SUMMARY Intestinal lymphoma is frequently associated with sprue-like bowel patterns. A standardized approach to the problem is suggested.Intestinal lymphoma has been subdivided into four groups, depending on the extent of involvement of the anatomical region. Only cases with specific lesions are accepted as primary lymphoma.The villous pattern in 179 cases at necropsy with suitably preserved mucosa was determined to form a normal baseline for comparison with the uninvolved portions of the lymphomatous small bowel. Only 15 % of all small bowel of this random material of children more than 1 year old and adults showed a flattened mucosa.The non-lymphomatous mucosa of 20 cases with definitely primary intestinal reticulum or lymphosarcoma showed severe sprue-like atrophy in 18 (90%). Two cases of intestinal Hodgkin's disease and four cases of gastric lymphoma were associated with regular mucosal patterns.It is concluded that sprue-like villous atrophy of the small bowel is definitely a triggering factor for the development of primary intestinal reticulum cell or lymphosarcoma. A hypothesis for the possible aetiological relationship of these two conditions is discussed.

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In a 6-year period (January 1, 1963-December 31, 1968), a total of 3,295 malignant neoplasms essentially derived from the Fars Province, Southern Iran, were diagnosed by biopsy, resection, blood and/or marrow examination, a n d necropsy. The site-, age-a n d sex-specific rates for these cancers were compared with the corresponding incidence rates from the Connecticut Registry, adjusted to the age structure of our population. T h e most common cancers i n both sexes were skin, lymph nodes, stomach, female breast, a n d leukemias. Cancers of pharynx, esophagus, stomach, liver, nasal cavities and sinuses, and conjunctiva occurred more frequently a t a younger age in Fars. Gestational choriocarcinomas were much more common than in Connecticut. Although similar independent ligures are not available for Connecticut, it is probable that primary upper small intestinal lymphomas a n d carcinomas of the renal pelvis were also more comm,on in our region.

A study of 81 childhood lymphomas diagnosed in the Department of Pathology of Pahlavi University Medical Center, Shiraz, Iran, encompassing all histologically diagnosed childhood lymphomas from the Fars Province, Southern Iran over a 14-year period (1963--1976) revealed a 3:1 male predominance and a 1:4 frequency compared to adult lymphomas. Peripheral lymphadenopathy at the initial physical examination was almost twice as common as deep node involvement. Comparison of cumulative and age-standardized (to world population) incidence rates with those of selected Tumor Registries in various continents revealed a higher rate in our region of both non-Hodgkin's and Hodgkin's lymphoma relative to some of the Western countries. Our incidence rates were in general intermediate between Western populations on one hand and some South America, African and Asian populations on the other. Hodgkin's disease accounted for 64% (males) and 88% (females) of lymphomas and mixed cellularity was the commonest histologic subtype. Histologically almost all non-Hodgkin's lymphomas were diffuse at the time of diagnosis.