Primary Small-bowel Non-Hodgkin's Lymphoma: A Study of Clinical Features, Pathology, Management and Prognosis

Abstract

The records of 34 patients diagnosed with primary small bowel non-Hodgkin's lymphoma during a 10-year period between January 1996 and December 2005, including 27 cases for which complete follow-up records were available, were studied. Abdominal pain (70.6% of patients) was the main presenting symptom, followed by intestinal obstruction (38.2%). The most common primary site was the ileum (58.8%), followed by the jejunum (26.5%) and duodenum (17.6%); one case had tumours at two sites in the small bowel. Twenty-seven patients had small bowel B-cell lymphoma (24 diffuse large B-cell lymphoma; three mucosa-associated lymphoid tissue B-cell lymphoma) and seven patients had small bowel T-cell lymphoma. Cumulative survival in patients with small bowel B-cell lymphoma was higher than that in patients with small bowel T-cell lymphoma. Data on 16 male and eight female patients with diffuse large B-cell lymphoma showed that 62.5% of these patients presented with disease stages I or II and 37.5% with stages III or IV. Cumulative survival in patients at stages IE or IIE was significantly higher than that of patients at stages IIIE or IVE. Four of five patients who died from diffuse large B-cell lymphoma had abnormal levels of lactate dehydrogenase and serum albumin.

Non-Hodgkin’s lymphoma revealed by an ilio-colic intussusception in a Moroccan patient: a case report

“…However Radical tumor resectability had a highly significant effect on survival. In addition surgery in combination with chemotherapy was superior to any other treatment combination in localized disease and in disseminated cases [6]. Unfortunately, our patient refused post operative chemotherapy.…”

“…Chemotherapy and radiotherapy have been used either alone or in combination with surgery [24]. Some other studies do not support the need for radiotherapy in intestinal B-cell lymphoma patients [6]. The results have not been evaluated adequately and the efficacy of these procedures is not known yet.…”

“…Few cases were reported in the literature [6]. Small bowel lymphomas are rare due to several reasons [7]; however, the incidence of this disease has been rising in recent years particularly among immunocompromised patients [8,9].…”

“…Another aspect is that surgery is necessary but in combination with chemotherapy. According to few cases and to the absence of randomized trials in primary small bowel lymphoma, the optimal treatment strategy is not known [6].…”

“…Page number not for citation purposes 6 A wide range of clinical presentations can occur for primary small bowel non-Hodgkin's lymphoma [12] including non-specific abdominal pain, ileus and weight loss. Diarrhea and fever are present in approximately one third of patients with T-Cell NHL but are rare in patients with B-Cell NHL [1].…”