Non-Hodgkin's lymphomas in the Middle East. A study of 417 patients with emphasis on special features

Abstract

A total of 417 evaluable patients with non-Hodgkin's lymphomas were diagnosed between January 1974 and December 1983 at the American University of Beirut Medical Center in Beirut, Lebanon. Of these, 179 (43%) patients had nodal lymphomas, and 183 (44%) had extranodal lymphomas. The commonest lymphoma was diffuse large cell (27%), followed by large cell immunoblastic (21%). The histopathologic pattern was follicular in 18% of the nodal lymphomas and in 5.3% of the extranodal forms. The most common site of extranodal lymphoma was the gastrointestinal tract (46.5%), followed by Waldeyer's ring (19%). Small intestinal lymphomas were three times more common than gastric lymphomas. Immunoproliferative small intestinal disease (IPSID) was diagnosed in 20 of 59 patients who had primary small intestinal lymphoma. Of the 34 patients who had Waldeyer's ring lymphoma, 7 had gastrointestinal involvement at some time during the course of the disease. Nodal lymphomas were associated with poor prognostic factors: 82% were diffuse; 77% had advanced disease at presentation; 77% had intermediate- or high-grade malignancy lymphoma; 40% had marrow involvement; and 46% had B symptoms. In children, the most common lymphoma was Burkitt's, and 80% of pediatric lymphomas were high-grade malignancy. In conclusion, this study delineates the special features of non-Hodgkin's lymphomas in the Middle East: The presence of IPSID; the high incidence of extranodal forms, in particular the intestinal ones; and the rarity of follicular lymphomas.

Primary gastrointestinal lymphoma in Japan

“…This may be partly explained by the high prevalence of IPSID in these areas. 22,40,41 Among the three groups classified by primary site, histology and clinical stage were different. The gastric group contained a predominance of early-stage, low- grade B-cell lymphomas, most of which were marginal zone lymphomas.…”

Application of the international prognostic index in a study of chinese patients with non-hodgkin's lymphoma and a high incidence of primary extranodal lymphoma

“…20 In other Western countries, the incidence was higher: in Italy, 48%; 21 in Denmark, 37%; 22 and in the Netherlands, 41%. 23 The incidence in Lebanon and Israel, representing Middle Eastern countries, was 44% 24 and 36%, 25 respectively. As for Asian countries, the incidence varied from 28.5% reported in Hong Kong 3 to 31.6% in Taiwan 26 and as high as 45% in China.…”

Maladie immunoproliférative de l'intestin grêle associée à Campylobacter jejuni

“…Des cas ont aussi été rapportés chez des patients originaires de la plupart des pays en voie de développement, notamment d'Afrique noire [1][2][3]. Il semble qu'il s'agisse du lymphome extra-ganglionnaire le plus fréquent dans ces pays, même si sa préva-lence semble avoir décru ces dernières décennies [4]. L'IPSID atteint préfé-rentiellement les adultes jeunes et correspond à une infiltration de l'intestin grêle par une population mixte de cellules d'aspect centrocytique et de plasmocytes qui sécrètent une chaîne lourde alpha d'immunoglobuline monotypique tronquée qui n'est pas associée à une chaîne légère.…”