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Chang H, Kang J, Pu T, Su R, Chen C, Hu J. Diffuse large B-cell lymphoma-induced intussusception: A case report and literature review. Clin Case Rep 2024; 12:e9046. [PMID: 38895050 PMCID: PMC11183938 DOI: 10.1002/ccr3.9046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/21/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
Adult intussusception necessitates early surgical intervention. We emphasis the significance of considering diffuse large B-Cell lymphoma in differential diagnoses for adult intussusception, particularly in the colon, to ensure precise diagnosis and optimal management.
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Affiliation(s)
- Hao‐Cheng Chang
- Department of Surgery, Tri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
| | - Jung‐Cheng Kang
- Department of Surgery, Division of Colon and Rectal SurgeryTaiwan Adventist HospitalTaipeiTaiwan
| | - Ta‐Wei Pu
- Division of Colon and Rectal Surgery, Department of Surgery, Tri‐Service General Hospital Songshan BranchNational Defense Medical CenterTaipeiTaiwan
- Division of Colon and Rectal Surgery, Department of Surgery, Tri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
| | - Ruei‐Yu Su
- Department of Pathology, Tri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
- Department of Pathology and Laboratory MedicineTaoyuan Armed Forces General HospitalTaoyuanTaiwan
| | - Chao‐Young Chen
- Division of Colon and Rectal Surgery, Department of Surgery, Tri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
| | - Je‐Ming Hu
- Division of Colon and Rectal Surgery, Department of Surgery, Tri‐Service General HospitalNational Defense Medical CenterTaipeiTaiwan
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Warrick J, Luo J, Robirds D, Branson J, Frater JL, Kreisel F, Hassan A, Nguyen TT. Gastrointestinal lymphomas in a North American population: clinicopathologic features from one major Central-Midwestern United States tertiary care medical center. Diagn Pathol 2012; 7:76. [PMID: 22742986 PMCID: PMC3537672 DOI: 10.1186/1746-1596-7-76] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 05/22/2012] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Gastrointestinal (GI) lymphomas are very common types of extranodal lymphomas, and we hypothesize there are regional differences in subtype, distribution in the GI tract, and epidemiological features among the different populations. METHODS We retrospectively evaluated the clinical, molecular and histologic features of North American primary and secondary GI lymphomas diagnosed from 2000-2009 seen at our institution. We utilized immunohistochemistry and fluorescence in situ hybridization to further evaluate a subset of the gastric lymphomas. RESULTS Extranodal marginal zone lymphomas of mucosal associated lymphoid tissue (MALTs) and diffuse large B cell lymphomas (DLBCLs) were the most common subtypes of GI lymphomas. Select gastric DLBCLs (N = 6) and MALTs (N = 13) were further examined for API2-MALT1 and IGH translocations, and P16 and P53 protein expression. Gastric MALTs showed frequent API2-MALT1 (38%) but not IGH translocations (0%), and the DLBCLs showed neither translocation. Expression of P16 and P53 proteins and the proliferative index were compared between high grade gastric lymphomas (gastric DLBCLs) and low grade gastric lymphomas (gastric MALTs). P53 overexpression (P = 0.008) and a high proliferation index [Ki-67] (P = 0.00042) were significantly associated with gastric DLBCL, but no statistically significant difference was observed in P16 expression (p = 0.108) between gastric DLBCL and gastric MALT. CONCLUSION Our study revealed that GI lymphomas from a Central-Midwestern North American population showed differences and similarities to non-North American cohorts. In addition, API2-MALT1, P16 and P53 abnormalities occurred frequently in gastric lymphomas from this North American population. VIRTUAL SLIDES The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1415505838687793.
