Primary Gastrointestinal Tract Lymphoma-A Clinico-pathological Study of 28 Cases

Abstract

A retrospective study of 28 patients with primary gastrointestinal tract lymphoma is presented. There were 27 cases of non-Hodgkin''s lymphoma and 1 case of Hodgkin''s disease. The patients with non-Hodgkin''s lymphoma of the gastrointestinal tract represented 10% of all non-Hodgkin''s lymphoma cases seen at the Royal Adelaide Hospital/Institute of Medical and Veterinary Science [Adelaide, Australia] over the 6 yr survey period, 1972-1977. Of the patients with non-Hodgkin''s lymphoma, 26 cases were diffuse type and 1 case was nodular type. There was a MIF [male/female] sex preponderance of 2.8/1, 70% of cases were between 40 and 69 yr. The commonest site was the stomach (19 cases), followed by the small intestine (7 cases); 1 case involved the large intestine. At initial presentation, the disease was confined to the affected viscus (Stage IE) in 7 patients (25%); in 12 patients (43%) the disease involved viscus and regional lymph nodes (Stage IIE). The 1 patient with Hodgkin''s disease had involvement of the large intestine, abdominal lymph nodes and bone marrow (Stage IV). This study was retrospective, and a management protocol was not employed. Of the 7 patients presenting with Stage IE disease, 6 cases had diffuse poorly differentiated lymphocytic lymphoma. Five of these patients were treated by surgical resection alone, and were in complete remission at a follow-up of 66-103 mo. To realistically compare the survival of different groups of patients with primary gastrointestinal lymphoma, a prospective multicenter clinical trial with comprehensive staging procedures, uniform histological classification and accepted management protocol is warranted.