Primary Gastrointestinal Non-Hodgkin’s Lymphoma of the Small and Large Intestines: a Systematic Review

Abstract

The majority of patients with non-follicular small and large intestinal PGINHLs are treated with both chemotherapy and surgery. Although surgery appears to be an important part of the treatment algorithm, definitive statements regarding its survival benefit remain limited due to lack of patient stratification based on timing and indication for surgery.

Clinical trends and management outcome of primary intestinal lymphoma

“…It is fairly considered to be acceptable as compared with other many recent studies that reported the 5 years survival rate is (52-86%), considering our results performed in a small number of cases and during less follow up period. 16 Additionally, we observed that 2/3 of total deaths had acute complications, necessitating urgent laparotomy and this is consistent with Lightner et al, who noticed that urgently operated patients with primary intestinal lymphoma carried poor prognosis. 16 These variations in the results of surgical outcome of our series in comparison with other studies may be due to difference in patient's clinical criteria, tumor size and location, histopathologic subtype, in addition to the available facilities of early diagnosis.…”

“…However, the incidence of the disease has been increasing by 5% per year in Westernized countries, peaking at 1.73 per 100.000 in North America. [14][15][16] In this study the mean age at time of presentation is 46±32 year this is near to what reported by different groups. 10,12 Primary intestinal lymphoma usually affects males than females.…”

“…In the present study the males to female ratio was 2.4:1 which is close to what detected by other studies. 16,17 Also, in the current study, the initial clinical presentation of our patients was non-specific, including abdominal pain, abdominal mass, intestinal obstruction, rectal bleeding and perforated viscus. This is consistent with other many studies which reported that primary intestinal lymphoma patients are usually presented by vague symptoms and easily misdiagnosed or discovered incidentally during laparotomy due to associated serious acute complications.…”

“…Collection of series of 23 studies was found that the majority of patients were concerned to stage I and II at diagnosis (77%). 16 In our study, most of our series were found at stage I and II at time of diagnosis.…”

“…This is consistent with other many studies which reported that primary intestinal lymphoma patients are usually presented by vague symptoms and easily misdiagnosed or discovered incidentally during laparotomy due to associated serious acute complications. 4,16,17 Additionally, the definite preoperative histopathological diagnosis was detected in 7 patients only (41%) (3 of them by CT guided biopsy, 2 via diagnostic laparoscopic biopsy and the remaining 2 by lower endoscopic biopsy), while the other 10 patients (59%) were discovered incidentally during abdominal exploration due to variable aetiological indications, necessitating laparotomy (5 of them had acute symptoms and underwent urgent abdominal exploration) This is consistent with other many studies which stated that primary intestinal lymphoma usually discovered at the time of operation during surgical exploration. 1,10,12 In this literature the ileocecum was the predominant site of involvement and the common histopathological subtype was DLBCL.…”