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This question was answered on Thu 18, Dec 2008 07:51am by Dr Fernando, MD

difference between non-hodgkin's lymphoma and colon cancer


    
Asked by grp (Female; 48; high cholesterol-inherited; non-smoker. non-drinker.; Relevant drugs:lipitor and zetia ) on Wed 17, Dec 2008 08:03am

My mother, aged 71, was diagnosed with a high grade B-cell non-hodgkin's lymphoma of the G.I. tract. She died from it very quickly-about 37 days from the time I took her into the hospital.The doctors said it was rare. Actually, 2 years before her death she presented with a bloody pericardial effusion in her chest. She never had swollen lymph nodes, and after a bone marrow biopsy and a peridardial window, it was determined she did not have cancer, although lymphoma was talked about.The fluid from her chest was tested and there were suspicious cells in the fluid but not enough to make a definitive diagnosis. For the next two years I saw her go downhill, and she was always sick to her stomach and complained of constipation.She was not monitored on a regular basis. Her gastroenterologist would just give her Prilosec or Prevacid for the stomach problems. When the diagnosis finally came, she had had a colonoscopy and a CT scan, and an upper endoscopy, and the doctor had found lymphatic tissue in her colon. They tried one chemotherapy treatment, but she threw a pulmonary embolism and died one week later.I am confused about the type of cancer she had. Was it non-hodgkin's that started in her colon, or was it colon cancer that caused the non-hodgkin's or are the two not even related. I am her only child. Should I be screened regularly for colon cancer. I just had a colonoscopy anyway at the age of 48, about 5 months ago, and it was normal. My mother also had been diagnosed with h. pylori infection, and I had it also, and was treated with antibiotics. I had the upper G.I. and no lymphocytes were found. My mother also had lung cancer-adenocarcinoma-ten years before her death. The doctor got it all in surgery-she had no chemo after. By the way, she never smoked, but she had jobs in factories, especially one where they made talc, so I don't know what she breathed in.Could you please be so kind as to clear up this confusion for me. Thank you. Also, can cancer lay dormant in your body before it is found?

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Answer by Dr Fernando, MD  on Thu 18, Dec 2008 07:51am:

Hi. I am more inclined to think that your mother had non-hodgkin’s lymphoma rather than colon cancer. The two are totally unrelated conditions. The usual type of colon cancer, which is adenocarcinoma, originates from cells lining the inner surface of the large intestine. Lymphoma on the other hand, is a malignancy of lymphocytes, which is a type of white blood cell. Because of the difference in tissue of origin, it is impossible for lymphoma to arise from colon cancer and vice versa. It is however, possible for lymphoma to occur in the colon, or anywhere along the gastrointestinal tract, since there are pockets of lymphatic tissue scattered along the tract. It is not unusual for lymphoma to spread to the mediastinum. This is a compartment found in the middle of the chest which contains the heart and pericardium. Colon cancer does not commonly spread to the mediastinum or cause pericardial effusion. This is the reason why I’m primarily considering lymphoma as your mother’s condition. I think that your mother’s bloody pericardial effusion was already a manifestation of her cancer, even if no frankly malignant cells were found in the fluid. A biopsy sample of the pericardial sac should have been obtained, because the malignant cells are often found there. It is possible for cancer to “lay dormant” and be without symptoms for a number of years before becoming detectable. Cancers often come from a solitary or a few mutated cells, and it takes a while for these cells to multiply and grow into a mass substantial enough to cause symptoms.

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