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Affiliation(s)
- Joshua Warrick
- Department of Pathology & Immunology, Washington University Medical School, 660 S, Euclid Ave, Campus Box 8118, St Louis, MO 63110, USA
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Choi JY, Lee GH, Ahn JY, Kim MY, Lee JH, Choi KS, Kim DH, Choi KD, Song HJ, Jung HY, Kim JH. The role of abdominal CT scan as follow-up after complete remission with successful Helicobacter pylori eradication in patients with H. pylori-positive stage I(E1) gastric MALT lymphoma. Helicobacter 2011; 16:36-41. [PMID: 21241410 DOI: 10.1111/j.1523-5378.2010.00807.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Eradication of Helicobacter pylori with antibiotics is the established initial treatment of patients with localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, there are few reports on follow-up modalities to identify sustained remission in patients who achieve complete remission (CR). We therefore investigated the role of abdominal computed tomography (CT) as follow-up after CR with H. pylori eradication. PATIENTS AND METHODS We retrospectively analyzed 122 patients with H. pylori-positive stage I(E1) gastric MALT lymphoma who achieved CR with successful H. pylori eradication. RESULTS The median follow-up after CR was 35 months (range 3-140 months). At a median of 17 months (range 12-21 months) after CR, 7 of 122 patients (5.7%) experienced lymphoma recurrence, all cases of which were confined to the gastric mucosa and were detectable only by endoscopy with multiple biopsies. At the time of recurrence, four of seven patients showed re-infection by H. pylori. Eradication therapy was successful in these patients, resulting in both bacterial eradication and tumor regression. Three patients who experienced histologic recurrence without H. pylori re-infection were observed by a watch and wait strategy and again achieved CR. CONCLUSIONS None of the patients with H. pylori-positive stage I(E1) gastric MALT lymphoma who experienced tumor recurrence after CR with successful H. pylori eradication showed recurrence at extragastric sites, including lymph nodes without gastric mucosal lesion. These findings indicate that endoscopic biopsies without abdominal CT scans are sufficient to detect recurrence in these patients.
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Affiliation(s)
- Ji Young Choi
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Songpa-gu, Seoul, Korea
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Samee A, Rukin N, Siddiqui I, Halliday M, Farmer M. A solitary rectal mucosa-associated lymphoid tissue (MALT) lymphoma. BMJ Case Rep 2010; 2010:2010/jul16_2/bcr0120102649. [PMID: 22767556 DOI: 10.1136/bcr.01.2010.2649] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Mucosa-associated lymphoid tissue (MALT) is a type of extra nodal malignant lymphoma seen in organs such as the stomach, thyroid and salivary glands. Furthermore, occurrence of colorectal MALT lymphoma is extremely rare. We report a case of a solitary rectal MALT lymphoma treated by surgical resection and radiotherapy. Lymphoma should be considered as a rare differential diagnosis when dealing with large bowel pathology. We would advocate the use of surgery as a primary treatment option for a medically fit patient.
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Affiliation(s)
- A Samee
- Surgical Directorate, Princess Royal Hospital, Telford, UK.
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Mehta RS, Modi N, Sapanara N, Ramachandra P, Mikhail M. Extranodal marginal zone B-cell mucosa-associated lymphoid tissue (MALT) lymphoma of cecum presenting as bright red bleed per rectum--a case report with review of literature. J Gastrointest Cancer 2009; 39:66-72. [PMID: 19225911 DOI: 10.1007/s12029-008-9048-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Accepted: 12/10/2008] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Primary colorectal lymphomas are particularly rare and contribute to 0.2% of all colorectal malignancies. Gastroentrointestinal (GI) tract is most commonly a secondary involvement site for non-Hodgkin's lymphoma (NHL). Primary NHL of GI tract are very rare, constituting about 1-4% of all GI tract malignancies. In GI tract, two-thirds of all cases occur in stomach followed by small intestine (9%). Clinical presentation depends upon the site of involvement. Pain, loss of appetite, and weight loss are the most common symptoms, while bleeding occurs more with gastric involvement. CASE REPORT We present a case of a female presenting as bright red bleed per rectum who was found to have a cecal mass, subsequently diagnosed as extranodal marginal zone B-cell mucosa-associated lymphoid tissue lymphoma with extensive plasma cell differentiation. CONCLUSION The diagnosis may be challenging, but a solitary extranodal plasmacytoma and multiple myeloma must be excluded in all such cases.
