Clinical Analysis Of 81 Cases Of Primary Gastrointestinal Lymphoma

Objectives To analyze the clinicopathologic features in order to improve the level of diagnosis of primary gastrointestinal lymphoma(PGIL).Methods Eighty-one patients with PGIL, including 49 men and 32 women, were analyzed retrospectively. All patients were divided into A group(no systemic symptoms) and B group (with systemic symptoms). According to different disease site, all patients were divided into three groups: 43 patients with primary gastric lymphoma, 16 patients with primary small intestine lymphoma and 22 patients with primary large intestine lymphoma. Five patients received H. pylori eradication, 14 received surgery alone, 1 received exploratory laparotomy and biopsy, 10 received chemotherapy alone, 48 received combination therapy and 8 were untreated.Results①Clinical features: Common symptoms of PGIL were abdominal pain(87.7%), loss of weight(61.7%), loss of appetite(53.1%) and bleeding(40.7%); B group with systemic symptoms frequently occurred in intestinal tract, rarely occurred in stomach; Perforation, ileus, anemia were more common in small intestinal lymphoma(12.5%, 18.8%, 40.0%); Stool changes and tenesmus symptoms occurred more frequently in large intestine than in other sites;②Predilection site: The most frequent location was the stomach(53.1%), the second was large intestine(27.2%), followed by lymphoma originating in the small intestine(19.7%);③Endoscopic appearances: including ulcer type, exophytic type, superficial type, mixed type, hypertrophic type, diffuse infiltrative type. Ulcer type was the most frequent endoscopic appearance(57.4%), the second was exophytic type(33.3%);④Pathologic type: All 81 patients with PGIL were diagnosed of non-Hodgkin's lymphoma(NHL) by pathology. Diffuse large B-cell lymphoma was the most common pathologic type(56.7%). Most pathologic types of gastric lymphoma were B cell lymphoma(97.7%), but T cell lymphomas were common in those of the small intestinal region(50.0%);⑤Diagnosis rate: 12.5% by gastrointestinal barium meal, 60.0% by endoscopy and 11.8% by CT scan.Conclusions There are no speccific clinical characteristics in PGIL.The most frequent endoscopic appearance is ulcer type, the second is exophytic type. Diffuse large B-cell lymphoma is the most common pathologic type. The distribution of pathologic type is related to the involved gastrointestinal tract. The diagnosis made by gastrointestinal barium meal and CT scan are low, endoscopy plus biopsy and other examinations can improve the accuracy of diagnosis.