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Lai Q, Zhao Y, Yan H, Peng H. Advances in diagnosis, treatment and prognostic factors of gastrointestinal DLBCL. Leuk Res 2023; 135:107406. [PMID: 37944240 DOI: 10.1016/j.leukres.2023.107406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/08/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023]
Abstract
Gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL) is an extremely aggressive form of B-cell non-Hodgkin lymphoma (BNHL) which has complex histological characteristics and manifests a high degree of heterogeneity in terms of clinical, morphological, immunological, and genetic features. GI-DLBCL mainly spreads by infiltrating neighboring lymph nodes, and common gastrointestinal complications (GICS) such as obstruction, perforation, or bleeding, frequently arise during the progression of the disease, posing significant challenges in both diagnosing and treating the condition. Meanwhile, the incidence of GI-DLBCL has been gradually increasing in recent years, and its strong invasiveness makes it prone to being misdiagnosed or completely missed. In clinical practice, over half of the patients diagnosed with the disease are in stage III or stage IV. What makes it worse is that certain patients may not exhibit a favorable response to chemotherapy. All these lead to intricacies in management of this disease. Unfortunately, there is currently no large prospective study or evidence-based medical evidence to provide clear guidance on treatment decisions for this specific type of lymphoma. Neither do physicians have a consensus regarding the optimal approach to address this condition. Recent studies have identified the presence of various prognostic factors that significantly impact survival in GI-DLBCL, which demonstrates the unique particularity of GI-DLBCL, and could help optimize the clinical decision.
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Affiliation(s)
- Qinqiao Lai
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yan Zhao
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Haiqing Yan
- Department of gastric and abdominal cancer ward, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hongling Peng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Hunan Engineering Research Center of Cell Immunotherapy for Hematopoietic Malignancies, Changsha, Hunan, China.
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Wu P, Zhu D, Lou Y, Wang X. Clinical characteristics and prognostic factors for primary pediatric and adolescent Non-Hodgkin Lymphomas of the gastrointestinal tract: a population-based study. World J Surg Oncol 2023; 21:353. [PMID: 37968641 PMCID: PMC10647069 DOI: 10.1186/s12957-023-03238-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/09/2023] [Indexed: 11/17/2023] Open
Abstract
PURPOSE To investigate the clinical features and survival outcomes of primary gastrointestinal non-Hodgkin lymphomas (PGINHL) in pediatric and adolescent population, we conducted a population-based cohort study. METHODS All pediatric and adolescent patients with PGINHL diagnosed between 2000 and 2019 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Kaplane-Meier estimations were used to generate survival curves based on various criteria. To compare survival curves, the log-rank test was applied. A multivariate Cox proportional hazards model was developed to investigate the effect of each component on overall survival. RESULTS A total of 334 pediatric and adolescent with PGINHL patients were identified. The median age at diagnosis was 12 years (range 1.0-19 years). Tumors were most commonly found in the small bowel (47.3%), followed by the large bowel (42.8%) and the stomach (9.9%). Overall, the most common histological subtype was Burkitt lymphoma (56.9%), followed by diffuse large B-cell lymphoma (DLBCL) (27.8%). Overall survival rates for all patients were 92.2% at 5- year and 91.6% at 10- year, respectively. The Cox proportional hazard regression revealed that only chemotherapy was an important independent predictor in this model. Patients with chemotherapy have a higher survival rate than those without. CONCLUSIONS Our study revealed that only chemotherapy was found to be the most important predictor of the OS in pediatric and adolescent PGINHL, providing critical information for therapeutic care.
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Affiliation(s)
- Peng Wu
- Department of Pediatric Surgery, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, China
| | - Dongsheng Zhu
- Department of Pediatric Surgery, The First People's Hospital of Lianyungang, Haizhou District, Lianyungang, People's Republic of China
| | - Yi Lou
- Department of Pediatric Surgery, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Xinxin Wang
- Department of Radiation Oncology, The Third Hospital of Nanchang, Nanchang, 330025, Jiangxi, China.
