often, it involves the use of complex therapy, which includes surgery, chemotherapy and radiotherapy.

Testicular lymphoma

Testicular lymphoma - the development of a primary tumor in this zone of lymphoid origin is considered quite rare and occurs in only two percent of cases among all lymphomas. The risk group includes men over fifty years of age. In every fifth case, bilateral damage to these organs is observed.

The photo shows a multiradiate mass with a diameter of 5.4 cm. Histology and immunohistochemical findings diagnosed diffuse testicular B-cell lymphoma.

Diagnosis in the early stages is possible due to the presence of compaction and the sensation of a foreign body in the scrotum. In this regard, the treatment regimen used is successful in eighty percent of cases.

Lymphoma in children

This is a common disease due to the fact that children are at risk. This is due to the development of the immune system and its restructuring during the period of six to seven years of age. At this point, a malfunction in the replication of the genetic code may develop, which leads to the development of the disease.

There are the following types of lymphoma in children:

The mass of complications associated with lymphoma in children obliges specialists to devote every effort to early detection of pathology and comprehensive treatment. The most common symptoms at this age are:

• Weight loss.
• Development of low-grade fever.
• Increased sweating at night.
• Chronic weakness and accelerated fatigue.
• Itching of the skin.
• Pallor.
• Pain in the bones and joints.

Marginal zone lymphoma of the spleen

Marginal zone lymphoma of the spleen is a tumor that develops at the border of the white and red pulp of the spleen. It is this part of the organ that is called the magrinal zone; there is a large accumulation of lymphocytes. This non-Hodgkin's lymphoma mostly affects people over seventy years of age and accounts for no more than three percent of all non-Hodgkin's lymphomas.

Splenic lymphatic marginal zone. An enlarged image shows the chromatin pattern characteristic of lymphoid cells, accompanied by polar villi.

Nonspecific manifestations of the disease are the following symptoms:

• Weakness.
• Excessive sweating.
• Fast fatiguability.
• Heaviness in the left hypochondrium, which is not associated with food intake.
• Low-grade fever.
• Weight loss.

Mantle cell lymphoma

Mantle cell lymphoma is a formation of B lymphocytes that develops as a result of a chromosomal mutation. This pathology is characterized by enlargement of the lymph nodes, spleen, liver size, as well as damage to the lymph nodes of the digestive tract. Differential diagnosis must be carried out with intestinal polyposis, this is due to a similar clinical picture.

Mantle cell lymphoma, general pathology - the mucous membrane of the colon, dotted with tumor nodules in intestinal lymphomatous polyposis.

The growth originates from the mantle zone, where pathological cells multiply. Lymphoma from the cells of the mantle zone is considered a pathology with a low degree of malignancy, since there is no proliferation in the germinal center of the lymph nodes.

Lymphoma: prognosis, survival

Lymphoma is a type of cancer involving immune system cells called lymphocytes. Lymphoma is found in many different types of cancer (about 35). But all diseases of this type are divided into two categories:

The first type affects only about 12% of people and is currently a treatable disease.

Non-Hodgkin's cancer attacks the body's lymphatic system, which is made up of vessels that carry fluid called lymph to the body. When subtypes of B or T cells begin to multiply uncontrollably, malignant transformation occurs. Abnormal cells may collect in one or more lymph nodes or other tissues such as the spleen. Through the lymphatic system, the tumor quickly spreads to distant parts of the body.

Rapidly growing lymphoma - prognosis

There is an international prognostic index that was developed to help doctors determine the cancer outlook and survival rate for people with fast-growing lymphoma.

The indicator depends on 5 factors:

1. Patient's age.
2. Stages of lymphoma.
3. The presence of disease in the organs of the external lymphatic system.
4. General condition (how well a person can perform daily activities).
5. A blood test to determine the level of lactate dehydrogenase (LDH), which comes with the amount of lymph.

Many conditions influence a positive prognosis for lymphoma:

• patient's age (up to 60);
• stage (I or II);
• the absence of lymphoma outside the lymph nodes or the presence of metastases in only one area outside them;
• the patient’s body is able to function normally;
• serum LDH is normal.

If the indicators differ from those indicated, this indicates poor prognostic factors. Accordingly, on a 5-point scale, such patients have the least favorable prognosis for recovery and survival. In this regard, there are 4 risk groups:

1. Low (zero or single unfavorable circumstances).
2. Low intermediate (2 unfavorable conditions).
3. Cancers with high intermediate rates (3 low survival rates).
4. High (4 or 5 unfavorable factors).