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Affiliation(s)
- Rohtesh S Mehta
- Department of Internal Medicine, Mercy Catholic Medical Center/Drexel University School of Medicine, Mercy Fitzgerald Hospital, 1500 Lansdowne Avenue, Medical Science Building, Darby, PA 19023, USA.
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6
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Analysis of genomic instability in adult-onset celiac disease patients by microsatellite instability and loss of heterozygosis. Eur J Gastroenterol Hepatol 2008; 20:1159-66. [PMID: 18946361 DOI: 10.1097/meg.0b013e3283094ee9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND AIMS Malignant complications of celiac disease (CD) include carcinomas and lymphomas. The genetic basis behind cancer development in CD is not known, but acquisition of genetic abnormalities and genomic instability has been involved. The aim of this study was to explore molecular characteristics of genomic instability in CD patients by analyzing microsatellite instability (MSI) and loss of heterozygosis (LOH) with carefully selected microsatellites. METHODS We genotyped small bowel biopsies and peripheral blood samples from 20 untreated CD patients using five microsatellites related to MMR genes (panel A), and five repeats associated with tumor suppressor genes, chromosome instability, inflammation, and cancer (panel B). RESULTS Genomic instability was found in seven out of 20 (35%) cases at: D5S107, D18S58, GSTP, TP53 or DCC, being TP53 the most frequently affected (five out of seven cases; 71%). Microsatellite alterations were significantly found using panel B markers (P=0.04). No cases with high frequency of MSI and replication error phenotype were detected. Only one case displayed MSI-L alone. Three patients exhibited LOH and three other cases showed LOH with low level of MSI, being classified as having chromosome instability phenotype. CONCLUSION Two novel observations were found in this study: first, the finding that non-neoplastic cells from a group of untreated CD patients present genomic instability at nucleotide level; and second, the advantage to use carefully selected microsatellites to identify celiac patients with molecular instability. Our data support the existence of chromosome instability phenotype in CD, suggesting that stable and unstable patients are genomically distinct subtypes that may follow a different evolution.
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Chuang SS, Ye H, Yang SF, Huang WT, Chen HK, Hsieh PP, Hwang WS, Chang KY, Lu CL, Du MQ. Perforation predicts poor prognosis in patients with primary intestinal diffuse large B-cell lymphoma. Histopathology 2008; 53:432-40. [DOI: 10.1111/j.1365-2559.2008.03140.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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8
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Adenocarcinoma and Other Small Intestinal Malignancies. Oncology 2007. [DOI: 10.1007/0-387-31056-8_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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9
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Barth TFE, Barth CA, Kestler HA, Michl P, Weniger MA, Buchholz M, Möller P, Gress T. Transcriptional profiling suggests that secondary and primary large B-cell lymphomas of the gastrointestinal (GI) tract are blastic variants of GI marginal zone lymphoma. J Pathol 2007; 211:305-13. [PMID: 17152084 DOI: 10.1002/path.2096] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The pathogenetic relationship of marginal zone B-cell lymphoma (MALT lymphoma) of the gastrointestinal (GI) tract and eventually co-existing aggressive B-cell lymphoma and primary aggressive B-cell lymphoma remains to be elucidated. The RNA of laser-microdissected cells was isolated and amplified from small and/or large cell compartments of eight MALT lymphomas (small cell lymphoma, SCL), 14 GI diffuse large B-cell lymphomas (large cell lymphoma, LCL), and ten GI B-cell lymphomas with composite small and large cell compartments (ComL) and expression analyses were performed using cDNA arrays. Hierarchical cluster analysis clearly separated SCL and LCL and the small and large cell compartments of ComL. Likewise, cluster analysis with all samples of SCL, LCL, and ComL yielded two main 'small cell' and 'large cell' branches. Furthermore, 60 genes were differentially expressed between SCL and LCL, and 82 genes between the small and large cell components of ComL; 26 genes were discriminators in both settings. Use of the profiles of ComL as training sets for class prediction resulted in 95% accuracy for the classification of SCL and LCL. Collectively, the data strongly suggest that both secondary and primary aggressive B-cell lymphomas of the GI tract are blastic marginal zone lymphomas.
