Primary pediatric gastrointestinal lymphoma

Area of Science:

• Pediatric Oncology
• Gastrointestinal Pathology
• Hematology

Background:

• Primary gastrointestinal (GI) non-Hodgkin's lymphoma (NHL) is rare in children but is the most common extranodal lymphoma.
• The rarity and variable presentation of pediatric GI NHL often delay diagnosis and treatment.
• Early detection is crucial for improving cure rates in pediatric GI lymphoma.

Purpose of the Study:

• To analyze the clinical presentation, anatomical distribution, and histopathological characteristics of primary GI NHL in pediatric patients.
• To identify common lymphoma subtypes and presenting symptoms in this rare condition.
• To provide insights for earlier diagnosis and improved management strategies.

Main Methods:

• Retrospective analysis of six pediatric cases with primary GI NHL.
• Review of clinical presentations, anatomical locations, and histopathological findings.
• Utilized immunohistochemistry (Tdt, CD20, CD3, CD30, bcl2, bcl6) to confirm diagnoses.

Main Results:

• Most cases occurred in males; intestinal obstruction was the primary presentation in 50% of patients.
• Ileocecal involvement was observed in 50% of cases, with 16% involving the large bowel.
• Histological analysis revealed four diffuse large B-cell lymphomas (DLBCL), one Burkitt lymphoma, and one Burkitt-like lymphoma.

Conclusions:

• Pediatric GI lymphoma frequently involves the ileocecal region and often presents with intestinal obstruction.
• Diffuse large B-cell lymphoma (DLBCL) shows a higher prevalence in pediatric GI lymphoma cases compared to other reported series.
• A high proliferative index is a key factor in distinguishing Burkitt-like lymphoma from DLBCL.