Research developed over the past decade indicates that about 75% of people in the lowest risk group lived at least 5 years. While in the high-risk group, about 30% of patients lived for 5 years.

Over the past five years, treatment methods have changed, and new procedures have been developed for the treatment of malignant tumors, which has a positive effect on prognostic data. Global research in recent years shows that about 95% of people in the very low risk group lived for at least 4 years. While with high hazard rates (low survival rate), life expectancy is already 55%.

Follicular lymphoma - survival prognosis

For follicular lymphoma, which is characterized by slow growth, other prognostic indices have been developed.

Good prognostic factors:

• age under 60 years;
• Stage I or II;
• hemoglobin 12/g or higher;
• metastatic lesion has spread to 4 or fewer lymphatic areas;
• serum LDH is normal.

Risk groups and survival:

1. Low risk (1 unfavorable factor): 5-year survival rate becomes 91%, 10-year survival rate becomes 71%.
2. Intermediate risk (2 unfavorable factors): 5-year survival rate - 78%, 10-year survival rate - 51%.
3. High risk (3 negative factors): 5-year survival rate - 53%, 10-year survival rate - 36%.

Lymphoma survival

The survival rate directly depends on the stage of the cancer. Also, it should be borne in mind that modern clinical trials (for example, such as stem cell transplantation) can reduce the risk of an unfavorable outcome.

Survival also varies significantly depending on the subtype of Non-Hodgkin's lymphoma. Follicular lymphoma has a better prognosis (96%) than diffuse B-cell lymphoma (65%). Large cell lymphoma is characterized by indications that reach 71%. For the marginal zone of the disease - 92%.

Lymphatic cancer with a survival prognosis by stage is presented as follows:

1. In patients with stage 1 lymphoma, five-year prognostic indicators are quite high - 82%.
2. Patients with stage 2 disease have an 88% five-year survival rate.
3. The five-year prognosis from the initial diagnosis of the disease for patients of the third stage includes 63%.
4. The fourth stage of cancer is represented by rates of 49% within 5 years of the course of the disease from the first diagnosis.

Five-year survival rates for young men and women are highest and decrease with increasing age:

• in men, the five-year prognosis for lymphoma ranges from 83% (for 15-39 year olds) to 36% (for adults);
• In women, the five-year survival rate for lymphoma ranges from 86% to 40% in the same age groups.

Compared to the 1990s, in 2014–2015, cancer of the lymphatic system in most cases can have a favorable outcome. Thus, the five-year standardized survival rate for men increased by 30%, and for women by 39 points, which represents a positive trend.

Intestinal lymphoma: etiology, clinical picture, survival

One of the rare cancer diseases is intestinal lymphoma, which affects only 1% of the total number of people with malignant tumors.

As a rule, lymphoma is most often diagnosed in men over 50 years of age. In most cases, the pathology affects the small intestine, and only in 20% is localized in the large intestine.

Definition

Intestinal lymphoma is a malignant pathology that affects the walls of the organ, where fibrous tissue grows. The pathology tends to develop slowly and be highly sensitive to chemotherapy at different stages. In the absence of timely treatment, the tumor metastasizes to the bone marrow and liver.

Signs

Lymphoma, unlike other types of intestinal cancer, has its own specific signs and clinical manifestations:

1. Decreased tone of the intestinal walls, manifested by constant diarrhea. As the pathological formation spreads, diarrhea can lead to malabsorption syndrome and subsequently to exudative type enteropathy. Against this background, there is a pronounced loss of body weight, up to exhaustion.
2. The appearance in the feces of mucous impurities associated with the syndrome of excessive reproduction and growth of bacteria, and partial rejection of dead epithelium;
3. The formation of submucosal formations of a round shape, indicating hyperplasia of lymphoid tissue with the formation of nodules. As a result of extensive hyperplasia, the nodules merge, and the intestinal walls completely lose their natural relief.
4. An increase in the lymphatic mesenteric nodes of the retroperitoneal group, as a result of which polycyclicity of the general intestinal contour is formed.

Lymphoma includes several types of cancer that affect the intestines. Each type is characterized by its own development mechanisms and features of the manifestation of the clinical picture.

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Primary B-cell non-Hodgkin lymphoma

This type of pathology is characterized by the formation of a polyp-shaped tumor that grows into the intestinal lumen. Lymphoma can be either single or multiple. Single tumor formations are observed in the ileocecal region or ileum.

