Clinical trends and management outcome of primary intestinal lymphoma

Abstract

Background: Primary gastrointestinal lymphomas are the most common type of primary extra nodal lymphomas. In particular, primary intestinal lymphomas constitute about 25-40% of all gastrointestinal lymphomas. Our aim in this study is to find out the clinical patterns and surgical outcome in management of patients with primary intestinal lymphoma.Methods: A retrospective study at Sohag University Hospital from January 2013-to February 2017, included 17 cases, diagnosed histopathologically as primary intestinal lymphoma and subjected to surgical treatment. Demographic data, clinical presentations and management outcome were analyzed.Results: Seventeen consecutive patients with primary intestinal lymphoma, presented mainly by abdominal pain and abdominal mass. The definite preoperative diagnosis was detected only in 7 patients (41%) via preoperative histopathologic biopsy (3 by CT guided biopsy, 2 via diagnostic laparoscopy and remaining 2 by lower endoscopic biopsy). The other 10 patients (59%) were discovered incidentally during laparotomy. Radical resection was performed to 11 cases (65%), while palliative resection was employed to the remaining 6 cases. All patients received postoperative adjuvant chemotherapy. Two patients were lost to follow up, while the remaining investigated 15 cases, 3 of them were died (20%), 2 of the 3 total deaths presented with preoperative acute symptoms necessitating urgent laparotomy.Conclusions: Primary intestinal lymphomas are commonly diagnosed incidentally during abdominal exploration and most of them presented with abdominal pain. Complete surgical resection followed by adjuvant chemotherapy seems to be effective treatment in most cases. Surgical outcome of urgent cases of primary intestinal lymphoma carries poor prognosis.