All of the following are true about small bowel lumphoma except –
Correct Answer: It is a very uncommon tumour amongst small bowel malignancies
Description: Ans. is 'c' i.e., It is a very uncommon tumour amongst small bowel malignancies Small bowel lymphomao Lymphoma of the small bowel is the most common small bowel malignancy, accounting accounts for-25% of all primary small bowel malignancies and -40% of all primary gastrointestinal lymphomas.Epidemiologyo Small bowel lymphoma is most commonly seen as secondary extranodal involvement in widespread systemic lymphoma. When primary it is seen predominantly in well defined patient groups and the demographics therefore match those of said groups. Predisposing conditions include1.# AIDS# Coeliac disease# Organ transplant (see post transplant lymphoproliferative disorder# Helicobacter pylori positive patientsClinical presentationo Presentation is variable and includes:# Gastrointestinal haemorrhage# Perforation# Small bowel obstruction (uncommon)Radiographic featureso Typically small bowel lymphoma involves a single loop of bowel with 5-20cm of its length demonstrating :# Bowel wall thickening: 1-7 cm.# Aneurysmal dilatation: 30%, it occurs due to replacement of muscularis by tumour or infiltration of myenteric nerve plexus.o Despite the extensive involvement, small bowel obstruction is uncommon because of lack of desmoplastic reaction, and perforation is rare.o Regional lymph node enlargement is seen in approximately 50% of cases.o Less frequently the disease may manifest as a solid mass lesion (polypoidal/excentric). In such cases differentiation from adenocarcinoma may be difficult. However, presence of extensive retroperitoneal lymphadenopathy and splenomegaly favours lymphoma, while adjacent fat infiltration supports adenocarcinoma.Treatment and prognosis.o Most frequently the involved segment is resected, with subsequent chemoradiotherapy.
Category:
Surgery
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