Multiple growths most often affect the small and large intestines. This type of tumor is characterized by an intense increase in volume and growth into adjacent tissues. During the growth process, numerous lesions form on the surface of the affected tissues. As a rule, the pathology is accompanied by frequent bleeding and intestinal obstruction.

T cell lymphoma

T-cell lymphoma is one of the most rapidly progressing and rare malignant pathologies. The tumor in this case develops from large atypical lymphocyte cells. Most often, it affects the walls of the small intestine, from where it spreads to other parts of the gastrointestinal tract.

The main cause of the pathology is disruption of the functioning of the intestine. The disease is characterized by the formation of a voluminous tumor that blocks the intestinal lumen. The growth of the tumor leads to a decrease in the tone of the walls of the organ and its atrophy.

Western type small bowel lymphoma

This pathology is mainly diagnosed in people living in Western countries. The main location of the developing tumor is the ileum. The growth of the neoplasm begins from the submucosal layer of lymphoid tissue and gradually grows throughout the entire intestinal wall.

This type of tumor is characterized by local invasive growth. As the affected area increases, multiple ulcers form on the mucous membrane. As a rule, the tumor tends to quickly metastasize to regional lymph nodes and the spleen.

How this blood test determines the signs of leukemia in children.

Heavy A-chain disease

This type of lymphoma is typical for residents of North Africa and the Middle East. The pathology affects the proximal small intestine, as well as the duodenum. The initial stage of the disease is characterized by diffuse infiltration of the mucosa with many leukocyte and plasma cells.

With the intensive development of pathology, dense tumor-like nodes are noted that grow into all layers of the organ wall. At the same time, the wall thickens excessively, resulting in dilatation and strictures.

Hodgkin's lymphoma

Pathology of this type is characterized by wide localization and can simultaneously affect both the large and small intestines. Hodgkin's lymphoma is characterized by variability in forms of manifestation. It can form in the form of polyps, germinate as an infiltrate, or form extensive ulcers. The peculiarity of this type of disease is the late onset of symptoms.

Most often it manifests itself as severe pain. As the tumor grows, the intestine becomes deformed due to abnormal thickening of the walls, which has precise boundaries. At the same time, their elasticity is practically not impaired, and the intestinal lumen is not narrowed.

Forms

In addition to the types, there are several forms for intestinal lymphoma:

Nodal. It is a tumor that forms in the form of a node. It is characterized by the presence of multiple formations that spread over a limited area of ​​the organ. As they grow, they change the structure of the wall surface, leading to its atrophy.

The nodular form has a short development period. As a rule, 3 months after the onset of the first symptoms, signs of intestinal obstruction and organ perforation appear, which is typical for the later stages of the pathology.

Diffuse. This form is most often observed in non-Hodgkin's lymphoma. It is characterized by germination through the entire intestinal wall and damage to adjacent sections and organs.

Pathology quickly involves the lymph nodes of the retroperitoneal region and small intestine in the pathological process. Against this background, the diffuse form is often accompanied by exudative type enteropathy syndrome.

Absent-minded. It is the most difficult to diagnose, in which only a comprehensive study is used. It is characterized by low growth rates and minimal manifestations.

Localized in the submucosal layer, the tumor grows along the walls, gradually spreading to the entire section, and then beyond it. Damage to the mucous layer occurs only in the later stages, when the pathological process leads to complete atrophy of one of the sections.

Symptoms

Intestinal lymphoma is characterized by a certain group of symptoms that appear in the initial stages of pathology development:

• lack of appetite;
• the appearance of a constant feeling of nausea;
• sensations of a full abdomen, which may be accompanied by discomfort or slight pain in the lower part;
• stool disorder. At the beginning of the disease, regular diarrhea is observed, but as the tumor increases, they are replaced by prolonged constipation, lasting from several days to two or more weeks;
• constant gas formation, leading to bloating;
• anemia;
• the appearance of brown or bloody mucus in the stool;
• temperature increase;
• constant drowsiness, fatigue and weakness;
• disruption of the heart;
• capillary type bleeding;
• frequent belching, regardless of food intake;
• protrusion of the intestinal walls, which leads to deformation of the shape of the abdomen.

