R-CHOP with dose-attenuated radiation therapy could induce good prognosis in gastric diffuse large B cell lymphoma

Mishima, Yuko; Terui, Yasuhito; Yokoyama, Masahiro; Nishimura, Noriko; Sakajiri, Sakura; Ueda, Kyoko; Kuboki, Yasutoshi; Nakano, Kenji; Suzuki, Kazuhito; Nara, Eriko; Tsuyama, Naoko; Takeuchi, Kengo; Oguchi, Masahiko; Hatake, Kiyohiko

doi:10.1186/2162-3619-1-30

Cited by 11 publications

(10 citation statements)

References 15 publications

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“…For DLBLs of the stomach and intestine the consensus is that chemotherapy incorporating rituximab-cyclophosphamide-oncovin-prednisolone should be the standard regimen 45 47–49. Here again, surgery is restricted to the management of complications such as perforation and haemorrhage 45.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal lymphoma: the new mimic

Thomas

Schwartz

Quigley

2019

BMJ Open Gastroenterol

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BackgroundGastrointestinal (GI) lymphomas comprise a group of distinct clinicopathological entities of B- or T- cell type, with primary gastrointestinal Hodgkin lymphoma being extremely uncommon. The GI tract is the predominant site of extranodal non-Hodgkin lymphoma accounting for 30–40% of all extranodal lymphomas. In the Western world, the stomach is the most commonly involved site followed by the small bowel. Several chronic inflammatory and immune-mediated disorders which predispose to accelerated cell turnover may lead to the malignant transformation of gut lymphocytes and ultimately manifest as GI lymphoma. The challenge for the clinical gastroenterologist is that these tumors may have varied presentations, ranging from nonspecific symptoms such as dyspepsia or bloating to abdominal pain, nausea, vomiting, GI bleeding, diarrhea, weight loss or bowel obstruction.ObjectiveWe illustrate the range of presentations of GI lymphoma with examples based on consecutive cases evaluated at our institution over a 6-month period. These cases demonstrate how appropriately directed endoscopic evaluation with biopsies has the potential to provide a definitive diagnosis and allow the patient to proceed to definitive therapy.ConclusionsThe GI tract is the most commonly involved site for extranodal lymphoma with the stomach being most frequently involved organ.Chronic Helicobacter pylori infection, celiac disease, inflammatory bowel disease and autoimmune disorders may predispose to GI lymphoma. This heterogenous group of diseases has varied presentations that may mimic several other GI clinico-pathologic entities. GI lymphomas may be diagnosed with appropriately directed endoscopic evaluation coupled with generous tissue sampling and expert pathologic assessment. Management may range from antibiotic therapy, in the case of Helicobacter pylori-associated gastric MALT lymphoma, to chemotherapy with or without radiation and, in rare instances, surgery. There are presently no guidelines to direct endoscopic surveillance of GI lymphomas following treatment.

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Section: Discussionmentioning

confidence: 99%

Gastrointestinal lymphoma: the new mimic

Thomas

Schwartz

Quigley

2019

BMJ Open Gastroenterol

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“…Surgery is traditionally the first-line therapy for the management of gastric DLBCL. However, several studies [73][74][75] have suggested that chemotherapy (CHOP or R-CHOP) alone or followed by radiotherapy produced similar or better results compared with surgical resection. Chemotherapy is more tolerable than surgery, as it can avoid GI dysfunction, malnutrition, dumping syndrome and the deterioration in patient's quality of life.…”

Section: Treatment Treatment For Primary Gi B-cell Lymphomamentioning

confidence: 99%

Primary lymphomas in the gastrointestinal tract

Peng

Zhong

Ran

2015

J of Digest Diseases

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Primary gastrointestinal (GI) lymphomas are uncommon diseases that can involve the whole GI tract. The etiologies of the disease remain unclear, and potential risk factors include celiac disease, Helicobacter pylori infection, use of immunosuppressive agents, human immunodeficiency virus (HIV) or Epstein-Barr virus (EBV) infection and inflammatory bowel disease, etc. Diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma are the most common subtypes of GI lymphomas. B-cell lymphomas of the GI tract are more common in Western countries, while in Asia-Pacific region T-cell lymphomas are more frequently reported. In this review, lymphomas in the esophagus, stomach and intestine are described, including their epidemiology, histology, clinical manifestations, endoscopic findings, radiological features and treatment.

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“…Although the biological characteristics seem to be different from DLBCL and the effects of rituximab for THRLBCL remain to be determined, it is recommended at present that THRLBCL should be treated similar to stage-matched DLBCL [2]. On the other hand, localized extranodal DLBCL is often treated with radiation therapy with or without chemotherapy, as reported in gastric lymphoma [5]. In this case, however, a tracheotomy was done before lymphoma treatment and radiation therapy could cause airway trouble; so that the patient was treated with R-CHOP chemotherapy without radiation.…”

Section: To the Editormentioning

confidence: 99%

T-Cell/Histiocyte-Rich Large B-Cell Lymphoma of the Thyroid

et al. 2013

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T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a rare subtype of diffuse large B-cell lymphoma, and has been reported to mainly affect lymph nodes with advanced Ann Arbor stage. We present a 69-year-old woman with a past history of chronic thyroiditis, who had suffered from rapidly-growing thyroid tumor. No other lymph nodes swelling or extranodal lesions were detected. She promptly underwent surgery with resection of the thyroid tumor, and the diagnosis of THRLBCL was established pathologically. She was successfully treated by standard rituximab-containing chemotherapy. To our knowledge, this is the first case report of THRLBCL exclusively arising in the thyroid.

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R-CHOP with dose-attenuated radiation therapy could induce good prognosis in gastric diffuse large B cell lymphoma

Cited by 11 publications

References 15 publications

Gastrointestinal lymphoma: the new mimic

Gastrointestinal lymphoma: the new mimic

Primary lymphomas in the gastrointestinal tract

T-Cell/Histiocyte-Rich Large B-Cell Lymphoma of the Thyroid

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