Clinical trends and management outcome of primary intestinal lymphoma

Authors

  • Omar Abdelraheem Department of General Surgery, Faculty of Medicine, Sohag University, Egypt

DOI:

https://doi.org/10.18203/2349-2902.isj20175551

Keywords:

Diagnosis, Primary intestinal lymphoma, Treatment

Abstract

Background: Primary gastrointestinal lymphomas are the most common type of primary extra nodal lymphomas. In particular, primary intestinal lymphomas constitute about 25-40% of all gastrointestinal lymphomas. Our aim in this study is to find out the clinical patterns and surgical outcome in management of patients with primary intestinal lymphoma.

Methods: A retrospective study at Sohag University Hospital from January 2013-to February 2017, included 17 cases, diagnosed histopathologically as primary intestinal lymphoma and subjected to surgical treatment. Demographic data, clinical presentations and management outcome were analyzed.

Results: Seventeen consecutive patients with primary intestinal lymphoma, presented mainly by abdominal pain and abdominal mass. The definite preoperative diagnosis was detected only in 7 patients (41%) via preoperative histopathologic biopsy (3 by CT guided biopsy, 2 via diagnostic laparoscopy and remaining 2 by lower endoscopic biopsy). The other 10 patients (59%) were discovered incidentally during laparotomy. Radical resection was performed to 11 cases (65%), while palliative resection was employed to the remaining 6 cases. All patients received postoperative adjuvant chemotherapy. Two patients were lost to follow up, while the remaining investigated 15 cases, 3 of them were died (20%), 2 of the 3 total deaths presented with preoperative acute symptoms necessitating urgent laparotomy.

Conclusions: Primary intestinal lymphomas are commonly diagnosed incidentally during abdominal exploration and most of them presented with abdominal pain. Complete surgical resection followed by adjuvant chemotherapy seems to be effective treatment in most cases. Surgical outcome of urgent cases of primary intestinal lymphoma carries poor prognosis.

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References

Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma. World J Gastroenterol. 2011;14;17(6): 697-707.

Schottenfeld D, Beebe-Dimmer JL, Vigneau FD. The epidemiology and pathogenesis of neoplasia in the small intestine. Ann. Epidemiol. 2009;19:58-69.

Dionigi G, Annoni M, Rovera F, Boni L, Villa F, Castano P, et al. Primary colorectal lymphomas: review of the literature. Surg Oncol. 2007;16:S169-71.

Han SL, Cheng J, Zhou HZ, Guo SC, JiaZR, WangPF. Surgically treated primary malignant tumor of small bowel: A clinical analysis. World J Gastroenterol. 2010;16(12):1527-32.

Pennazio M. Small-intestinal pathology on capsule endoscopy: spectrum of vascular lesions. Endoscopy. 2005;37:864-9.

Chung HH, Kim YH, Kim JH, Cha SH, Kim BH, Kim TK, et al. Imaging findings of mantle cell lymphoma involving gastrointestinal tract. Yonsei Med J. 2003;44:49-57.

Schmidt WP, Schmitz N, Sonnen R. Conservative management of gastric lymphoma: the treatment option of choice. Leuk. Lymphoma 2004;45:1847-52.

Rohatiner A, d'Amore F, Coiffier B, Crowther D, Gospadarowicz M, Isaacson P, et al. Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma. Ann Oncol. 1994;5:397-400.

Shimodaira M, Tsukamoto Y, Niwa Y, Goto H, Hase S, Hayakawa T, et al. A proposed staging system for primary gastric lymphoma. Cancer. 1994;73:2709-15.

Eser B, Kaplan B, Unal A, Canoz O, Altuntas F, Sari HI, et al. Clinicopathologic Characteristics and Therapeutic Outcomes of Primary Gastrointestinal Non-Hodgkin's Lymphomas in Central Anatolia, in Turkey. Yonsei Med J. 2006;47(1):22-33.

Xu J, Lu W, Shen Z, Ji F, Li Y, Zhang H. Diagnosis and treatment for primary small intestinal lymphoma of 59 cases: a follow-up study Int. J. Colorectal Dis. 2016;31:1377-9.

