Diffuse histiocytic lymphomas of the gastrointestinal tract in the adult

Diffuse histiocytic lymphomas (Rappaport) are extranodal lesions frequently formed in the digestive tract. They are clinically different from lymphomas of nodal origin and are no longer considered to arise from histiocytes. They comprise from one-third to one-half of non Hodgkin's lymphomas and chiefly involve the stomach and duodenum. Identification of these tumors and their place in current systems of classification, at present, depends on sophisticated immunologic, histochemical and ultramicroscopic procedures not always suitable for clinical prognosis. Staging laparotomy, useful in Hodgkin's disease, does not always correlate with the prognosis of non Hodgkin's lesions. Radical removal of the affected organ may be curative. Nonresectable lesions may be treated with radiation and chemotherapy. Methotrexate, cyclophosphamide, vincristine, prednisone, nitrogen mustard, Adriamycin, bleomycin and other substances have been used in various combinations to obtain remission of the disease. While results have been favorable, the ideal therapeutic agent has not been found.