Gastrointestinal Non-Hodgkin's lymphoma: a clinico-pathological study

The aim of this study is to determine the clinico-pathological features of primary gastrointestinal non-Hodgkin's lymphoma (GI NHL) at King Abdulaziz University Hospital, Jeddah, and to compare our results to those reported in the literature.

Twenty-three adult patients with primary GI NHL diagnosed over a 5-year period (2000 through 2005) were retrospectively studied clinically and histopathologically. They were classified using the REAL/WHO histopathologic classification.

Of the 23 patients with primary GI NHL, 14 (60.9%) were Saudis, with a male-to-female ratio of 1.3:1. The mean age of male patients was 61. 3 years, ranging from 42-83 years with an SD of +/-13.09; while for females, the mean age was 64 years, ranging from 50-75 years with an SD of +/-9.14. Abdominal pain was the most common presenting symptom (78.3%), and the most common primary site was the stomach (73.9%), followed by the small bowel (13%). The most frequent histologic subtype was the diffuse large B cell lymphoma, accounting for 60.9% of all cases, followed by the marginal-zone cell lymphoma (MALT type), which was Helicobacter pylori associated (39.1%). A large proportion of patients with primary GI NHL had early disease (Stage IE - 20%, Stage IIE - 58.6%). With regards to treatment, 15 patients (65.2%) had chemotherapy, while only 2 patients (8.7%) were treated by Helicobacter pylori eradication. The overall 5-year survival was 47.8%.

The data demonstrated that primary GI NHL is more common among males, mainly in their sixth decade. Abdominal pain is the most common presenting symptom, with stomach being the most common involved site. Diffuse large B cell lymphoma is the most frequent histologic subtype, followed by extranodal marginal-zone B cell lymphoma (MALT type), which was Helicobacter-associated. A majority of cases have early disease (stage IE and IIE), mostly treated by combination chemotherapy.