A Case Report of Primary Malignant Lymphoma of the Rectum

Tetsunobu Udaka, Shigeharu Moriyama, Toshihito Hanaoka, Takahiro Kinoshita, Ryuichiro Ohashi

Department of Surgery, Fuchu General Hospital

Primary malignant lymphoma of the gastro-intestinal tract largely originates in the stomach or in the small intestine. We report a rare case of primary malignant lymphoma of the rectum. A 70-year-old woman came to our hospital with the chief complaint of anal bleeding. A rectal mass, which occupied the anterior wall of the rectum and extended 4 cm from the anal verge, was detected by digital examination. The tumor revealed an elevated lesion about 6 cm long by barium enema examination. Endoscopy showed that the surface of the mass was coverd with rectal mucosa, and that it was multinodular and had an ulceration in the center. Histological diagnosis of the biopsy specimen was suspicion of malignant lymphoma. Abdomino-perineal resection with R₃ lymph node dissection and partial resection of the posterior wall of the vagina were performed. The clinical stage was A_i N_i (+) P₀H₀M (-), stage III. Histological and imunohistological diagnosis of the resected specimen was diffuse lymphoma, medium-sized cell, B-cell type (IgA, κ). The patient had multiple organ failure on the 10th postoperative day. Although she recovered from that, she unfortunately died of aspiration pneumonia 8 months after surgery. In this paper, we clinico-pathologically reviewed 65 cases of malignant lymphoma of the rectum reported in Japan from 1981 to 1992.

Key words
malignant lymphoma, rectum

Reprint requests
Tetsunobu Udaka Department of Surgery, Fuchu General Hospital
555-3 Ukai-cho, Fuchu City, 726 JAPAN

Accepted
May 13, 1992

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