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Zhang C, Zhang X, Liu Z, Tao J, Lin L, Zhai L. The impact of surgery on long-term survival of patients with primary intestinal non-Hodgkin lymphomas based on SEER database. Sci Rep 2021; 11:23047. [PMID: 34845308 PMCID: PMC8630038 DOI: 10.1038/s41598-021-02597-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 11/08/2021] [Indexed: 12/15/2022] Open
Abstract
Evidence regarding the need for surgery for primary intestinal non-Hodgkin lymphoma (PINHL) patients with chemotherapy is limited and controversial. We aimed to investigate the specific impact of surgery on survival of PINHL patients. Data from PINHL patients (aged > 18 years) with chemotherapy between 1983 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We concerned about overall survival (OS) and improved cancer-specific survival (CSS). Propensity score matching (PSM) analysis was also used to explore the reliability of the results to further control for confounding factors. Finally, we screened 3537 patients. Multivariate regression analysis showed that patients with surgery and chemotherapy had better OS (hazard ratio [HR] 0.83; 95% confidence interval [CI] 0.75–0.93; p = 0.0009) and CSS (HR 0.87; 95% CI 0.77–0.99; p = 0.0404) compared with the non-operation group after adjusting for confounding factors. After PSM analysis, compared with non-surgery, surgery remained associated with improved OS (HR 0.77; 95% CI 0.68–0.87; p < 0.0001) and improved CSS (HR 0.82; 95% CI 0.72–0.95; p = 0.008) adjusted for baseline differences. In the large cohort of PINHL patients with chemotherapy older than 18 years, surgery was associated with significantly improved OS and CSS before and after PSM analysis.
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Affiliation(s)
- Cuifen Zhang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaohong Zhang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zeyu Liu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiahao Tao
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lizhu Lin
- Cancer Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, Guangzhou, 510405, Guangdong, China.
| | - Linzhu Zhai
- Cancer Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, Guangzhou, 510405, Guangdong, China.
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Owattanapanich W, Ruchutrakool T, Pongpruttipan T, Maneerattanaporn M. A 10 -year cohort study of 175 primary gastrointestinal lymphoma cases in Thailand : clinical features and outcomes in the immunochemotherapy era. ACTA ACUST UNITED AC 2021; 26:249-255. [PMID: 33618613 DOI: 10.1080/16078454.2021.1889160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Primary gastrointestinal lymphoma (PGIL), an uncommon subtype of lymphoma, accounts for 1%-4% of gastrointestinal cancers. This study, therefore, aimed to investigate the current 10-year epidemiology and outcomes of PGIL. METHODS This retrospective study involved a hospital-based chart review to analyze the epidemiology, clinical features, predisposing factors, and clinical outcomes of patients diagnosed with, and treated for, PGIL. Data covering 10 years was collected of Thai patients aged ≥ 15 years who had been diagnosed as PGIL with pathological confirmation and treated at Siriraj Hospital, Thailand. RESULTS A total of 175 PGIL patients were enrolled. Their median age was 60 years (range, 20-98), with a male predominance. The stomach was the most common site of gastrointestinal (GI) organ involvement by lymphoma (38.9%), followed by the small intestine (23.4%) and multiple sites of GI involvement (23.4%). Diffuse large B-cell lymphoma (DLBCL) had the highest proportion of PGIL, accounting for 61.1%. The median patient follow-up time was 13.9 months (range: 0-104.9 months). The median overall survival (OS) of PGIL patients was not reached during the 10 years, with a 5-year OS of 64.4%. The probability of having a better OS was demonstrated in patients with a good performance status who received a rituximab-containing regimen. CONCLUSIONS The stomach was the most common site of lymphoma involvement in the GI tract, with DLBCL accounting for the highest proportion of those patients. The long-term survival outcome was significantly improved in patients with good performance status and rituximab exposure. Trial registrationNot applicable.
