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International Journal of Hematology

, Volume 87, Issue 4, pp 375–381 | Cite as

Primary non-Hodgkin lymphomas in the small and large intestine: clinicopathological characteristics and management of 40 patients

  • Bo Li
  • Yuan-kai Shi
  • Xiao-hui He
  • Shuang-mei Zou
  • Sheng-yu Zhou
  • Mei Dong
  • Jian-liang Yang
  • Peng Liu
  • Li-yan Xue
Original Article

Abstract

To investigate the clinicopathological characteristics and optimal treatment modalities of primary non-Hodgkin lymphoma (NHL) in the small and large intestine. Forty patients with primary NHL in the small and large intestine were studied retrospectively. All cases were reclassified according to the World Health Organization (WHO) classification of lymphoma in 2001. Fourteen patients had primary disease in the small intestine, which were all of B-cell origin with diffuse large B-cell lymphoma (DLBCL) diagnosed in 5 of 14 (35.7%) patients and mucosa-associated lymphoid tissue (MALT) lymphoma in 8 of 14 (57.1%) patients. Ileum was the most commonly involved site (8 of 14 patients, 57.1%), followed by jejunum (2 of 14 patients, 14.3%) and duodenum (1 of 14 patients, 7.1%). Twenty-five patients had primary colorectal lymphoma, with B-cell origin accounting for 92.0% and T-cell origin for 8.0% of these patients. The ileocaecal region has the highest involved rate (13 of 25 patients, 52.0%), followed by colon (7 of 25 patients, 28.0%) and rectum (3 of 25 patients, 12.0%). Compared with surgery alone, post-operation chemotherapy or chemoradiotherapy can significantly improve DLBCL patients’ event-free survival (EFS). However, no post-operation treatment modality can improve OS or EFS for patients with MALT lymphoma. B-cell lymphoma is the most common pathological type of intestinal lymphomas. Chemotherapy-containing treatment modality is an effective way to improve intestinal lymphoma patients’ EFS, especially for those with DLBCL subtype.