Diagnostics

A set of standard methods is used to diagnose lymphoma. The following are considered the most effective of them:

1. Laparotomy. It is a standard surgical operation of the abdominal type, in which an incision is made in the abdominal cavity. Laparotomy is used to obtain pathological tissues, which are sent for histological examination. As a result of the procedure, the form and type of pathology is revealed.
2. X-ray. Designed to detect small tumors and areas of metastasis.
3. Ultrasound. Allows you to determine the volume of the tumor and study the structure of pathological and healthy tissue located within the affected area.
4. Blood tests. They are carried out first of all, as they help to identify pathology by changes in certain indicators. Additionally, a blood test for tumor markers can be used to determine the affected organ.

Treatment

To treat this pathology, two main methods are used to prevent the pathology from spreading to other parts and organs:

1. Delete. This method is used in the second and more advanced stages. It represents a localized resection of a section of the intestine and the combination of its healthy sections. If the lymph nodes have been damaged by pathology, they are removed along with part of the organ. If it is impossible to combine two sections of the intestine, a colostomy is performed.

Chemotherapy. It is used as the main method in the first stage of the disease. At later stages it is prescribed after tumor removal. For this pathology, chemotherapy is carried out using cytostatics and hormonal drugs: adriamycin, prednisolone, vincristine, cyclophosphamide.

The drugs can be administered either by injection or intravenously. As a rule, one course of chemotherapy lasts no more than 8 weeks.

Rehabilitation after removal

During this period, the patient feels severe pain in the area of ​​the damaged organs and the incision, which can be relieved with painkillers. To shorten the healing period and reduce the likelihood of relapses, the patient is prescribed a special diet, daily routine and supportive therapy.

Forecast

The prognosis for lymphoma affecting the intestines will depend on the stage of the disease. Treatment of early stages gives good results. In this case, more than 90% of patients survive and only 15% experience relapses in the next few years.

After radical treatment in the final stages, the 5-year survival rate is 43%. Often, one third of patients experience relapses, which are fatal in half the cases.

In this video, experts talk about lymphoma in more detail.

Lymphoma of the intestine

This type of intestinal disease is diagnosed in approximately eighteen cases out of a hundred, among all malignant pathologies of the small intestine, and in one case out of a hundred, when it comes to the large intestine. Most often, the presence of B-cell non-Hodgkin lymphoma is determined in this part of the digestive tract.

In the photo: Sectional view of a removed intestinal lymphoma

There are such types of small intestinal lymphoma as posterior type lymphoma, as well as alpha heavy chain disease. The pathology mainly affects children under ten years of age, or men after fifty. The most common location (in eighty percent) is the small intestine. Precancerous diseases in this case are usually called celiac disease, hypogammaglobulinemia, and Crohn's disease.

This is a rather dangerous pathology, the diagnosis of which should be treated with the utmost caution. The fact is that there are no specific symptoms that can distinguish small intestinal lymphoma from other tumors. In this regard, treatment must be comprehensive, including all available methods.

Liver lymphoma

This is the development of a tumor from lymphatic tissues in the liver. Primary liver lymphoma is identified, which occurs in no more than fifteen percent of cases and is most often a solitary formation; usually this type develops in patients with immunodeficiency syndrome or against the background of a recent transplantation of this organ.

Secondary lymphoma is also isolated, which forms as a distant metastasis from other affected organs. This is due to the good blood supply to the liver and the fact that one of the main functions of this organ is filtering and purifying the blood. In this case, diffuse small-focal lesions are more typical.

Predisposing factors are pathologies such as:

• Cirrhosis of the liver.
• Diabetes mellitus of any type.
• Alcohol abuse.
• Biliary dyskinesia.

Thyroid lymphoma

Lymphoma of the thyroid gland is an oncological disease that originates from the lymphoid inclusions of the organ. Characteristic clinical symptoms develop, which are manifested by compression of the surrounding anatomical structures, which leads to an increase in the anterior surface of the neck, lymph nodes, as well as problems with the passage of the food bolus through the esophagus and hoarseness of the voice.

Diagnostic measures are limited to a blood test for thyroid hormones, as well as a fine-needle biopsy. Thyroid lymphoma is treated with a course of chemotherapy for lymphoma cancer, and in the presence of limited forms of the disease, a radical ectomy of the organ is performed, followed by lymph node dissection. Thyroid lymphoma is more common in women after sixty years of age and has fairly good prognostic indicators.

Lymphoma of bone

Bone lymphoma usually develops in people over sixty years of age; this type of sarcoma can grow from absolutely any bone. In the case of secondary damage, most often the primary site is the liver, intestines or thyroid gland.

