Clinicopathologic Study Of Primary Gastrointestinal Lymphoma

Objective To study the clinicopathological features in patients with primary gastrointestinal non-Hodgkin's lymphoma(GI-NHL) and the relationship of histological typing, clinical staging with the prognosis; to explore the clinical and pathological features of mantle cell lymphoma in gastrointestine. Methods From June 1994 to March 2001, 82 cases of GI-NHL were classificated histologically by immunohistochemical method and histopathological observation according to WHO(2000) classification of neoplastic disease of the hematopoietic and lymphoid tissue; meantime clinical staging were determined according to the Ann Arbor classification in its modification by Musshoff. Follow-up and statistical analysis were made, P<0.05 was the level of significance. Results In 82 cases of the GI-NHL, 48.8%(n=40) patients were gastric NHL, 24.4%(n=20) patients were small bowel or intestine (including ileoceal region) NHL, multiple GI involvement was 2.4%(n=2). 50 patients were male, 32 female, the male to female ratio was 1.56:1. 23-83 years old was involved, mean age was 54.6 years old. Abdominal pain was the predominant symptom, followed by tumor and intestinal obstruction. 77.5%(n=62) of the GI-NHL were in stages IIE/IIIE. 41.5%(n=34) of the GI-NHL were of mucosa-associated lymphoid tissue type (MALT type), with 64.8%(n=22) of these arising from the stomach. Diffuse large B-cell lymphoma(DLBCL)were the largest histological subtype seen 46.3%(n=38)and 60%(n=12) of the intestinal lymphomawere DLBCL, 28.9%(n=ll) of these DLBCL had MALT type lymphoma components. Additional , 8cases(9.8%) of the GI-NHL were diagnosed as T cell lymphoma, and 2cases(2.4%) mantle cell lymphoma. T cell lymphoma had the poorest prognosis, which died in one year(6/7), mean survival time 6.7 + 4.3 months. One case of the MCL died in 14 months after diagnosed. There were significant differences on survival rate between T cell lymphoma and B cell lymphoma, P<0.01, but no significant differences between MALT type and DLBCL, P>0.05. Significant differences were observed between I E/ II E and IIIE/IVE, >60 years old and 60 years,(P<0.05,0.01). Conclusions No especial symptoms can be used to diagnose in patients with GI-NHL, diffuse large B cell lymphoma was the largest histological type. There were significant relationships in patients of clinical staging, histological typing and age with prognosis. Correct histological typing, clinical staging may be a sensitive predictor in prognosis and therapy. Mantle cell lymphoma has poor prognosis, which can not be mutiple polyposis in gastrointestine.