Clinicopathologic characteristics and therapeutic outcome of primary gastrointestinal lymphoma in cuddalore district in india

Authors:Rajesh Kumar N
Int J Biol Med Res. 2012; 3(1): 1419-1422  |  PDF File

Abstract

Objectives: The aim of the study is to determine the clinico-pathological features and therapeutic out come of primary gastrointestinal lymphoma [PGIL] at Rajah Muthiah Medical College and Hospital, Chidambaram, Cuddalore district. Materials and methods: 36 patients with primary Gastrointestinal lymphoma[PGIL] diagnosed over a 6 year period from 2003 to 2008 were retrospectively and prospectively studied clinically and histopathologically they were classified using the REAL/WHO histopathologic classification and follow up was done for a minimum period of 3 years. Results: 36 patient (38.7%) were PGIL arising out of 93 total lymphomas diagnosed. Out of 980 primary gastrointestinal malignancies, 36(3.6%) were PGIL, with a male to female ratio of 1.5 : 1. All the patient were non vegetarians and majority of males were alcoholics and smokers. The mean age of the male patients was 61.3 years with age varying from 42 – 83 years with an SD of ±13.09: while for females, the mean age was 64 years, ranging from 50-75 years with an SD of ±9.14. Abdomen pain was the most common presenting syphtom (70%), and the most common primary site was stomach (72.2%), followed by small bowl (16%), the important histological type was Non Hodgkins lymphoma (100%), no Hodgkins lymphoma was diagnosed. The predominant subtype was diffuse large B cell lymphoma accounting for 72.5 % of the csases. followed by the marginal marginal zone cell lymphoma (25%) which was hecicopylori associated (55%). A large proportion of patient with primary GIL had early disease( stage I E – 20 % and stage IIE 60%) . 17 (47.2%) Patient had chemotheraphy, 11(30.5%) patients underwent gastrectomy followed by chemotheraphy and only one patient was treated by HPylori eradication. The overall 3 survival rate was 58%. Conclusion: primary gastrointestinal lymphomas constitute about 3.6 % of all gastric malignancies and Hodgkins lymphoma was nil and Non Hodgkins lymphoma constituted all the PGIL. Abdomen pain was the common presenting symptom and stomach being the commonly involved site and majority of cases presenting as exophyitc mass. Diffuse large B cell lymphoma is the most common histological subtype, followed by extra nodal marginal zone B cell lymphoma(MALT) The majority of the cases have early disease( stagey and IIE), mostly treated by combination chemotheraphy.