Characteristic symptoms of the pathology are bone pain, which usually worsens at night, swelling, and the development of pathological fractures as a result of osteoporosis. Predisposing factors are considered to be congenital malformations, genetic conditions, and the presence of chronic exposure to radiation or chemical harmful factors.

Abdominal lymphoma

This is a type of blood cancer that causes abnormal lymphocytes to accumulate in the abdominal area. The characteristic clinical picture usually consists of the following symptoms:

• The presence of a palpable neoplasm in the abdomen, which leads to compression of the intestinal loops and the clinical picture of chronic intestinal obstruction.
• Frequent feeling of a full stomach as a result of eating the usual amount of food.
• Splenoid and hepatomegaly.
• Chronic abdominal pain and decreased appetite, even to the point of aversion to food.
• Accumulation of free fluid in the abdominal cavity.

Diffuse lymphoma (large B-cell) is a type of pathology in which lesions develop not only in the lymph nodes, but also in other internal organs. The risk group includes people with reduced immune reactivity, the presence of the Epstein-Barr virus, as well as those with infectious mononucleosis.

Lymphoma of the central nervous system

There are both primary and secondary types of this tumor. Secondary CNS lymphoma develops as a result of metastasis of lymphoma cells from other organs or tissues. Primary central nervous system lymphomas are considered to be quite rare types of non-Hodgkin lymphomas that arise in the area of ​​​​the structures of the central nervous system, but do not subsequently spread beyond its boundaries.

Diagnosis is based on the presence of focal brain symptoms and invasive instrumental methods such as tumor resection or biopsy. A frequent clinical manifestation is an unbearable headache of a bursting nature, the appearance of damage to the spinal or optic nerves.

Lymphoma of the breast

This is an oncological tumor in the mammary gland, which occurs in five-tenths of one percent of all cases of pathological neoplasms in this anatomical structure. Usually it develops secondarily. As a result of metastasis from the primary tumor.

Palpation reveals a round inclusion with clearly defined edges, which is combined with local thickening of the skin. Once the final diagnosis is determined by biopsy, the choice of treatment follows. Most often, it involves the use of complex therapy, which includes surgery, chemotherapy and radiotherapy.

Testicular lymphoma

Testicular lymphoma - the development of a primary tumor in this zone of lymphoid origin is considered quite rare and occurs in only two percent of cases among all lymphomas. The risk group includes men over fifty years of age. In every fifth case, bilateral damage to these organs is observed.

Diagnosis in the early stages is possible due to the presence of compaction and the sensation of a foreign body in the scrotum. In this regard, the treatment regimen used is successful in eighty percent of cases.

Lymphoma in children

This is a common disease due to the fact that children are at risk. This is due to the development of the immune system and its restructuring during the period of six to seven years of age. At this point, a malfunction in the replication of the genetic code may develop, which leads to the development of the disease.

There are the following types of lymphoma in children:

• Non-classical.
• Mixed cell.
• With lymphotosis.
• With lymphopenia.
• Nodular form.

The mass of complications associated with lymphoma in children obliges specialists to devote every effort to early detection of pathology and comprehensive treatment. The most common symptoms at this age are:

• Weight loss.
• Development of low-grade fever.
• Increased sweating at night.
• Chronic weakness and accelerated fatigue.
• Itching of the skin.
• Pallor.
• Pain in the bones and joints.

Marginal zone lymphoma of the spleen

Marginal zone lymphoma of the spleen is a tumor that develops at the border of the white and red pulp of the spleen. It is this part of the organ that is called the magrinal zone; there is a large accumulation of lymphocytes. This non-Hodgkin's lymphoma mostly affects people over seventy years of age and accounts for no more than three percent of all non-Hodgkin's lymphomas.

Nonspecific manifestations of the disease are the following symptoms::

• Weakness.
• Excessive sweating.
• Fast fatiguability.
• Heaviness in the left hypochondrium, which is not associated with food intake.
• Low-grade fever.
• Weight loss.

Mantle cell lymphoma

Mantle cell lymphoma is a formation of B lymphocytes that develops as a result of a chromosomal mutation. This pathology is characterized by enlargement of the lymph nodes, spleen, liver size, as well as damage to the lymph nodes of the digestive tract. Differential diagnosis must be carried out with intestinal polyposis, this is due to a similar clinical picture.

