Advanced primary non-Hodgkin's lymphoma of the small intestine in childhood: report of four cases.

Primary non-Hodgkin's lymphoma of the small intestine (PLI) is an uncommon malignancy in childhood which carries a poor prognosis. Consideration of the possible diagnosis of PLI is important when children have vague abdominal symptoms, since thoughtful multidisciplinary treatment can result in a better prognosis. This paper reports the cases of four children who have presented to our hospital since 1985 with advanced stage III or IV PLI. All the children had a huge abdominal mass but none of them had complete intestinal obstruction. Regarding the diagnosis, ultrasonography frequently reveals a hypoechoic thickening of the intestinal wall with dilated intestinal loops. A delayed primary or second-look operation may be the treatment of choice following adequate chemotherapy, while total parenteral nutritional support may prevent gastrointestinal complications. Three of the four patients have been in complete remission for 2 to 4 1/2 years since their initial treatment.