Il Kwon Jung

Primary colon lymphoma in Korea: A KASID (Korean Association for the Study of Intestinal Diseases) study

Although almost all primary colorectal lymphomas are of B-cell lineage in Western countries, primary colorectal T-cell lymphomas are not uncommon in the East. The aim of this study was to review the clinical characteristics and treatment outcomes of primary colorectal lymphomas, with special emphasis on the differences between T-cell and B-cell lymphomas. Ninety-five cases of primary colorectal lymphomas that satisfied Dawsons criteria were identified from the clinical databases of 13 university hospitals in Korea. The mean age at the time of presentation was 51.1 years and the male:female ratio was 64:31. The clinical information, including endoscopic and histological characteristics, was retrospectively analyzed. Of the primary colorectal lymphomas, 78 cases (82.1%) were of B-lineage and 17 cases (17.9%) were of T-cell lineage. Patients with T-cell lymphomas presented at a younger age than patients with B-cell lymphomas (42.8 vs 52.9 years, respectively; P= 0.016). The most common presenting symptom was abdominal pain (87.1%) for B-cell lymphomas, whereas hematochezia or night fever was more common for T-cell lymphomas (52.9% and 35.3%, respectively). The most common endoscopic type was fungating mass (54.0%) for B-cell lymphomas and ulcerative/ulcero-infiltrative lesions (80.0%) for T-cell lymphomas. Intussusception was more common in B-cell lymphomas than in T-cell lymphomas (30.8% vs 5.9%, respectively; P= 0.035), but perforation was more common in T-cell lymphomas than in B-cell lymphomas (23.5% vs 3.8%, respectively; P= 0.005). The prognosis was significantly worse for T-cell lymphomas than for B-cell lymphomas (P= 0.002). Primary colorectal T-cell lymphomas are characterized by multifocal ulcerative lesions in relatively young patients, a high rate of hematochezia, fever, or perforation, and a poor prognosis even for cases of localized disease.

Predictors of Isolated Advanced Proximal Neoplasia of Colon: The Kasid Prospective Multicenter Study

Predictors of Isolated Advanced Proximal Neoplasia of Colon: The Kasid Prospective Multicenter Study Hyun Soo Kim, Won Ho Kim, Tae Il Kim, Young-Ho Kim, Hyo Jong Kim, Suk-Kyun Yang, Seung-Jae Myung, Jeong-Sik Byeon, Moon Sung Lee, Il Kwon Jung, Sung-Ae Jung, Moon Kwan Chung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Dong Soo Han, Jae Suk Song Background: Although advanced adenomatous polyp is an ideal target of colorectal cancer screening, isolated proximal neoplasia without distal pathology would have been missed on a flexible sigmoidoscopy, an effective colorectal cancer screening technique. The aim of the study is to identify predictors of isolated advanced proximal neoplasia of colon. Methods: Data were prospectively collected from the 17,200 patients who presented for colonoscopy in 12 tertiary endoscopic centers. Information gathered included demographic characteristics including body mass index (BMI), endoscopic findings, histology, drug history of aspirin/ NSAID, and known risk factors for colorectal neoplasia. We compared the patients with isolated proximal advanced neoplasia with the patients without colon neoplasia. We defined advanced neoplasia as adenocarcinoma, high-grade dysplasia, villous polyps, or adenomas more than 11 mm. Results: Isolated advanced proximal neoplasia was found in 371 (2.2%) patients, and 6234 (36.2%) patients as a control group had no colon neoplasia. While patients older than 65 year had a risk for isolated advanced proximal neoplasia (OR Z 1.38: 95% CI Z 1.07-1.78; p Z 0.015), male gender, obesity (BMI; O27), those who took a daily aspirin or NSAID, and a family history of colorectal cancer were not associated with an increased risk of isolated advanced proximal neoplasia. Conclusion: Because age greater than 65 year increased the risk of finding isolated proximal advanced neoplasia, colonoscopy rather than flexible sigmoidoscopy should be the first consideration as a colorectal screening in the older population.