The growth originates from the mantle zone, where pathological cells multiply. Lymphoma from the cells of the mantle zone is considered a pathology with a low degree of malignancy, since there is no proliferation in the germinal center of the lymph nodes.

Lymphocytes are one of the most important immune factors, which are a type of white blood cells (leukocytes). The main task of lymphocytes is to remember (immune memory) and destroy foreign, infected, mutated cells, including tumor cells. An increased level of lymphocytes in the blood in the absence of clinical manifestations of infection - or any other symptoms - is considered as a possible early sign of the oncological process. However, in some cases the concentration of lymphocytes themselves increases malignantly; multiplying chaotically, uncontrollably and inadequately (in relation to the internal situation in the body), they accumulate in the lymph nodes and other organs, which leads to the development of a specific clinical picture.

This kind of pathology of the lymphatic system is designated by the collective term “lymphoma” and includes a group of rare hematological diseases. There are two histologically and clinically different types of lymphomas: Hodgkin's lymphogranulomatosis (accounts for no more than one percent of the total volume of registered oncopathology) and the so-called. non-Hodgkin's lymphoma, which occurs much more often than the first type (about 70% of all malignant lymphomas).

Intestinal lymphoma, therefore, is one of the types of lymphoma, which is characterized by a pathologically rapid, progressive accumulation of lymphocytes mainly in the intestine. From a statistical point of view, intestinal lymphoma is less common than any other localization option, and is almost always of the non-Hodgkin type.

2. Reasons

The etiopathogenesis of lymphomas, including intestinal lymphoma, has currently been studied and insufficiently clarified.

The clinical picture is formed by numerous and, as a rule, significantly pronounced symptoms, none of which, however, is pathognomonic (unambiguously indicating this disease). The diagnosis of “intestinal lymphoma” is assumed based on a specific combination of such manifestations as significant enlargement and palpable tenderness of the lymph nodes, pain (usually aggravated by defecation and/or eating), fever and general malaise, various dyspeptic symptoms, and hyperhidrosis. Sometimes there is an admixture of blood in the stool. One of the features of intestinal lymphoma that distinguishes it from other oncological diseases is the rapid appearance and increase in clinically significant symptoms, which leaves a chance for early correct diagnosis.

It should be noted that intestinal lymphomas vary widely in terms of aggressiveness, growth rate, specific localization (usually the small intestine, less often the large intestine, very rarely total damage to the entire intestine occurs), histological characteristics, as well as staging in each specific case of seeking help.

The decisive diagnostic method is biopsy. Some clinical variants of intestinal lymphoma, especially in advanced forms, are characterized by an extremely unfavorable prognosis, while others (up to 50%) are considered curable.

4. Treatment

Once the diagnosis is established and confirmed, a standard oncological treatment regimen is prescribed, usually with surgical removal of foci of malignant lymphocyte accumulation and mandatory subsequent chemotherapy. Currently, the possibilities of innovative treatment methods (immunotherapy, HIFU therapy, etc.) are being intensively and effectively studied, which gives grounds for reasonable optimism in terms of prospects.

It must be emphasized that the prognosis for intestinal lymphoma (as with any other oncological diseases) critically depends on the timely detection and identification of pathology, especially since in this case early reliable diagnosis is quite possible. Therefore, if you have any combination of the symptoms described above, you should consult a doctor immediately.

Intestinal lymphoma is a rare cancer that affects no more than 1% of patients with malignant neoplasms. The disease predominantly affects men over 50 years of age. The main location of the pathological process is the small intestine. In the colon, lymphoma is detected only in 20% of cases.

Most often, lymphoma is diagnosed in men over 50 years of age, and in the absence of timely treatment, the tumor metastasizes to the bone marrow and liver

This pathology involves the development of a cancerous tumor on the walls of the intestine, representing a malignant degeneration of lymphoid tissue. Intestinal lymphoma is characterized by extremely slow development, which is why it can remain invisible for a long time. The main danger of this disease is late detection. As a rule, the disease is identified in the last stages of development, having managed to metastasize to the tissue of the liver and bone marrow.

The pathology is highly sensitive to chemotherapy, and even in the last stages it can be treated well with the use of highly effective drugs.

Classification

Intestinal lymphoma is a group of several types of cancer that affect the walls of the small and large intestines. Each form has its own development mechanisms and clinical picture features.

Primary non-Hodgkin B-cell lymphoma

With this pathology, a polypoid tumor develops that grows into the intestinal lumen. Both single and multiple localizations are possible. In the first case, the pathology affects the ileum or ileocecal intestine.