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MESH Headings
- Gastrointestinal Neoplasms/genetics
- Gastrointestinal Neoplasms/pathology
- Gene Expression Profiling
- Genetic Markers
- Humans
- Immunohistochemistry/methods
- In Situ Hybridization, Fluorescence
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Oligonucleotide Array Sequence Analysis
- Reverse Transcriptase Polymerase Chain Reaction
- Transcription, Genetic
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Affiliation(s)
- T F E Barth
- Department of Pathology, Albert-Einstein-Allee 11, University of Ulm, Ulm, Germany
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10
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Mihaljević B, Nedeljkov-Janćić R, Cemerikić-Martinović V, Babić D, Colović M. Ki-67 proliferative marker in lymph node aspirates of patients with non-Hodgkin's lymphoma. Med Oncol 2006; 23:83-89. [PMID: 16645233 DOI: 10.1385/mo:23:1:83] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2005] [Revised: 11/30/1999] [Accepted: 04/22/2005] [Indexed: 11/11/2022]
Abstract
Proliferative activity of lymphoma cells was tested by immunocytochemical staining with Ki-67 monoclonal antibody in 63 aspirates of peripheral lymph nodes sampled from patients suffering from non-Hodgkin's lymphoma. Referring to the dominant cell population in nodal aspirates, a rising trend of Ki-67 proliferative marker was noted from the small cells (X = 13.20) and small cells with notched nucleus (X = 43.52) and large cells (X = 79.47) with histopathologic equivalents corresponding to aggressive lymphoma. Statistical testing of the difference in the Ki-67 proliferative marker against demographic and clinical-laboratory characteristics of the studied patients revealed the levels of significance for the performance status, bone marrow infiltration, and albumin serum value. Correlation of cytomorphological and immunocytochemical results was tested against International Prognostic Index (IPI). Statistically significant correlation of Ki-67 with cytomorphology and REAL-immunocytochemical classification of lymphoma was confirmed, but not with the IPI index. In order to determine the prognostic importance of Ki-67 marker, the patients were classified into those with low Ki-67 (<20% of proliferating cells), mean proliferation index Ki-67 (range 20-59%), and high proliferative index Ki-67 (positive in over 60% of lymphoma cells). Testing Ki-67 with survival we have found that the low proliferative index was associated with the longest survival, median about 36 mo; for proliferative marker values ranging between 20 and 59%, the median survival was 30.4 mo; and survival of patients with the high proliferative index was only 12.9 mo.
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Affiliation(s)
- B Mihaljević
- Institute of Hematology, Clinical Center of Serbia, 11000 Belgrade, Serbia.
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11
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Eser B, Kaplan B, Unal A, Canoz O, Altuntas F, Sari HI, Er O, Ozkan M, Kucuk C, Arar M, Gursoy S, Cetin M. Clinicopathologic characteristics and therapeutic outcomes of primary gastrointestinal non-Hodgkin's lymphomas in central Anatolia, in Turkey. Yonsei Med J 2006; 47:22-33. [PMID: 16502482 PMCID: PMC2687578 DOI: 10.3349/ymj.2006.47.1.22] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2003] [Accepted: 05/18/2004] [Indexed: 02/05/2023] Open
Abstract
Primary gastrointestinal lymphoma is a common presentation of non-Hodgkin's lymphoma. The main controversy arises when many aspects of its classification and management are under discussion, particularly regarding roles for surgical resection. The aim of this study was to evaluate clinicopathologic characteristics and the therapeutic outcome of primary gastrointestinal non-Hodgkin's lymphoma. We carried out a retrospective analysis of 74 patients who were presented to our center with histopathological diagnosis of primary gastro-intestinal non-Hodgkin's lymphoma between 1990 and 2001. All patients have been staged according to Lugano Staging System. For histopathological classification, International Working Formulation was applied. The treatment choice concerning the surgical or non-surgical management was decided by the initially acting physician. Treatment modalities were compared using the parameters of age, sex, histopathological results, stage, and the site of disease. Of the 74 patients, 31 were female and 43 were male, with a median age of 49 years (range 15-80). The stomach was the most common primary site and was seen in 51 of 74 patients (68.9%). The intermediate and high grade lymphomas constituted 91.9% of the all cases. In a median follow-up of 29 months (range 2-128), 20 out of 74 patients died. There was a three year overall survival rate in 65.4% of all patients. The three year overall survival rate was better in stage I and II1 patients who were treated with surgery plus chemotherapy (+/-RT) than those treated with chemotherapy alone (93.7% vs. 55.6%, p < 0.05). The stage and presence of B symptoms affected the disease free survival and overall survival significantly, but the histopathologic grade only affected the overall survival. On the basis of these results, we suggest that surgical resection is necessary before chemotherapy in early stage (stage I and II1) patients with gastrointestinal non-Hodgkin's lymphomas because of the significant survival advantage it would bring to the patient.
