Primary gastrointestinal lymphoma--a clinicopathologic study.

Gastrointestinal tract is the most common site for the development ofextra nodal lymphoma. This study was done to analyze clinical and pathological features as well as the treatment outcome of this disease. We carried out analysis of25 cases of primary gastrointestinal (GI) lymphomas during period from March 2001 to February 2003 at Gujarat Cancer & Research Institute. Out of 25 cases of primary GI lymphoma, nine cases of gastric lymphoma, nine cases of small intestinal lymphoma and seven cases of large intestinal lymphoma were identified. A male to female ratio of 2.6:1 was observed. Peak incidence was observed infirst and second decades of life (range 4-63 years). Abdominal pain and abdominal lump were the two most common presenting symptoms. Diffuse large B-cell type and Burkitt's lymphoma were the most common histologic variants, accounting for equal proportions (36% each). All the patients were treated with either surgery alone or in combination of surgery, chemotherapy and radiotherapy depending on the site, stage and histology. Anti H-pylori kit was used in early stage GI maltomas. 18 cases of GI lymphoma were evaluable, and out of these, 66.6% (11 cases) attained complete remission with a median follow up time of 12 months. The disease free survival was 50% (9 cases), and the overall survival was 72.2% (13 cases). In conclusion, although there are considerable therapeutic controversies, surgery with adjuvant chemotherapy and radiotherapy yield good survival. Clinical and histopathologic characteristics and prognosis of our cases with primary gastrointestinal lymphoma were usually similar to the cases in western countries with some differences in the incidence and histologic subtypes.