Multiple tumor foci are characterized by localization in the area of ​​both the large and small intestines. In this case, the cancerous tumor quickly increases in volume and invades adjacent tissues. As a result of the progression of the pathological process, the affected tissues become covered with numerous ulcerations. When the disease is advanced, frequent bleeding and intestinal obstruction may develop.

Western type small bowel lymphoma

It is predominantly detected in residents of Western countries. Most often it affects the ileum, originating in the submucosal layer of lymphoid tissue, eventually affecting the entire intestinal wall.

The tumor is characterized by local invasive growth. As the tumor increases in size, the mucous membrane begins to become covered with numerous ulcers. The danger of this type of lymphoma lies in its extremely rapid metastasis to the spleen and regional lymph nodes.

T cell lymphoma

Severe fatigue, general weakness and drowsiness are all symptoms of intestinal lymphoma

One of the most rapidly progressing forms of the disease. Tumor development occurs from mutated large lymphocyte cells. The main place of its localization is the small intestine, from the walls of which the pathology grows, affecting the nearby sections of the gastrointestinal tract.

As a result of the pathological proliferation of lymphoid tissue, a large tumor is formed that blocks the intestinal lumen. As a result, the organ undergoes atrophic changes, during which the tone of its walls decreases.

With the development of this pathology, numerous ulcerations appear, causing constant abdominal pain.

Heavy chain disease

This form of lymphoma is common in the Middle East and North Africa. The malignant process is observed in the duodenum and can spread to the upper part of the small intestine.

In most cases, the pathology develops intensively, provoking the development of dense tumor-like nodes that grow into all layers of the intestinal wall. The latter thickens to a large extent, leading to the appearance of areas of expansion and contraction of the intestine.

Hodgkin's lymphoma

It can occur in the tissues of the large and small intestines, and often affects them simultaneously. The manifestation of this form of the disease is highly variable. For example, the formation of polyps, the appearance of extensive nodes, or the infiltration of infiltration into neighboring tissues is possible.

The disease is characterized by late symptoms, which is why it is extremely dangerous. As a rule, patients experience severe pain caused by intestinal deformation due to significant hypertrophy of its walls. In this case, there is no narrowing of the intestinal lumen, and tissue elasticity remains within acceptable limits.

In addition to the types described above, intestinal lymphoma can have several forms:

1. Nodal. The tumor is a node. Most often, such neoplasms are numerous. As they grow, they change the structure of the mucosa, gradually leading to atrophy of the intestinal walls. This form is characterized by rapid development - within three months after the appearance of the first symptoms, the patient develops intestinal obstruction.
2. Absent-minded. It is difficult to diagnose and requires complex studies. It develops slowly and has practically no manifestations. A common site of tumor localization is the submucosal layer. Next, the malignant process spreads along the intestinal wall, gradually extending beyond one section of the intestine. The mucous membranes are affected already in the later stages of the disease, when the pathology causes complete atrophy of the intestinal wall.
3. Diffuse. In most cases, it is detected during the development of non-Hodgkin lymphoma. Such tumors grow through the intestinal wall, affecting nearby organs. In this case, the retroperitoneal lymph nodes are very quickly involved in the pathological process.

Symptoms

Frequent belching that occurs regardless of food intake is a symptom of the disease

The most common symptoms of intestinal lymphoma are:

• decreased appetite;
• nausea;
• bloating caused by increased gas formation;
• feeling of a full stomach with slight soreness or heaviness in the lower part;
• heart failure;
• elevated temperature;
• brown or red mucus appears in the stool;
• severe fatigue, general weakness and drowsiness;
• stool disorders in the form of diarrhea, followed by prolonged constipation;
• frequent belching that occurs regardless of food intake;
• Abdominal deformation due to protrusion of the intestinal walls.

Causes

Lymphoma of the small intestine is an extremely rare cancer type disease, the causes of which are currently unknown. However, scientists were able to identify a risk group for developing this disease, which includes the following individuals:

• having a hereditary predisposition to the development of intestinal cancer;
• those who eat poorly and irregularly;
• having impaired functioning of the immune system.

What is the danger of intestinal lymphoma?

Since this disease is malignant in nature, it poses a significant danger not only to the health, but also to the life of the patient. As such tumors grow, they can cause intestinal obstruction, which is why the patient will need urgent surgery, which involves removing the intestine through the abdominal wall.

