P-0037 - Malignant lymphoma diagnosed from gastrointestinal biopsy

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Lymphomas
Presenter Kazuhiko Natori
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors K. Natori1, Y. Kuraishi1, K. Arai2, H. Izumi1, D. Nagase1, S. Ishihara1, A. Sakai3, M. Kato4
  • 1Toho University Medical Center Oomori Hospital, Oota-ku/JP
  • 2Toho University Faculty of Nursing, Oota-ku/JP
  • 3Toho University Medical Center, Oota-ku/JP
  • 4Division of Hematology&Oncology, Department of Medicine, Toho University Medical Center Oomori Hospital, Oota-ku/JP

Abstract

Introduction

Malignant lymphoma is systemic disease. The gastrointestinal tract is important as occurring lesion and infiltration lesion of the malignant lymphoma. It is diagnosed in the malignant lymphoma in biopsy lymph nodes in many cases. And malignant lymphoma can be diagnosed from a gastrointestinal lesion. So, We reviewed and studied about malignant lymphoma that diagnosed from gastrointestinal tract biopsy.

Methods

In the case that malignant lymphoma was diagnosed in our hospital from 2003 to 2013, we intended for 446 cases and we investigated the 48 cases that were diagnosed malignant lymphoma by biopsy from gastrointestinal tract. So we reviewed and reported about age, gender, kind of pathological findings, therapy, prognosis and the cause of death. About statistical examination, we used SPSS statistics ver21.

Results

All cases are 48 cases, including male 28 cases and female 20 cases, median age is 68 years (ranged 40-88 years). First manifestations are abdominal pain 10 cases, epigastralgia 15 cases, general fatigue 2 cases, appetite loss 2 cases, melena 5 cases, without manifestation examination revealed abnormality 8 cases, abdominal tumor palpable 2 cases, others 4 cases. The lesion performed biopsy, stomach 32 cases, jejunum 1 cases, Ileum 5 cases, Ileocecum 7 cases, colon 2 cases. About diagnosis, all cases are non-Hodgkin's lymphoma, result of immunochemical stain, diffuse large B cell lymphoma 33 cases, MALT lymphoma 8 cases, follicular lymphoma 1 cases, mantle cell lymphoma 1 case, marginal zone B cell lymphoma 1 case, T cell lymphoma 1 case, B cell lymphoma 1 case, adult T cell lymphoma 1 case. Result of clinical stage, primary gastrointestinal lymphoma is 26 cases rest of 22 cases are advanced stage, so we could not decide that gastrointestinal lesion is primary or infiltrated lesion. About therapy, R-CHOP therapy 27 cases, R-CHOP therapy + radiation therapy 2 cases, radiation therapy alone 3 cases, CHOP or CHO therapy 6 cases, total gastrectomy + RCHOP therapy 2 cases, eradication alone 1 case, eradication + R-CHOP therapy 1 case, best supporting care 5 cases, other 1 case. Median survival time of primary gastrointestinal lymphoma is not reached (maximum observation period is 106 month) and 5 years survival rate 74.6%. About advanced stage of 22 cases, median survival time is not reached (maximum observation period is 111 month), 5 years survival rate 51.2%. At Dec 2013, 32 cases alive, 16 cases dead. Cause of death, all cases resulted from primary disease (because primary therapy refractory, relapse and no curative therapy).

Conclusion

The gastrointestinal examination is necessary for treatment of the malignant lymphoma. Upper digestive endoscopy and colon endoscopy are comparatively intervention examination, but when we decide correct clinical stage, it is essential. Avoiding fatal phenomena, such as gastrointestinal perforation, gastrointestinal examination is helpful.