Ibrahim EM, Ezzat AA, El-Weshi AN, Martin JM, Khafaga YM, Rabih W Al, et al. Primary intestinal diffuse large B-cell Non-Hodgkin's lymphoma: Clinical features, management, and prognosis of 66 patients. An Oncol. 2001;12:53-8.

Dawson PJ, Harrison CV. A clinicopathological study of benign Hodgkin’s disease. J Clin Pathol. 1961;14:219-31.

Nalesnik MA, Jaffe R, Starzl TE. The pathology of posttransplant lymphoproliferative disorders occurring in the setting of cyclosponn A-predmsone immunosuppression. Am. J. Pathol. 1988;133:173-92.

Lvine AM. Acquired immunodeficiency syndrome-related lymphoma Blood. 1992;80:8-20.

Lightner AL, Shannon E, Gibbons MM, Russell MM. Primary Gastrointestinal Non-Hodgkin’s Lymphoma of the Small and Large Intestines: a Systematic Review. J Gastrointest Surg. 2015;3052-4.

Lal A, Bhurgri Y, Vaziri1 I, Rizvi1 NB, Sadaf A, Sartajuddin S, et al. A Extra-nodal Non-Hodgkin’s Lymphomas - A Retrospective Review of Clinico-Pathologic Features and Outcomes in Comparison with Nodal Non-Hodgkin’s Lymphomas. Asian Pacific J. 2008;9:453-8.

Dickson BC, Serra S, Chetty R. Primary gastrointestinal tract lymphoma: diagnosis and management of common neoplasms. Expert Rev. Anticancer Ther .2006;6:1609-28.

Wang SL, Liao ZX, Liu XF, Yu ZH, Gu DZ, Qian TN, et al. Primary early-stage intestinal and colonic non-Hodgkin’s lymphoma: clinical features, management, and outcome of 37 patients. World J Gastroenterol. WJG. 2005;11(37):5905.

Morton JE, Leyland MJ, Vaughan Hudson G, Vaughan HB, Anderson L, Bennett MH, et al. Primary gastrointestinal non-Hodgkin's lymphoma: A review of 175 British National Lymphoma Investigation cases. Br J Cancer. 1993;67:776-82.

Verreet PR, Borchard F, Stöltzing H, Thon K, Röher HD. Status of gastrectomy in the multi-modality therapy concept of primary non-Hodgkin's lymphoma of the stomach. Langenbecks Arch Chir. 1990;375:151-5.

Koch P, del Valle F, Berdel WE, Willich NA, Reers B, Hiddemann W, et al. Primary gastrointestinal nonHodgkin's lymphoma: I. Anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German Multicenter Study GIT NHL 01/92. J Clin Oncol. 2001;19:38-61.

Gospodarowicz MK, Wasserman TH. Non-Hodgkin's Lymphoma. In: Perez CA and Brady LW, editors. Principles and practice of radiation oncology. New York: Lippincott-Raven; 1998:2000-1.

Valicenti RK, Wasserman TH, Monyak DJ, Kucik NA. Non-Hodgkin Lymphoma: Whole- abdomen irradiation as an adjuvant to chemotherapy. Radiology. 1994;192:571-6.

Kim SJ, Choi CW, Mun YC, Oh SY, Kang HJ, Lee SI, et al. Multicenter retrospective analysis of 581 patients with primary intestinal non-Hodgkin lymphoma from the Consortium for Improving Survival of Lymphoma (CISL). BMC cancer. 2011;11(1):321.

Hwang HS, Yoon DH, Suh C, Park CS, Huh J. Intestinal diffuse large B-cell lymphoma: an evaluation of different staging systems. J Korean Med Sci. 2014;29(1):53-6.

Zhai L, Zhao Y, Lin L, Tian Y, Chen X, Huang H, Lin T. Non-Hodgkin's lymphoma involving the ileocecal region: a single-institution analysis of 46 cases in a Chinese population. J Clin Gastroenterol. 2012;46(6):509-14.

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Published

2017-12-26

How to Cite

Abdelraheem, O. (2017). Clinical trends and management outcome of primary intestinal lymphoma. International Surgery Journal, 5(1), 20–26. https://doi.org/10.18203/2349-2902.isj20175551

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Original Research Articles