Duodenal Lymphoma: A Rare and Morbid Tumor

Abstract

We conducted a retrospective tumor registry review of a 36-year experience in a university center and identified 10 patients with duodenal lymphoma (five localized, five disseminated). Histologic types included diffuse large B-cell in four patients, mucosa-associated lymphoid tumor in three, and Hodgkin, follicular, and unclassified (one each). Treatments included chemotherapy in four patients, radiation therapy (RT) in two patients, Helicobacter pylori treatment in two, and observation in one. Five patients underwent operations (emergent in two, elective in three) for indications including massive bleeding in two patients, obstruction in two, or both in one. Survival for surgical group was 25 per cent at 1 year. One-year survival for nonsurgical group was 100 per cent, and all nonoperated patients lived at least 5 years, except for one who is alive 2 years after diagnosis. Surgical patients were younger and had more advanced lesions and less favorable cell types. When operation is required for bleeding or obstruction from secondary tumors in younger patients with disseminated disease, surgical challenges are formidable and survival is very limited. Tumors of less aggressive histology have far better prognosis.

Clinical course of duodenal mucosa‐associated lymphoid tissue lymphoma: Comparison with gastric mucosa‐associated lymphoid tissue lymphoma

“…Given these results, implementation of the follow‐up strategy recommended for gastric MALT lymphoma in the current guidelines would appear to be inadequate for patients with duodenal MALT lymphoma 24,25 . Several studies of duodenal MALT lymphoma have shown that H. pylori eradication is effective, either alone or in addition to chemotherapy 8,15,26,27 . By contrast, there are contradictory reports that H. pylori eradication is ineffective for duodenal MALT lymphoma 15,16,28 .…”

Early, Isolated Duodenal Mucosa-Associated Lymphoid Tissue Lymphoma Presenting without Symptoms or Grossly Apparent Endoscopic Lesions and Diagnosed by Random Duodenal Biopsies

“…For example, in a study of 307 cases of primary GI non-Hodgkin's lymphoma, 244 cases (80%) had gastric lymphoma and 63 cases (20%) intestinal lymphoma [ 14 ], whereas in another study of 150 GI lymphomas, 105 patients had gastric lymphoma, 27 patients had jejunoileal lymphoma, and only 1 patient had primary duodenal lymphoma [ 15 ]. The literature review of duodenal MALTomas identified only 17 cases reported before 2004 [ 16 ], and only moderately more cases have been reported since [ 11 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ].…”

“…Duodenal MALTomas appear similarly at EGD [ 41 ]. A comprehensive literature review revealed that duodenal MALTomas rarely present with no endoscopically apparent lesions [ 16 , 17 , 18 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 30 , 31 , 34 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ].…”

Gastroduodenal lymphoma

“…Jednogodišnje pre'ivljavanje pacijenata bilo je 25%, dok je jednogodišnje pre'ivljavanje za nehirurške bilo 10%. 4 U Sato-voj analizi folikularnih duodenalnih limfoma, gdje se analiziraju klini~ko patološke karakteristike 40 pacijenata sa ovim tumorom, zaklju~uje se da folikularni limfom duodenuma ima prelazne karakteristike MALTlimfoma 5 .…”