Primary gastrointestinal non‐Hodgkin's lymphoma in adults: a population‐based clinical and histopathologic study

Abstract

Abstract. Hansen PB, Vogt KC, Skov RL, PedersenBjergaard U, Jacobsen M, Ralfkiaer E (Herlev Hospital, University of Copenhagen and Gentofte Hospital, University of Copenhagen, Denmark). Primary gastrointestinal non-Hodgkin's lymphoma in adults: a population-based clinical and histopathologic study. J Intern Med 1998; 244: 71-8. Objectives.To analyse the clinical course and the histopathology of primary gastrointestinal nonHodgkin's lymphoma (GI-NHL) in adult patients and to investigate a possible impact of Helicobacter pylori. Design/setting. Retrospective study of all adult patients in Copenhagen county diagnosed during a 6-year period with NHL. Subjects. A total of 55 patients with GI-NHL diagnosed during the period from 1985 to the end of 1990. Results. Twenty-eight patients had primary lymphoma in the stomach, 14 in the small intestine, 11 in the large intestine and two patients had multifocal involvement. The dominant presenting symptoms were abdominal pain, weight loss, diarrhoea, constipation and fatigue. Acute emergency problems such as severe haemorrhage or perforation at initial presentation were unusual. According to the revised European-American lymphoma (REAL) classification, diffuse large B-cell lymphoma was the most frequent histologic subtype comprising 53% of the cases.Helicobacter pylori infection was documented in 15 of 25 evaluable patients (60%) with gastric lymphomas and was not associated with any specific histological subtype. Endoscopic procedures and barium X-rays were the diagnostic approaches with highest sensitivity. In total, 30 patients (58%) achieved complete remission, 10 (19%) achieved partial remission, and 12 (23%) did not respond to treatment. The overall 5 year survival rate was 0.36 without statistically significant difference between the histological subtypes. Likewise the presence of Helicobacter pylori did not affect survival. Conclusion. Primary GI-NHL is a heterogeneous disease entity with considerable therapeutic controversies. No specific clinical or histological phenotype was associated with the presence of Helicobacter pylori.

Gastrointestinal lymphomas in a North American population: clinicopathologic features from one major Central-Midwestern United States tertiary care medical center

“…First, primary gastric lymphomas tended to be more common than primary intestinal lymphomas in the European and Asian studies. Intestinal cases accounted for only 14%, 19%, 21%, 10%, 30%, 34%, 50% and 43% of cases in the Greek, Japanese, German, Austrian, Serbian, Turkish, Canadian-North American and Danish studies, respectively [2-5,7,9,28-30]. Gastric lymphomas accounted for >50% of total cases in most of these series.…”

“…Several series from Europe, Canada-North America, and Asia have reported on primary GI lymphomas by lymphoma type and anatomic site [2-5,7,9,28-30]. Several trends emerge when reviewing the data collectively.…”

Burkitt’s lymphoma associated with Helicobacter pylori

“…1 More recently, many studies have documented the association between H. pylori and gastric lymphoma. [2][3][4][5] In particular, high rates of H. pylori infection have been identified in patients with low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphomas. Case-control studies have subsequently documented an association between intermediate-grade lymphoma and H. pylori infection.…”

Jejunocolic Fistula Associated with an Intestinal T Cell Lymphoma

“…Gastrointestinal lymphomas represent 1% to 10% of all gastrointestinal malignancies,9,10 up to 20% of all small bowel malignancies5,6 and only 0.2% to 0.4% of large bowel malignancies 11. Most primary small intestine lymphomas originate from B-cells, with T-cell origin being rare 6,7. The most common location of PTCL is the jejunum12 and common symptoms include abdominal pain, nausea, vomiting, diarrhea, fatigue, weight loss and fever.…”

“…Malignant lymphoma accounts for up to 20% of all primary malignant tumors of the small bowel,6 and most primary small intestine lymphomas are of B-cell origin. Lymphomas originating from T-cells are rare 6,7. In Japan, only 24 cases of T-cell malignant lymphoma of the small intestine have been reported and primary intestinal peripheral T-cell lymphoma (PTCL) is especially rare 8.…”