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Affiliation(s)
- Bulent Eser
- Department of Hematology-Oncology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Bunyamin Kaplan
- Department of Radiation Oncology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Ali Unal
- Department of Hematology-Oncology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Ozlem Canoz
- Department of Pathology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Fevzi Altuntas
- Department of Hematology-Oncology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - H. Ismail. Sari
- Department of Hematology-Oncology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Ozlem Er
- Department of Hematology-Oncology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Metin Ozkan
- Department of Hematology-Oncology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Can Kucuk
- Department of Surgery, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Makbule Arar
- Department of Pathology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Sebnem Gursoy
- Department of Gastroenterology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Mustafa Cetin
- Department of Hematology-Oncology, Erciyes University, School of Medicine, Kayseri, Turkey
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Ho CL, Hsieh AT, Dai MS, Chen YC, Kao WY, Chao TY. Non-Hodgkin's lymphoma of the stomach: treatment outcomes for 57 patients over a 20-year period. J Chin Med Assoc 2005; 68:11-5. [PMID: 15742857 DOI: 10.1016/s1726-4901(09)70125-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Gastric non-Hodgkin's lymphoma (NHL) is a rare subtype of malignancy, for which no consensus exists about treatment. In this study, the treatment outcomes of gastric NHL in 57 patients were retrospectively evaluated for a period of 20 years at a single institute. METHODS Clinical stages were classified according to the Ann Arbor staging system: 29 patients were stage 1, 17 stage II, two stage III, and nine stage IV. The 46 stage I/II patients received aggressive, multimodal therapy: 24 of these (group A) were treated with surgery-based management, which included surgery alone (n = 6), surgery + chemotherapy (CT; n = 14), surgery + radiotherapy (RT; n = 2), and surgery + CT + RT (n = 2); 22 patients (group B) did not receive surgery, but received CT alone (n = 11), CT + RT (n = 5), or, in patients with low-grade mucosa-associated lymphoid tissue (MALT) lymphoma, an oral anti-Helicobacter pylori regimen (n = 6). The 11 stage III/IV patients received CT and/or RT with regimens similar to those for stage I/III patients. RESULTS Except for 1 patient with an initial surgical diagnosis, 56 patients underwent gastric endoscopic examination, which proved that 42 had NHL. The rate of diagnostic accuracy by gastroscopy was 75%. After multimodal treatment (n = 46) and a median follow-up of 54 months (range, 1-210 months), the 5-year survival rate was 40.3%. The 5-year survival rates for stage 1, II and III/IV patients were 57.2%, 47% and 0%, respectively (p < 0.005). Of the 24 surgical patients (group A) who received sequential CT, with or without RT, 12 remained disease-free after a median follow-up of 98 months (range, 1-210 months); three patients died because of postoperative complications. Of the 22 non-surgical patients (group B) who received CT, alone or combined with RT, 14 remained disease-free after a median follow-up of 40 months (range, 4-189 months); 1 patient died because of massive gastric hemorrhage after CT. All stage III and IV patients died after a median survival of 4 months (range, 1-8 months). CONCLUSION Clinical stage is the most important factor predicting the long-term survival of patients with gastric NHL. Surgery may still be necessary in cases of failed gastroscopic diagnosis. In early-stage gastric NHL, non-surgical treatment seems able to achieve the aims of improved long-term survival and, in some instances, cure.
