Cover Image

A HISTOMORPHOLOGICAL STUDY OF GASTRO-INTESTINAL LYMPHOMAS - AN ANALYSIS OF 47 CASES

SHANTHI SHANTHI

Abstract


Abstract :
BACKGROUND AND OBJECTIVES - The Gastro-intestinal tract
forms the commonest site of extra nodal lymphoma and is the
second most common extra nodal lymphoma in AIDS patients.
This study analyses the clinical and pathological findings of 47
patients diagnosed with gastrointestinal lymphomas, in our
hospital, a tertiary care centre in South India. MATERIALS AND
METHODS - The clinical and histopathological materials of 47
patients diagnosed with gastrointestinal lymphomas from
January 2008 to July 2012 were considered for study. The
pathologic findings including immunohistochemical profile were
analyzed. RESULTS - Of 47 cases, all were primary lymphomas
with 57.45 percent occurring in males and 42.55 percent in
females. Male female ratio is 1.35 is to 1. The mean age was
40.15 yrs. The most common site of involvement was stomach
(18 cases) followed by small intestine (12 cases) and large
intestine (10 cases).The commonest gross presentation was
nodular lesion. Using Working classification for clinical usage,
the grading of lymphomas was done and included 7 low grade,
31 intermediate grade and 9 high grade lymphomas. B cell
lymphomas constituted 94.3 percent cases (33 cases) while T
cell lymphomas constituted 5.7 percent cases (2 cases), after
exclusion of 12 cases in which IHC markers were not done.
Histologically, all were diffuse lymphomas with features of MALT
lymphomas seen in 5 cases, Diffuse Large B Cell Lymphomas
(DLBCL) in 9 cases and Immunoproliferative small intestinal
disease (IPSID) in 3 cases. As a comprehensive
Immunohistochemical panel was not available, further typing of
l ymp homas inc luding rar er t yp es was n ot
possible.CONCLUSION - The study highlights the increasing
incidence of lymphomas with various types of gross
presentation. The results parallel those of Western literature
with B cell lymphomas especially DLBCL being the commonest.
Cases of Immunoproliferative small intestinal disease which are
reported in certain geographically restricted locations are also
seen in our study. A definitive diagnosis rests on combined
histologic, immunohistochemical and molecular studies.
Keyword :Gastro-Intestinal Lymphoma, Histomorphology,
Diffuse Large B Cell Lymphoma


Full Text:

PDF

References


REFERENCES:

Muller AM, Ihorst G, Mertelsmann R, Engelhardt M.

Epidemiology of non-Hodgkin's lymphoma (NHL): Trends,

geographic distribution, and etiology. Ann Hematol 2005;

:1-12.

Wu XC, Andrews P, Chen VW, Groves FD. Incidence of

extranodal Non-Hodgkin lymphomas among whites, blacks,

and Asians/Pacific Islanders in the United States: Anatomic

site and histology differences. Cancer Epidemiol 2009;

:337-46.

Koch P, del Valle F, Berdel WE, Willich NA, Reers B,

Hiddemann W, et al. Primary gastrointestinal

non-Hodgkin's lymphoma: I. Anatomic and histologic

distribution, clinical features, and survival data of 371

patients registered in the German Multicenter Study GIT

NHL 01/92.

J Clin Oncol 2001; 19:3861-73. Dawson IM, Cornes JS,

Morson BC. Primary malignant lymphoid tumours of the

intestinal tract. Report of 37 cases with a study of factors

influencing prognosis. Br J Surg 1961; 49:80-89.

Arora N, Manipadam MT, Pulimood A, Ramakrishna BS,

Chacko A, Kurian SS, et al. Gastrointestinal lymphomas:

Pattern of distribution and histological subtypes: 10 years

experience in a tertiary centre in South India. Indian J

Pathol Microbiol 2011; 54:712-9.

Surveillance, Epidemiology, and End Results (SEER)

Program (www.seer.cancer.gov) SEER*Stat Database:

Incidence— SEER 9 Regs. Public-Use, Nov 2002 Sub

(1973–2000). ‘

National Cancer Institute, DCCPS, Surveillance

Research Program, Cancer Statistics Branch, released

April 2003.

Crump M, Gospodarowicz M, Shepherd F: Lymphoma of

the gastrointestinal tract. Semin Oncol 1999; 26:324-337.

Koch P, del Valle F, Berdel W, et al: Primary

gastrointestinal non-Hodgkin's lymphoma: I. Anatomic and

histologic distribution, clinical features, and survival data of

patients registered in the German multicenter study

GIT NHL 01/92. J Clin Oncol 2001; 19:3861-3873.

Loehr JW, Mujahed Z, Zahn FD, Gray GF,

Thorbjarnarson B. Primary lymphomas of the gastrointestinal

tract: A review of 100 cases. Ann Surg 1969; 170:232-

Ghimire P, Wu GY, Zhu L. Primary gastrointestinal

lymphoma. World J Gastroenterol 2011; 17:697-707.

Ansell SM, Armitage J. Non-Hodgkin lymphoma:

diagnosis and treatment. Mayo Clin Proc 2005; 80: 1087-

Musshoff K. [Clinical staging classification of

non-Hodgkin's lymphomas (author's transl)].

Strahlentherapie 1977; 153:218-221.

Hampson FA, Shaw AS. Response assessment in lymphoma.

Clin Radiol 2008; 63: 125-135.

An Initiative of The Tamil Nadu Dr. M.G.R. Medical University

University Journal of Pre and Para Clinical Sciences

Naresh KN, Srinivas V, Soman CS. Distribution of various

subtypes of non-Hodgkin's lymphoma in India: A study of 2773

lymphomas using R.E.A.L. and WHO Classifications. Ann Oncol

; 11:63-7.

Heise W. GI-lymphomas in immunosuppressed patients (organ

transplantation; HIV) Best Pract Res Clin Gastroenterol 2010; 24:57-


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

An Initiative of The Tamil Nadu Dr M.G.R. Medical University