Keywords

Lymphoma Intestine Chemotherapy 

References

  1. 1.
    Nakamura S, Matsumoto T, Iida M, Yao T, Tsuneyoshi M. Primary gastrointestinal lymphoma in Japan: a clinicopathologic analysis of 455 patients with special reference to its time trends. Cancer. 2003;97:2462–73.CrossRefPubMedGoogle Scholar
  2. 2.
    Yoshino T, Miyake K, Ichimura K, et al. IIncreased incidence of follicular lymphoma in the duodenum. Am J Surg Pathol. 2000;24:688–93.CrossRefPubMedGoogle Scholar
  3. 3.
    Zucca E, Roggero E, Bertoni F, Cavalli F. Primary extranodal non-Hodgkin’s lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol. 1997;8:727–37.CrossRefPubMedGoogle Scholar
  4. 4.
    Amer M, el-Akkad S. Gastrointestinal lymphoma in adults: clinical features and management of 300 cases. Gastroenterology. 1994;106:846–58.CrossRefPubMedGoogle Scholar
  5. 5.
    Wong MT, Eu KW. Primary colorectal lymphomas. Colorectal Dis. 2006;8:586–91.CrossRefPubMedGoogle Scholar
  6. 6.
    Lewin KJ, Ranchod M, Dorfman RF. Lymphomas of the gastrointestinal tract: a study of 117 cases presenting with gastrointestinal disease. Cancer. 1978;42:693–707.CrossRefPubMedGoogle Scholar
  7. 7.
    Kashimura A, Murakami T. Malignant lymphoma of the large intestine-15-year experience and review of literature. Gastroenterol Jpn. 1976;11:141–7.PubMedGoogle Scholar
  8. 8.
    Henry CA, Berry RE. Primary lymphoma of the large intestine. Am Surg. 1988;54:262–6.PubMedGoogle Scholar
  9. 9.
    Dragosics B, Bauer P, Radaszkiewicz T. Primary gastrointestinal non-Hodgkin’s lymphomas: a retrospective clinicopathologic study of 150 cases. Cancer. 1985;55:1060–73.CrossRefPubMedGoogle Scholar
  10. 10.
    Nakamura S, Matsumoto T, Takeshita M, et al. clinicopathologic study of primary small intestine lymphoma: prognostic significance of mucosa-associated lymphoid tissue-derived lymphoma. Cancer. 2000;88:286–94.CrossRefPubMedGoogle Scholar
  11. 11.
    Koch P, Probst A, Berdel WE, et al. Treatment results in localized primary gastric lymphoma: data of patients registered within the German multicenter study (GIT NHL 02/96). J Clin Oncol. 2005;23:7050–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Kim YH, Lee JH, Yang SK, et al. Primary colon lymphoma in Korea: a KASID (Korean Association for the Study of Intestinal Diseases) Study. Dig Dis Sci. 2005;50:2243–7.CrossRefPubMedGoogle Scholar
  13. 13.
    kohno S, Ohshima K, Yoneda S, Kodama T, Shirakusa T, Kikuchi M. Clinicopathological analysis of 143 primary malignant lymphomas in the small and large intestines based on the new WHO classification. Histopathology. 2003;43:135–43.CrossRefPubMedGoogle Scholar
  14. 14.
    Bairey O, Ruchlemer R, Shpilberg O. Non-Hodgkin’s lymphomas of the colon. Isr Med Assoc J. 2006;8:832–5.PubMedGoogle Scholar
  15. 15.
    Gan JL, Tang ZJ. Clinical, endoscopic and pathological features of primary colorectal non-Hodgkin lymphoma: 24 cases report. Zhonghua Wei Chang Wai Ke Za Zhi. 2006;9:502–5.PubMedGoogle Scholar
  16. 16.
    Bai CM, Yang T, Xu Y, et al. Clinical analysis of 32 primary intestinal non-Hodgkin’s lymphoma. Zhonghua Zhong Liu Za Zhi. 2006;28:142–4.PubMedGoogle Scholar
  17. 17.
    Koch P, del Valle F, Berdel WE, et al. Primary gastrointestinal non-Hodgkin’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;19:3861–73.CrossRefPubMedGoogle Scholar
  18. 18.
    Ibrahim EM, Ezzat AA, El-Weshi AN, et al. Primary intestinal diffuse large B-cell non-Hodgkin’s lymphoma: clinical features, management, and prognosis of 66 patients. Ann Oncol. 2001;12:53–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Fan CW, Changchien CR, Wang JY, et al. Primary colorectal lymphoma. Dis Colon Rectum. 2000;43:1277–82.CrossRefPubMedGoogle Scholar
  20. 20.
    Haselkorn T, Whittemore AS, Lilienfeld DE. Incidence of small bowel cancer in the United States and worldwide: geographic, temporal, and racial differences. Cancer Causes Control. 2005;16:781–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Morton JE, Leyland MJ, Vaughan Hudson G, et al. Primary gastrointestinal non-Hodgkin’s lymphoma: a review of 175 British National Lymphoma Investigation cases. Br J Cancer. 1993;67:776–82.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Bruneton JN, Thyss A, Bourry J, Bidoli R, Schneider M. Colonic and rectal lymphomas. A report of six cases and review of the literature. Rofo. 1983;138:283–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Kajanti M, Karkinen-Jaaskelainen M, Rissanen P. Primary gastrointestinal non-Hodgkin lymphoma. A review of 36 cases. Acta Oncol. 1988;27:51–5.CrossRefPubMedGoogle Scholar
  24. 24.
    Brands F, Monig SP, Raab M. Treatment and prognosis of gastric lymphoma. Eur J Surg. 1997;163:803–13.PubMedGoogle Scholar
  25. 25.
    Crump M, Gospodarowicz M, Shepherd FA. Lymphoma of the gastrointestinal tract. Semin Oncol. 1999;26:324–37.PubMedGoogle Scholar
  26. 26.
    Fischbach W, Dragosics B, Kolve-Goebeler ME, et al. Primary gastric B-cell lymphoma: results of a prospective multicenter study. The German-Austrian Gastrointestinal Lymphoma Study Group. Gastroenterology. 2000;119:1191–202.CrossRefPubMedGoogle Scholar
  27. 27.
    Azab MB, Henry-Amar M, Rougier P, et al. Prognostic factors in primary gastrointestinal non-Hodgkin’s lymphoma. A multivariate analysis, report of 106 cases, and review of the literature. Cancer. 1989;64:1208–17.CrossRefPubMedGoogle Scholar
  28. 28.
    Bellesi G, Alterini R, Messori A, et al. Combined surgery and chemotherapy for the treatment of primary gastrointestinal intermediate- or high-grade non-Hodgkin’s lymphomas. Br J Cancer. 1989;60:244–8.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Salles G, Herbrecht R, Tilly H, et al. Aggressive primary gastrointestinal lymphomas: review of 91 patients treated with the LNH-84 regimen. A study of the Groupe d’Etude des Lymphomes Agressifs. Am J Med. 1991;90:77–84.CrossRefPubMedGoogle Scholar
  30. 30.
    Schmidt WP, Schmitz N, Sonnen R. Conservative management of gastric lymphoma: the treatment option of choice. Leuk Lymphoma. 2004;45:1847–52.CrossRefPubMedGoogle Scholar
  31. 31.
    Aviles A, Nambo MJ, Neri N, et al. The role of surgery in primary gastric lymphoma: results of a controlled clinical trial. Ann Surg. 2004;240:44–50.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Aviles A, Nambo MJ, Neri N, Talavera A, Cleto S. Mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach: results of a controlled clinical trial. Med Oncol. 2005;22:57–62.CrossRefPubMedGoogle Scholar
  33. 33.
    Nakamura S, Matsumoto T, Suekane H, et al. Long-term clinical outcome of Helicobacter pylori eradication for gastric mucosa-associated lymphoid tissue lymphoma with a reference to second-line treatment. Cancer. 2005;104:532–40.CrossRefPubMedGoogle Scholar
  34. 34.
    Park YH, Lee SH, Kim WS, et al. CHOP followed by involved field radiotherapy for localized primary gastric diffuse large B-cell lymphoma: results of a multi center phase II study and quality of life evaluation. Leuk Lymphoma. 2006;47:1253–9.CrossRefPubMedGoogle Scholar
  35. 35.
    Mihaljevic B, Nedeljkov-Jancic R, Vujicic V, Antic D, Jankovic S, Colovic N. Primary extranodal lymphomas of gastrointestinal localizations: a single institution 5-yr experience. Med Oncol. 2006;23:225–35.CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2008

Authors and Affiliations

  • Bo Li
    • 1
  • Yuan-kai Shi
    • 1
    • 2
  • Xiao-hui He
    • 1
  • Shuang-mei Zou
    • 1
  • Sheng-yu Zhou
    • 1
  • Mei Dong
    • 1
  • Jian-liang Yang
    • 1
  • Peng Liu
    • 1
  • Li-yan Xue
    • 1
  1. 1.Department of Medical OncologyCancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC)BeijingChina
  2. 2.BeijingChina

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