Intestinal lymphoma can grow, affecting neighboring organs, and metastasize to distant parts of the body. When the disease is advanced, vital organs may be damaged, which causes their dysfunction and ultimately leads to death.

Diagnostics

A blood test is carried out first, as it helps to identify pathology by changes in certain indicators

To diagnose lymphoma, it is necessary to use a set of standard techniques. The most informative in this case are:

1. Laparotomy. This is a surgical method during which an incision is made in the abdominal cavity. This technique is used to take tissue samples, after which their histological examination is carried out. Laparotomy allows us to identify the type of pathology and the degree of its development.
2. Ultrasound. A traditional technique that allows you to determine the size of a tumor and thoroughly study its structure. Healthy tissues close to the affected area are also examined.
3. Radiography. Allows you to identify small tumors and determine the location of metastases.
4. Laboratory research. They suggest carrying out blood tests that allow you to determine the degree of deviation in certain indicators. Such information gives the specialist a complete picture of the development of the disease and allows you to develop an individual treatment plan.

Features of treatment

As a rule, treatment of this pathology involves two main methods: chemotherapy and removal of affected tissue. They prevent the spread of the oncological process to other parts and organs.

Let's look at them in more detail:

1. Chemotherapy. This is the main treatment method used at all stages of the disease. It is especially effective in the initial stages of the development of the disease. In the third and fourth stages, it is used to reduce the size of the tumor before surgery. It is often carried out in conjunction with radiation therapy, which increases the effectiveness of the technique.
2. Surgical removal. Used in advanced stages of the disease. The operation involves resection of the affected part of the intestine.

If lymph nodes are involved in the pathological process, they are removed along with the intestines.

The prognosis of the disease depends on the stage of its development. If the disease is not advanced, and the treatment has been selected adequately, then more than 90% of patients are completely cured. If the disease was at stages 3-4, then the survival rate of patients is about 50%.

Rectal lymphoma arises in the submucosal layer of the rectum from lymphoid tissue or its closed follicles and is apparently rare.

Lymphomas of the rectum are:

• diffuse
• localized.

The diffuse form most often represents a local manifestation of general lymphosarcomatosis, while the localized form is a primary tumor.

Diffuse lymphoma is usually located low, sometimes above the outermost sphincter, and can involve it, but can also spread to the pelvic-colic loop and even affect the entire colon up to the bauginian valve. The infiltrated intestinal mucosa has a number of convolutions, bulges, grooves and is always on a broad base. Sometimes there are papillary formations, some of which are pedunculated and resemble polyps. To the touch, the tumor is dense and elastic, its color is dull gray, the mucous membrane over it is ulcerated in places, sometimes completely absent. The intestinal lumen is narrowed, but not so much as to cause obstruction. The surrounding tissue is rarely involved, but damage to the lymph nodes is common and not only regional. In the localized form of rectal lymphosarcoma, the tumor is delimited, dense, protrudes in the intestinal lumen, lifts the mucous membrane covering it, which sometimes ulcerates. It most often sits on a wide base, but can have a leg and fall out of the anus. Under the influence of certain factors, the tumor can progress.

In both forms, the tumor is built from lymphoid-reticular tissue, which captures and infiltrates the intestinal wall. The muscle fibers separate and disappear, the mucous membrane rises and becomes thinner, until the complete disappearance or formation of papillary outgrowths.

Symptoms of rectal lymphoma

The clinical course of lymphoma initially does not cause functional impairment. In the future, diarrhea is most often observed, first intermittent, and then constant, with foul-smelling discharge, and the sphincter relaxes. Bleeding is rare; blood is released with mucus. The patient's condition progressively worsens, pallor and fever develop.

Its diagnosis is not always simple. With digital examination, it is possible to establish either a localized form, in the form of a dense limited formation, or a diffuse infiltrating tumor with elevations and.

The tumor of lymphoma is less dense than cancer.

During rectoscopy, the mucous membrane is pale, sometimes pinkish, covered with superficial, flat ulcerations, and the boundaries of the tumor in a diffuse form are difficult to determine.

Treatment of rectal lymphoma

In localized forms, excision of the tumor is permissible only if its size is very limited; for more extensive tumors, the rectum is indicated; For diffuse sarcoma, surgical treatment is not advisable. Rectal lymphomas are very sensitive to X-rays. There is a known recovery that has been followed for many years. With this treatment, a number of