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Affiliation(s)
- Weerapat Owattanapanich
- Division of Hematology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Theera Ruchutrakool
- Division of Hematology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tawatchai Pongpruttipan
- Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Monthira Maneerattanaporn
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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5
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Shen H, Jiang L, Nie L, Fan X, Xu Y, Yin L, Xu L, Xia J, Li Z, Zhu F, Xu K. Prognostic Analysis of Patients with Primary Extranodal Lymphoma: A Retrospective Study. Cancer Manag Res 2021; 13:2171-2180. [PMID: 33688260 PMCID: PMC7936719 DOI: 10.2147/cmar.s299745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background Originating from extranodal organs or tissues, primary extranodal lymphoma (PENL) acts in different primary sites with diverse clinical performances and PENL has remarkable geographical differences and lacks the relevant reports in each region. Patients and Methods Two hundred and twenty PENL patients were enrolled, and the relevant clinical and laboratory indicators were analyzed. In addition, statistical methods were applied to analyze the effects of different factors on overall survival (OS) and progression-free survival (PFS) of patients. Results The three most frequent primary sites of PENL are the digestive system, head and neck, and central nervous system. The patients were classified into groups based on their risk status, resulting in low-risk, medium-low-risk, medium-high-risk, and high-risk, and their respective 3-year OS values were calculated, which showed that 121 patients (55%) were in the low-risk group and 3-year OS was 85.2% (25.9% medium-low-risk, 3-year OS 66.6%; 15% medium-high-risk, 3-year OS 61.9%; 4.09% high risk, 3-year OS 45.7%). A multivariate analysis of the Cox regression demonstrated that serum beta 2-microglobulin (β2-MG) and lactate dehydrogenase (LDH) were independent prognostic factors for OS and PFS, respectively. Both the performance status and pathological subtypes were independent prognostic factors for OS and PFS. Conclusion The correlated independent risk factors such as β2-MG, LDH, performance status, and pathological subtypes, were helpful for effectively determining the prognosis of PENL patients and guiding treatment.
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Affiliation(s)
- Hanying Shen
- Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Lingling Jiang
- Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Linlin Nie
- Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Xiaohui Fan
- Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Yanqiu Xu
- Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Lingling Yin
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, People's Republic of China
| | - Linyan Xu
- Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China.,Key Laboratory of Bone Marrow Stem Cell, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Jieyun Xia
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, People's Republic of China
| | - Zhenyu Li
- Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China.,Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, People's Republic of China.,Key Laboratory of Bone Marrow Stem Cell, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Feng Zhu
- Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China.,Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, People's Republic of China.,Key Laboratory of Bone Marrow Stem Cell, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Kailin Xu
- Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China.,Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, People's Republic of China.,Key Laboratory of Bone Marrow Stem Cell, Xuzhou, Jiangsu, 221000, People's Republic of China
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Development and Validation of Prognostic Nomograms for Patients with Primary Gastrointestinal Non-Hodgkin Lymphomas. Dig Dis Sci 2020; 65:3570-3582. [PMID: 31993894 DOI: 10.1007/s10620-020-06078-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 01/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS The objective of this study was to construct and authenticate nomograms to project overall survival (OS) and cancer-specific survival (CSS) in primary gastrointestinal non-Hodgkin lymphomas (PGINHL). METHODS Suitable patients were chosen from the Surveillance, Epidemiology and End Results database and Wannan Medical College Yijishan Hospital. The Cox regression model was used to acquire independent predictive factors to develop nomograms for projecting OS and CSS. The performance of the nomograms was validated using the Harrell's concordance index (C-index), calibration curves, and decision curve analysis (DCA) and was compared with that of the AJCC 7th staging system. Survival curves were obtained using the Kaplan-Meier method, while the log-rank test was used to compare the difference among the groups. RESULTS The C-index of the nomograms for OS and CSS was 0.735 (95% CI = 0.719-0.751) and 0.761 (95% CI = 0.739-0.783), respectively, signifying substantial predictive accuracy. These outcomes were reproducible when the nomograms were used for the internal and external validation cohorts. Moreover, assessments of the C-index, AUC, and DCA between the nomogram results and the AJCC 7th staging system showed that the former was better for evaluation and was more clinically useful. CONCLUSIONS We constructed the nomogram which could predict 1-, 3-, and 5-year OS and CSS of patients with PGINHL. Our nomogram showed good performance, suggesting that it can be used as an efficacious instrument for predictive assessment of patients with PGINHL.
