Primary malignant lymphoma of the intestine: Clinicopathologic and immunohistochemical studies of 39 cases

Abstract

Clinicopathologic and immunohistochemical features in 39 cases of primary intestinal non-Hodgkin's lymphoma (NHL) in Japanese patients were studied. Only resection materials in state IE and IIE-1 were included in this study because of the certainty that the intestine was the primary site of the lymphoma. The updated Kiel classification was used to classify NHL. Histologically, only two cases (5.1%) were follicular lymphomas, and the others were diffuse lymphomas. Twenty-eight patients (71.8%) had high-grade NHL and 11 (28.2%) had low-grade NHL. Twenty (71.4%) of the 28 high-grade NHL were centroblastic lymphomas, and 14 (70.0%) of these 20 cases of centroblastic lymphoma were the polymorphic variant. Ten (90.9%) of the 11 low-grade NHL were low-grade mucosa-associated lymphoid tissue (MALT) lymphomas. Macroscopically, 18 patients had polypoid masses, 17 ulcerative tumors and four had diffusely infiltrating NHL. Seven of the 10 low-grade MALT lymphomas were polypoid masses. Immunohistochemically, 35 lesions (89.7%) were of the B cell phenotype and three (7.7%) were of the T cell phenotype. In the remaining case, the cell lineage could not be determined. No lesions were considered to be of histiocytic origin. The 5 year survival rate for high-grade B cell lymphomas was poorer than for low-grade B cell lymphomas, and the present study indicated that the histological grade of the intestinal B cell lymphomas was a prognostically significant factor.

Cell turnover parameters in small and large cell varieties of primary intestinal non-hodgkin's lymphoma

“…Although, according to the literature, most primary intestinal B-cell lymphomas are of MALT type, 34,35 we failed to detect MALT features, such as reactive B-cell follicles, centrocyte-like cells, and lymphoepithelial lesions, in 18 large B-cell lymphomas. When we compared large cell MALT lymphomas with large cell lymphomas that did not have a MALT component, the PIs were about the same, but the AIs in the large cell MALT lymphomas were lower (although the difference was not significant).…”

A clinicopathologic study of primary small intestine lymphoma

“…Other investigators studied fewer cases with or without gastric/colorectal lesions based only on univariate analyses. These investigators found that stage, 6,23 radical resection, 6 gender, 23 histologic grade, 27,29 and T-cell/B-cell phenotype 28 appeared to be correlated with survival probability. The majority of such previously reported factors were concordant with our results based on a univariate analysis ( Table 4).…”

“…To our knowledge the majority of published series have been small, and also have been combined with gastric and/or colorectal lymphomas. [22][23][24][25][26][27][28][29] To our knowledge, the current study of 80 cases with primary lymphoma of the small intestine is the third largest series reported. 5,15 In this study, we …”

“…The frequency of marginal zone B-cell lymphoma (including IPSID) among all patients with primary small intestine lymphoma in the current study was 19% (Table 2), and this value was comparable to the data published in several recent articles (range, 6 -22%). 6,15,[27][28][29] Macroscopically, marginal zone B-cell lymphoma of the small intestine presented as either ulcerative or polypoid type, and was indistinguishable from other high grade B-cell or T-cell lymphomas (Table 3). All patients with marginal zone B-cell lymphoma showed early stages of disease (IE or IIE1) and also demonstrated an excellent prognosis; these findings were similar to those observed in gastric MALT lymphoma, 13 whereas the overall survival probability in primary small intestine lymphoma in the current investigation was lower than that in primary gastric lymphoma.…”

Primary low‐grade gastric mucosa‐associated lymphoid tissue (MALT) lymphoma with polypoid appearance. Polypoid gastric MALT lymphoma: A clinicopathologic study of eight cases

“…Conversely, low‐grade MALT lymphomas arising in the intestine usually presented with polypoid lesions and showed no association with H. pylori infection. 14–17 However, the relationship between gastric and intestinal MALT lymphomas remains to be elucidated.…”