Gastro-intestinal lymphoma in southern Turkey

One hundred sixty three patients with primary gastro-intestinal lymphoma diagnosed during the last 10 years were reviewed retrospectively. Seventy five of them were female and 88 were male, aged between 14 to 80 years. Mean age for women was 36.8 +/- 17.6 years and 39.4 +/- 14.8 years for men. In 142 patients the disease was diagnosed by surgical intervention and endoscopic biopsy was used as diagnostic tool in only 21 patients. Tumour was located in the stomach in 61 cases in the mesenteric mass in 52 cases; in the small bowel in 42 cases; in the large bowel in seven cases and in the cases and esophagus in one case. Mean age for gastric lymphoma was 47.1 +/- 14.8; 42.2 +/- 14.3 for large bowel, 35.0 +/- 13.6 for mesenteric mass and 32.7 +/- 13.5 in small bowel lymphoma patients. Only four of the patients had stage I disease; 100 of them stage II disease and 59 had stage II-high tumour burden. Using the Working Formulation, 45 pc of the cases had low grade, 32 pc intermediate grade and 8 pc had high grade lymphoma, in 15 pc of the cases grading could not be achieved. In the low grade lymphoma stomach was the most common site and mesenteric mass in the intermediate grade lymphoma. One hundred and three cases were lost to follow up after surgery, so chemotherapy was given to 60 patients. Sixteen cases were lost to follow up in the early chemotherapy period and nine cases died while under chemotherapy. Three cases still receiving chemotherapy. Complete response was achieved in 32 cases. The stomach is the most common site for gastro intestinal lymphoma and occurs a decade earlier than other series in Southern Turkey. Low grade lymphoma accounts for 45 pc of the gastro-intestinal lymphoma. Chemotherapy is an important adjunctive therapy after an appropriate surgical intervention. Larger and further studies must be carried out on etiology, pathogenesis and management.