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Kurucu N, Akyüz C, Yalçın B, Bajin İY, Varan A, Orhan D, Karnak İ, Aydın B, Kutluk T. Primary gastric lymphoma: A report of 16 pediatric cases treated at a single institute and review of the literature. Pediatr Hematol Oncol 2020; 37:656-664. [PMID: 32705927 DOI: 10.1080/08880018.2020.1779884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Gastrointestinal tract is the most common extranodal site for childhood non-Hodgkin lymphomas (NHLs). However, primary gastric lymphoma (PGL) is very rare. We report our experience with PGL. Between 1972 and 2019, patients with PGL among 1696 NHL cases were evaluated retrospectively. Patient characteristics, treatments, and survival rates were recorded. We also reviewed the cases reported in literature. There were 16 PGL (11 males, five females) cases with a median age of 10 years. Most frequent complaints, similarly to the literature, were pain and vomiting. Hematemesis/melena and anemia were present in 20% of patients. Most common tumor location was antrum. Histopathological subtypes were Burkitt and non-Burkitt B-cell lymphoma in 43.75% and marginal zone lymphoma (MZL) in 6.25% of cases while mucosa-associated lymphoid tissue (MALT) and low-grade lymphomas constitute 15.3% of cases reported in the literature. In our series, Helicobacter pylori (H. pylori) was analyzed in only the case with MZL and found to be positive. However, H. pylori positivity was reported in 75% of the cases in the literature. H. pylori eradication, chemotherapy, and radiotherapy were applied in one, 14, and five patients. Subtotal gastrectomy with gastroduodenostomy/jejunostomy was performed in three patients. Gastrojejunostomy was done without tumor resection in two patients. Nine patients lived without disease for a median of 59 (12-252) months. Five-year EFS and OS were 69.6% and 64.3%, respectively. PGL constitutes 0.94% of our NHL cases. Interestingly, most of the cases in the literature were from Turkey. While adult PGL is mostly MALT lymphoma, most pediatric cases had high-grade histopathology. Although surgery and radiotherapy were applied earlier, chemotherapy alone is sufficient.
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Affiliation(s)
- Nilgün Kurucu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bilgehan Yalçın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İnci Y Bajin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Diclehan Orhan
- Department of Pediatric Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İbrahim Karnak
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burça Aydın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Tian C, Li Y, Chen Z. A Retrospective Analysis of Primary Gastrointestinal Non-Hodgkin Lymphomas: Clinical Features, Prognostic Factors and Treatment Outcomes. Onco Targets Ther 2020; 13:5345-5352. [PMID: 32606752 PMCID: PMC7293986 DOI: 10.2147/ott.s248381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/21/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Primary gastrointestinal non-Hodgkin lymphoma (PGIL) is a rare hematopoietic malignancy with limited data to guide management. Methods We analyzed the clinical characteristics and survival of 219 newly diagnosed PGIL patients. Results Our single-center data showed that the incidence rate of primary gastric lymphoma (PGL) was higher than that of primary intestine lymphoma (PIL). Most PGIL was B-cell originated and DLBCL was the most common pathological type both in PGL and PIL group. Univariate and multivariate analysis showed that IPI score and pathology were independent prognostic factors. The overall survival (OS) and progression-free survival (PFS) of patients with MYC rearrangement were much shorter compared to patients without MYC rearrangement indicating that MYC translocation was related to decreased survival. Neither OS nor PFS differed between patients who received chemotherapy with or without surgery. However, patients who received surgery alone had a poor prognosis. Conclusion Chemotherapy is the front-line treatment for PGIL while surgery was conducted to relieve tumor-related complications or make diagnosis. MYC rearrangement predicted poor prognosis of PGIL patients.
