Colon lymphomas: an analysis of our experience over the last 23 years.

INTRODUCTION: 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.

Bladder Herpes Infection in a Patient With Low-grade Non-Muscle-invasive Bladder Cancer.

Bladder herpes is a very uncommon event related to herpes simplex virus infection. We report a 69-year-old man with 4-year history of bladder cancer who presented with dysuria and urinary frequency. Cystoscopy showed erythematous lesion of the bladder mucosa that was biopsied and revealed multilobed nuclei with eosinophilic intranuclear inclusions, and presence of intracytoplasmic vacuoles that were suggestive of bladder involvement by herpes simplex virus. Different bladder disorders have been associated with herpes virus, but spontaneous resolution generally occurs in 1-2 months.

Unclassifiable CD20-negative Testicular Diffuse Large B-cell Lymphoma.

CD20-negative diffuse large B-cell lymphoma (DLBCL) is a very uncommon neoplasm, and very rare unclassifiable cases that did not meet the criteria for well-established subtypes of CD20-negative DLBCLs have been reported. CD20-negative DLBCLs often present an aggressive clinical course with important chemoresistance and poor prognosis. Here, we report a case of CD20-negative DLBCL presented as a testicular mass. To the best of our knowledge, this is one of the first reported cases of testicular unclassifiable CD20-negative DLBCL.