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[Primary gastrointestinal lymphoma: a study of 25 cases]
M Batlle1, J M Ribera, J F Llamazares
1Servicio de Hematología-Hemoterapia, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona.
Background:
The digestive tract constitutes the most frequent localization of the extranodular non Hodgkin's lymphoma. The chief clinical and histological characteristics were analyzed as were the evolution and response to treatment of 25 patients diagnosed with primary gastrointestinal lymphoma (PGIL) in one center over a period of eight years.
Methods:
To establish the diagnosis of PGIL the Dawson criteria were used and the state was determined by the Ann-Arbor classification modified by Musshoff. To histologically classify of the PGIL the Working Formulation was followed. The influence of the clinical, histological characteristics and the state of the obtention of complete remission (CR), the survival free period of the disease (SFD) and global survival (GS) were analyzed.
Results:
The mean age of the series was 56 years (standard deviation 15 years) (12 males). The most frequent localization was gastric followed by the small intestine and the large intestine. Abdominal pain and weight loss were the most frequent clinical manifestations in the PGIL, regardless of its site. In 12 patients the PGIL was of an intermediate grade of malignancy, 8 were of low grade and 5 of high grade. The state was IE in 11 patients, IE1 in 9 and IIE2 in 5. The most used treatment was radical surgery followed by polychemotherapy. Complete remission was obtained in 15 patients and 2 recurred. The foreseen SFP at 7 years was 69% of the cases and GS was 53%. In IE state patients was most frequently obtained and GS was also more prolonged in these patients.
Conclusions:
In the present series the gastric localization of patients with primary gastrointestinal lymphoma was more frequent than intestinal localization. The HNL of intermediate and high grades of malignancy predominated those of low grade. The prognosis of patients with primary gastrointestinal lymphoma in a IE state was more favorable than the remaining patients. In turn, surgery constituted a good option in the initial treatment of patients with primary gastrointestinal lymphoma.