Rectal malignancy is usually symptomatic due to its location, and most of the time presents with pain and bleeding due to its growth and ulceration. It is difficult to identify the primary as carcinoma or lymphoma based on symptoms only, as both have a similar presentation. As it presents the rarest form of histology, non-Hodgkin’s lymphoma in the rectum is still difficult to diagnose initially, and its treatment is debatable. We describe the case of a 49-year-old male from Bangladesh with the same presentation. His treatment was delayed for more than a month as immunohistochemistry and staging delayed the final diagnosis. The disease was diagnosed as stage IE with the help of a positron emission tomography (PET)-CT scan, and due to the local progression the patient had a massive rectal bleeding that needed an urgent intervention. Radiotherapy was applied to stop the bleeding. Hypofraction followed by a conventional fraction of external beam radiotherapy (EBRT) with a total of 40 Gy was applied. Post-EBRT digital rectal examination showed no residual except scaring, and a PET scan was also negative for residual disease. Due to uncertainties and lack of any precious guideline, 6 cycles of adjuvant chemotherapy with the R-CHOP schedule were also completed. Without surgery, the combination of EBRT and chemotherapy helped to preserve the organ, and the patient has been disease free for more than 2.5 years since his treatment.
Gastrointest Tumors

中文翻译：

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紧急放疗和化学疗法治疗原发性直肠非霍奇金淋巴瘤：1例报道和文献综述。

直肠恶性肿瘤通常由于其位置而有症状，并且大多数时候由于其生长和溃疡而出现疼痛和出血。仅基于症状就很难将原发灶确定为癌或淋巴瘤，因为两者的表现相似。由于它是组织学中最稀有的一种形式，因此直肠初生非霍奇金淋巴瘤仍然难以诊断，其治疗方法尚有争议。我们描述了一个来自孟加拉国的49岁男性，同样的情况。由于免疫组化和分期推迟了最终诊断，他的治疗被推迟了一个多月。该疾病在正电子发射断层扫描（PET）-CT扫描的帮助下被诊断为IE期，由于局部进展，患者发生了大面积直肠出血，需要紧急干预。放疗用于止血。进行超分割，然后进行常规部分的总剂量为40 Gy的外部束放射治疗（EBRT）。EBRT后数字直肠检查显示除害怕外没有残留物，PET扫描对残留疾病也呈阴性。由于不确定性和缺乏宝贵的指导原则，还完成了6个周期的R-CHOP辅助化疗方案。如果不进行手术，EBRT和化学疗法的结合将有助于保护器官，并且患者自治疗以来已经无病超过2.5年。PET扫描也未发现残留疾病。由于不确定性和缺乏任何宝贵的指导原则，还完成了6个周期的R-CHOP方案辅助化疗。如果不进行手术，EBRT和化学疗法的结合将有助于保护器官，并且患者自治疗以来已经无病超过2.5年。PET扫描也未发现残留疾病。由于不确定性和缺乏任何宝贵的指导原则，还完成了6个周期的R-CHOP方案辅助化疗。如果不进行手术，EBRT和化学疗法的结合将有助于保护器官，并且患者自治疗以来已经无病超过2.5年。
胃肠道肿瘤