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Affiliation(s)
- Ching-Liang Ho
- Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
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13
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Krugmann J, Tzankov A, Dirnhofer S, Fend F, Greil R, Siebert R, Erdel M. Unfavourable prognosis of patients with trisomy 18q21 detected by fluorescence in situ hybridisation in t(11;18) negative, surgically resected, gastrointestinal B cell lymphomas. J Clin Pathol 2004; 57:360-4. [PMID: 15047736 PMCID: PMC1770281 DOI: 10.1136/jcp.2003.012369] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The most frequent cytogenetic alteration in gastrointestinal (GI) B cell lymphoma (BCL) is t(11;18)(q21;q21). GI B cell non-Hodgkin lymphomas lacking this translocation vary in their biology and clinical outcome. The t(11;18) negative subgroup shows increased numerical changes of chromosome 18, although its clinical relevance remains unknown. METHODS Thirty surgically resected primary GI BCLs were examined-11 low grade marginal zone mucosa associated lymphoid tissue (MALT) lymphomas, four marginal zone lymphomas with diffuse large BCL (DLBCL), and 15 de novo DLBCLs. Chromosome 18 aberrations were examined using interphase fluorescence in situ hybridisation. Trisomy 18 was studied applying a centromere 18 probe and a dual colour probe for the MALT1 gene at 18q21. RESULTS Using the MALT1 probe, only one marginal zone MALT lymphoma had a break apart pattern, indicating t(11;18) or variants. In the GI BCLs lacking MALT1 breaks, trisomy 18q21 was seen in seven patients (four with complete trisomy 18 and three with partial trisomy of 18q21). Trisomy 18q21 was found in two of 10 low grade MALT lymphomas and five of 19 GI BCLs with large cell component. Six of 17 patients with trisomy 18q21 presented with >/= stage II and one of 12 with stage I disease. Trisomy 18q21 was associated with significantly shorter disease specific survival in the whole group and GI BCLs with large cell component, but not in the low grade group. CONCLUSIONS Trisomy 18q21, including MALT1, may be associated with advanced tumour stage and may be a predictor of poor outcome in surgically resected primary GI BCLs.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Chi-Square Distribution
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 18
- Female
- Gastrointestinal Neoplasms/genetics
- Gastrointestinal Neoplasms/mortality
- Gastrointestinal Neoplasms/pathology
- Humans
- In Situ Hybridization, Fluorescence
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Prognosis
- Survival Rate
- Translocation, Genetic
- Trisomy/genetics
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Affiliation(s)
- J Krugmann
- Institute of Pathology, University of Innsbruck, Müllerstrasse 44, A-6020 Innsbruck, Austria.
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14
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Ranaldi R, Goteri G, Baccarini MG, Mannello B, Bearzi I. A clinicopathological study of 152 surgically treated primary gastric lymphomas with survival analysis of 109 high grade tumours. J Clin Pathol 2002; 55:346-51. [PMID: 11986338 PMCID: PMC1769653 DOI: 10.1136/jcp.55.5.346] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To describe the clinicopathological features of a large number of surgically treated and followed up primary gastric lymphomas and thereby gain a better understanding of their biology, with particular reference to the prognostic factors of high grade tumours. METHODS A retrospective study of 152 patients. RESULTS High grade gastric lymphomas, both pure and with a residual low grade component, differed from low grade mucosa associated lymphoid tissue (MALT)-type lymphomas in that they were more frequently large, ulcerated, at an advanced stage, and highly proliferating. In addition, patients were older and had a worse outcome. The prognosis of high grade lymphomas was influenced by patient age, tumour stage, depth of infiltration in the gastric wall, and the invasion of adjacent organs. Adjuvant postsurgical treatment prolonged survival only in patients with advanced stage and deep neoplastic infiltration. CONCLUSIONS There is a sharp distinction between low grade MALT-type lymphomas and tumours with a high grade component, justifying their different treatment approach. The postsurgical management of high grade lymphomas should be based on the accurate evaluation of the neoplastic extension.
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Affiliation(s)
- R Ranaldi
- Department of Pathology, University of Ancona School of Medicine, 60020 Torrette di Ancona, Italy
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