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Linfomas de colon: análisis de nuestra experiencia en los últimos 23 años
| Content Provider | Semantic Scholar |
|---|---|
| Author | Domínguez, Martín Ortíz Mendoza, Juan López Díaz-Menéndez, Ariel Adrados, Murillo Ja, Moreno Monteagudo Santander, C. |
| Copyright Year | 2018 |
| Abstract | espanolIntroduccion: el linfoma de colon (LC) es una variedad poco frecuente de los linfomas no Hodgkin (LNH) que representa menos del 0,6% de todas las neoplasias primarias del colon. Realizar un diagnostico precoz es dificil debido a que las manifestaciones clinicas son inespecificas. El objetivo de esta revision fue presentar nuestra experiencia en los ultimos anos en cuanto a caracteristicas clinicas, endoscopicas, histologicas, diagnostico, tratamiento y evolucion de los LC. Pacientes y metodos: se realizo un analisis retrospectivo y descriptivo de pacientes con LC diagnosticados desde 1994 hasta 2016 en el Hospital Universitario de la Princesa, Madrid. Resultados: se identificaron 29 pacientes con LC (mediana de edad 67 anos, 18 hombres [62%]). Las manifestaciones clinicas mas comunes fueron dolor abdominal, sindrome constitucional, diarrea y masa abdominal palpable. Ocho (27,6%) pacientes se encontraban asintomaticos y seis (20,6%) debutaron con complicaciones quirurgicas. En 24 pacientes se realizo colonoscopia y los hallazgos mas frecuentes fueron infiltracion difusa y tumoracion. La localizacion mas comun fue el colon descendente y sigma. Los subtipos histologicos mas frecuentes fueron: LNH de celulas B del manto y linfoma difuso de celulas grandes tipo B. Se trato con quimioterapia a 28 pacientes (96,5%), con cirugia a seis (20,7%) y uno recibio quimio y radioterapia. La mediana del tiempo de supervivencia fue de 156 meses. La supervivencia al ano fue del 100,0% y a los diez anos, del 55,0%. Conclusiones: debido al aspecto endoscopico variable del LC, es necesario el estudio histologico de todos los segmentos del colon. El tratamiento de eleccion es la quimioterapia y en casos de complicaciones es necesaria la cirugia urgente con quimioterapia posterior. Los principales factores asociados a peor supervivencia son la edad mayor de 65 anos, la existencia de recidiva y las respuestas parciales o nulas. EnglishIntroduction: colon lymphoma (CL) is an uncommon variety of non-Hodgkin lymphoma (NHL) that represents less than 0.6% of all primary colonic neoplasms. Early diagnosis is challenging as clinical manifestations are non-specific. The goal of this review was to discuss our experience over the last few years regarding the clinical, endoscopic, histological, diagnostic, therapeutic and evolutionary characteristics of CL. Patients and methods: a retrospective, descriptive analysis of patients with CL diagnosed from 1994 to 2016 at the Hospital Universitario de La Princesa (Madrid, Spain) was performed. Results: a total of 29 patients with CL were identified, with a median age of 67 years; 18 were male (62%). The most common clinical manifestations included abdominal pain, constitutional syndrome, diarrhea and a palpable abdominal mass. Eight (27.6%) patients were asymptomatic and six (20.6%) initially presented with surgical complications. A colonoscopy was performed in 24 patients and the most common findings included diffuse infiltration and solid growth. The most common location was the descending and sigmoid colon. The most common histological subtypes included mantle B-cell NHL and diffuse large B-cell lymphoma. Chemotherapy was administered to 28 patients (96.5%), surgery was performed in six (20.7%) and combined chemo-radiotherapy was administered to one patient. Median survival was 156 months. Survival was 100.0% at one year and 55.0% at ten years. Conclusions: due to the variable aspects of CL on endoscopy, a histological study of all colonic segments is required. Chemotherapy is the treatment of choice and emergency surgery followed by chemotherapy is required for complications. Primary factors associated with poorer survival include age above 65 years, relapsing disease and partial or nil responses. |
| Starting Page | 762 |
| Ending Page | 767 |
| Page Count | 6 |
| File Format | PDF HTM / HTML |
| DOI | 10.17235/reed.2018.5445/2017 |
| Alternate Webpage(s) | http://scielo.isciii.es/pdf/diges/v110n12/1130-0108-diges-110-12-00762.pdf |
| Alternate Webpage(s) | https://doi.org/10.17235/reed.2018.5445%2F2017 |
| Volume Number | 110 |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
