Primary gastrointestinal lymphoma: A review of 21 cases

Abstract

A retrospective study of 21 patients who had suffered from gastrointestinal lymphoma was carried out. Gastric involvement was more common than involvement of the small or large intestine and carried a better prognosis. Gastrointestinal lymphoma generally occurs most frequently during the fourth to seventh decades of life. In our study, however, five lymphomas occurred in patients under 20 years of age. Clinical symptoms were nonspecific, and abdominal mass was found in only 15% of the patients on clinical examination. All patients were explored, 17 underwent resection, and 4 laparotomy and biopsy. Five-year survival was much better for patients who had undergone resection. Survival was inversely proportionate to the extent of nodal spread. Multiple lesions on the same organ yielded a 5-year survival of 20%, while a single lesion offered a 55% chance of 5-year survival. Diffuse histiocytic lymphoma was the commonest type, followed by the poorly differentiated lymphocytic type. A longer survival rate was present in the lymphocytic type. However, the highest survival rate was in those patients in whom definite resections of the lesion were performed followed by radiation and chemotherapy, especially for gastric tumor.

Primary gastrointestinal non-Hodgkin's lymphoma: a review of 175 British National Lymphoma Investigation cases

“…The site, age, and sex distribution of the present series were similar to those described in previous reports (Loehr et al, 1969;Contreary et al, 1980;Herrman et al, 1980;Kaufman et al, 1984;Ampil, 1987;Kajanti et al, 1988), although some investigators found small gut involvement to be relatively more common (Blackledge et al, 1979;Makepeace et al, 1987;Baildam et al, 1989); in the present series this was possibly due to failure to refer patients with Stage IE/IIE gastric lymphoma who had undergone complete resection. As in other reports abdominal pain was the commonest presenting feature (Novak et al, 1979;Contreary et al, 1980;Herrmann et al, 1980;Kaufman et al, 1984;Rao et al, 1984;Bonadonna & Valagussa, 1986;Makepeace et al, 1987;Kajanti et al, 1988;List et al, 1988;Jones et al, 1988).…”

“…As in other reports abdominal pain was the commonest presenting feature (Novak et al, 1979;Contreary et al, 1980;Herrmann et al, 1980;Kaufman et al, 1984;Rao et al, 1984;Bonadonna & Valagussa, 1986;Makepeace et al, 1987;Kajanti et al, 1988;List et al, 1988;Jones et al, 1988). Although comparisons of overall survival between different published series do not take account of differences in risk factors within the series, it is perhaps worth noting that the overall survival of 44% at 5 years in the present series compares favourably with previous reports, in which it ranges from 33% to 55% (Rao et al, 1984;Bonadonna & Valagussa, 1986;Ampil, 1987;Makepeace et al, 1987;Baildam et al, 1989).…”

“…These results suggest that surgical debulking does not necessarily protect the patients from complications. There is also disagreement as to whether adjuvant therapy following complete excision is necessary (Lim et al, 1977;Herrmann et al, 1980;Gospodarowicz et al, 1983;Kaufman et al, 1984;Rao et al, 1984;Sheridan et al, 1985;Bonadonna & Valagussa, 1986;Kajanti et al, 1988;Jones et al, 1988;Haber & Mayer, 1988;Mentzer et al, 1988). It is of interest that in the present study, patients who received chemotherapy had a worrying incidence of side effects: of the 15 patients who died with infection, 12 were receiving chemotherapy at the time.…”

Primary Gastrointestinal Lymphoma

“…The dis ease is more commonly seen in middle-aged (between 50 and 60 years) persons [8,10,14], unlike the average patient age observed in this limited experience. The malignancy was slightly preponderant in women as in the study of Kaufman et al, [15] in contrast to other investigators' reports [16 18], With respect to the ma lignant lymphoid neoplasm's primary site of origin within the alimentary tract, the stomach was more often involved than the small or large intestine [8,[14][15][16][17][18], From obtained results, diffuse histiocytic his tologic subtype of non-Hodgkin's lymphoma oc curred more frequently and had an acceptable survival rate. The latter finding may not be inconsistent with the observation of Steward et al [19] that 'patients with diffuse histiocytic lymphoma had a significantly longer relapse-free survival than other histological subtypes (p = 0.03)'.…”

“…The latter finding may not be inconsistent with the observation of Steward et al [19] that 'patients with diffuse histiocytic lymphoma had a significantly longer relapse-free survival than other histological subtypes (p = 0.03)'. In this report, the staging system on PM L-GIT was similar to that adopted by other authors [ 15,20] because of the peculiar natural history of the disease. It apparently has a propensity for confinement to the gastrointestinal tract and its drain ing lymph nodes for a prolonged period of time.…”