Lymphomas of gastrointestinal tract – clinico-pathological review
Authors:
A. Janíková 2; I. Zambo 1; A. Baumeisterová 2; M. Hermanová 1; J. Mayer 2
Authors‘ workplace:
Patologický ústav FN U svaté Anny Brno a LF MU Brno
1; Interní hematologická a onkologická klinika FN Brno a LF MU Brno
2
Published in:
Transfuze Hematol. dnes,19, 2013, No. 3, p. 140-151.
Category:
Comprehensive Reports, Original Papers, Case Reports
Overview
Primary extranodal lymphomas (lymphomas arising from extranodal organs) comprise approximately 30% of all of lymphomas, from which about 40% is diagnosed in gastrointestinal tract (GIT). Primary gastrointestinal lymphomas form nearly 5–10% of all non-Hodgkin’s lymphomas. Their frequency is much lower than carcinomas; nevertheless lymphoma is second most frequent tumour of stomach and gut.
The most common localization of lymphoma manifestation is stomach (about 60–75% cases) and small bowel; ileum, caecum and rectum are involved less often. Regarding of type, diffuse large B-cell lymphoma (DLBCL) and Mucosa associated lymphoid tissue lymphoma (MALT) are diagnosed most frequently, followed by other mature B- and T-lymphoproliferative diseases. Some of primary GIT lymphomas are associated with a chronic inflammation, in particular of infection (Helicobacter pylori, Campylobacter jejuni, EBV), or gluten enteropathy, how it is in the case of enteropathy associated T-lymphoma. Whereas non-Hodgkin’s lymphomas are common in GIT, the impairment of Hodgkin’s disease in this localization is rare.
The important tool for diagnosis, staging and follow up of upper GIT lymphoma, especially in stomach, is endoscopic ultrasonography. Treatment strategy depends on type of lymphoma, stage and etiology. In principle, localized stages of MALT lymphoma associated with H. pylori infection should be treated by antibiotics with Helicobacter eradication, which can lead to remission. Radiotherapy should be used in localized cases not suitable for antibiotics or with antibiotics failure. Immunotherapy or immunochemotherapy is indicated for the treatment of aggressive or more advanced lymphomas. Surgery is useful in diagnostics but in the treatment of GIT lymphoma has very limited place. .
Key words:
extranodal lymphomas, tumors of GIT
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