anorectal lymphomas

Primary anorectal lymphoma is very rare with a higher incidence in human immunodeficiency virus positive (HIV+) patients. Most of these are high-grade B-cell non-Hodgkin lymphoma (NHL) associated with Epstein-Barr virus (EBV).

Hodgkin lymphoma (HL) is also observed with a higher incidence in HIV+ patients and 100% are EBV+.

Involvement of the colon and rectum accounts for approximately 20% of gastrointestinal HL in immunocompromised individuals.

In HIV− individuals, this is extremely rare but cases of isolated rectal HL have been reported, particularly in the context of inflammatory bowel disease.

Diagnosis of extranodal HL can be difficult because of the polymorphic nature of the cellular infiltrate and the scarcity of the malignant cells.

Differential diagnosis with atypical lymphoid hyperplasia, particularly associated with viruses such as EBV, may be raised.

References

 Ioachim HL, Antonescu C, Giancotti F, et al. EBV-associated anorectal lymphomas in patients with acquired immune deficiency syndrome. Am J Surg Pathol. 1997;21:997–1006.

 umar S, Fend F, Quintanilla-Martinez L, et al. Epstein-Barr virus-positive primary gastrointestinal Hodgkin’s disease: association with inflammatory bowel disease and immunosuppression. Am J Surg Pathol. 2000;24:66–73.

 Pagano L, Ratto C, Teofili L, et al. Isolated primary Hodgkin’s disease of rectum. Haematologica. 2000;85:986–987.

 Pinover W, Pickens P, Cohn J, et al. Rectal Hodgkin’s disease in acquired immune deficiency syndrome. J Clin Gastroenterol. 1993;16:171–173.

 Valbuena JR, Gualco G, Espejo-Plascencia I, et al. Classical Hodgkin lymphoma arising in the rectum. Ann Diagn Pathol. 2005;9:38–42.