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Affiliation(s)
- Chen Tian
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, People's Republic of China
| | - Yueyang Li
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, People's Republic of China
| | - Zehui Chen
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, People's Republic of China
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Synchronous Primary Diffuse Large B Cell Lymphoma and Adenocarcinoma of the Stomach: a Clinical Dilemma. Indian J Surg Oncol 2020; 11:223-225. [PMID: 33364704 DOI: 10.1007/s13193-020-01119-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 06/02/2020] [Indexed: 10/24/2022] Open
Abstract
A 65-year-old Caucasian man was admitted to our department with progressive weakness, dyspepsia, and weight loss. Endoscopic biopsies revealed a gastric diffuse large B cell lymphoma. Computed tomography scan showed a locally advanced bulky gastric tumor with peritoneal involvement. Laparoscopic staging was performed and biopsies showed peritoneal localization of adenocarcinoma. A new endoscopy with multiple mapping biopsies confirmed the diagnosis of diffuse large B cell lymphoma. A multidisciplinary team evaluated the stage of both tumors and the patient started on a chemotherapy regimen with cisplatin, 5-fluorouracil, and trastuzumab (ToGA). He is currently alive with disease at 9 months after surgery. Synchronous occurrence of primary lymphoma and adenocarcinoma of the stomach is extremely rare. Symptomatology is similar and accurate diagnosis requires a combination of both morphological and immunohistochemical analyses. Treatment should be planned considering the stage of both diseases.
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Fernandez Turizo MJ, Kharfan‐Dabaja MA, Alhaj Moustafa M, Ayala E, Jiang L, Parrondo R. Primary diffuse large B-cell lymphoma presenting as acute appendicitis: A report of 2 cases and a literature review. Clin Case Rep 2020; 8:293-298. [PMID: 32128176 PMCID: PMC7044370 DOI: 10.1002/ccr3.2653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/11/2019] [Accepted: 11/16/2019] [Indexed: 12/19/2022] Open
Abstract
Primary appendiceal lymphomas (PAL) are a type of primary gastrointestinal non-Hodgkin lymphoma (PGINHL) with an incidence of <1%. There is considerable discordance with regard to the optimal management of PGINHL. We describe two cases of PAL, perform a literature review, and discuss the available evidence for optimal treatment.
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Affiliation(s)
| | | | | | - Ernesto Ayala
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFLUSA
| | - Liuyan Jiang
- Division of Hematology‐OncologyMayo ClinicJacksonvilleFLUSA
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11
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de Morais SD, Mikhael BM, Németh SIA, Paulo IML, de Barros ÉOH, Lima OAT. Burkitt's lymphoma presenting as acute appendicitis: a case report. J Surg Case Rep 2018; 2018:rjy131. [PMID: 29942479 PMCID: PMC6007797 DOI: 10.1093/jscr/rjy131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 05/29/2018] [Indexed: 12/02/2022] Open
Abstract
Appendiceal lymphomas are exceedingly rare, constituting around 0.015% of all gastrointestinal lymphoma cases. Burkitt’s lymphoma is the second most prevalent pathology, diagnosed in 25.9% of patients. We report a case of a 36-year-old male admitted with acute abdominal pain with 2 days of evolution, localized in the right lower quadrant associated with hyporexia, but no fever. On examination he presented abdominal tenderness on the right iliac fossa. A diagnosis of acute appendicitis was made clinically. At the post-operative follow up, 2 weeks later, he presented a low back pain of high intensity, associated with swelling of the abdomen, night sweats, daily fevers and weight loss. The histopathological exam of the appendix revealed diffuse and transmural lymphoid proliferation. Immunohistochemistry suggested high grade B-cell lymphoma indicative of Burkitt’s lymphoma. This patient was staged as a IVxB lymphoma and was submitted into polychemotherapy with a complete clinical response in 8 months.
