Primary gastrointestinal tract lymphoma--a clinico-pathological study of 28 cases

A retrospective study of 28 patients with primary gastrointestinal tract lymphoma is presented. There were 27 cases of non-Hodgkin's lymphoma and one case of Hodgkin's disease. The patients with non Hodgkin's lymphoma of the gastrointestinal tract represented 10% of all non-Hodgkin's lymphoma cases seen at the Royal Adelaide Hospital/Institute of Medical and Veterinary Science complex over the six year survey period, 1972-1977. Of the patients with non-Hodgkin's lymphoma, 26 cases were diffuse type, and one case was nodular type. There was a M/F sex preponderance of 2 . 8/1, and 70% of cases were aged between 40 and 69 years. The commonest site was the stomach (19 cases), followed by small intestine (7 cases), and one case involved large intestine. At initial presentation, the disease was confined to the affected viscus (Stage IE) in seven patients (25%), and in 12 patients (43%) the disease involved viscus and regional lymph nodes (State IIE). The one patient with Hodgkin's disease had involvement of the large intestine, abdominal lymph nodes and bone marrow (Stage IV). This study was retrospective, and a management protocol was not employed. However, of the seven patients presenting with Stage IE disease, six cases had diffuse poorly differentiated lymphocytic lymphoma. Five of these patients were treated by surgical resection alone, and were in complete remission at follow-up of 66 to 103 months. In order to compare realistically the survival of different groups of patients with primary gastrointestinal lymphoma, we consider that a prospective multicentre clinical trial with comprehensive staging procedures, uniform histological classification and accepted management protocol is warranted.