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Affiliation(s)
- Sebastião D de Morais
- HRAN (Hospital Regional da Asa Norte), Departmant of Surgery, Brasília 70710-910, Brazil
| | - Bruno M Mikhael
- Faculdades Integradas da União Educacional do Planalto Central, Brasília 72445-020, Brazil
| | - Stephanie I A Németh
- Faculdades Integradas da União Educacional do Planalto Central, Brasília 72445-020, Brazil
| | - Isabella M L Paulo
- Faculdades Integradas da União Educacional do Planalto Central, Brasília 72445-020, Brazil
| | - Érico O H de Barros
- HRAN (Hospital Regional da Asa Norte), Full Member of Colégio Brasileiro de Cirurgiões (CBC), Brasília 70710-910, Brazil
| | - Olímpia A T Lima
- HRAN (Hospital Regional da Asa Norte), Brasília University-UnB, Departmant of Surgery, Brasília 70710-910, Brazil
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12
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Li X, Meng Q, Sun S, Zhan Z, Zhang L, Sun B, Zhang Y. Histological transformation from gastric mucosa-associated lymphoid tissue lymphoma to gastric diffuse large B-cell lymphoma. Oncol Lett 2017; 14:2244-2248. [PMID: 28789445 PMCID: PMC5530083 DOI: 10.3892/ol.2017.6402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 04/13/2017] [Indexed: 01/30/2023] Open
Abstract
This study evaluated the clinical features, treatment and prognosis in Chinese patients with histological transformation (HT) from gastric mucosa-associated lymphoid tissue lymphoma to gastric diffuse large B-cell lymphoma. We reviewed the medical records of 71 patients diagnosed with HT between 2001 and 2013, retrospectively. Patients had a median age of 56 years. The ratio of sex (male:female) was 1.3:1. The clinical course was often insidious, lacking specific clinical presentation. Macroscopically, the antrum was the most commonly involved site. Thirty-one patients (45%) presented at stage I, and 25 (35%) presented with local (18/71, 25%) or distant (7/71, 10%) nodal involvement. There were also stage IIE (9/71, 12%) and stage IV (6/71, 8%) patients with advanced stages. For all 71 patients, the 5-year progression-free survival (PFS) and overall survival (OS) estimates were 50 and 56%, respectively. There was no statistical difference in 5-year PFS and OS estimates between patients receiving Helicobacter pylori (H. pylori) containing eradication (HPE) (p=0.189) and those receiving non-HPE (p=0.359). Upon the Cox regression model, advanced stages were the only independent prognostic factors associated with shorter PFS, and m-IPI was independently associated with shorter PFS and OS. There was no specific clinical manifestation for patients with HT. HPE is thus a promising therapeutic approach for such patients. Moreover, advanced stages and m-IPI significantly influenced patient outcome.
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Affiliation(s)
- Xiaowu Li
- Department of Medical Oncology, Xuzhou Central Hospital, Xuzhou, Jiangsu 277100, P.R. China
| | - Qingliang Meng
- Department of Oncological Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu 277100, P.R. China
| | - Sanyuan Sun
- Department of Medical Oncology, Xuzhou Central Hospital, Xuzhou, Jiangsu 277100, P.R. China
| | - Zhongli Zhan
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China
| | - Lianyu Zhang
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China
| | - Baochun Sun
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China
| | - Yizhuo Zhang
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China
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Ayub A, Santana-Rodríguez N, Raad W, Bhora FY. Primary appendiceal lymphoma: clinical characteristics and outcomes of 116 patients. J Surg Res 2017; 207:174-180. [DOI: 10.1016/j.jss.2016.08.079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/10/2016] [Accepted: 08/24/2016] [Indexed: 02/07/2023]
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