large intestine

Modern Aspects of Diagnosis and Treatment of Complicated Forms of Non-Hodgkin’s Lymphomas of Small and Large Intestine

LYMPHOID TUMORS , , , ,

OA Malikhova, AO Tumanyan, VA Shalenkov, AG Malikhov, YuP Kuvshinov, GV Ungiadze

N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: Ol’ga Aleksandrovna Malikhova, PhD, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)324-43-27; e-mail: malikhova@inbox.ru

For citation: Malikhova OA, Tumanyan AO, Shalenkov VA, et al. Modern Aspects of Diagnosis and Treatment of Complicated Forms of Non-Hodgkin’s Lymphomas of Small and Large Intestine. Clinical oncohematology. 2015;8(2):129–35 (In Russ).

ABSTRACT

Background & Aims. Lymphomas constitute 5 to 10 % of gastrointestinal tumors and most of them are non-Hodgkin’s lymphomas (NHLs). They constitute 30–45 % of all extranodal NHLs. Primary involvement of the gastrointestinal tract is observed in 2/3 of patients. The objective of this study is to determine clinical and morphological features and treatment outcomes of complicated forms of NHLs of the small and large intestine.

Methods. NHLs of the small and large intestine were studied in 189 patients treated in the N.N. Blokhin Russian Cancer Research Center within the period of 1985–2010. Large intestine involvement was observed in 64 patients and small intestine involvement in 125 patients.

Results. Surgical interventions for ileus, bleeding or perforation of a hollow organ were performed in 92 patients with primary or secondary involvement of the small and large intestine (48.7 %). The intestine involvement was primary in 58.9 % of cases and secondary in 41.0 % of cases.

Conclusion. Complications of gastrointestinal NHLs deteriorate the overall survival rate. Patients with small or large intestine involvement require a special approach to diagnosis and treatment because of a high risk of surgical complications.

Keywords: lymphoma, small intestine, large intestine, oncohematology, non-Hodgkin’s lymphomas.

Received: January 30, 2014

Accepted: February 12, 2015

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REFERENCES

  1. Thorling MS. Gastrointestinal lymphomas: Clinical features, treatment and prognosis. Acta Radiol Oncol. 1984;23(2–3):193–7. doi: 10.3109/02841868409136011.
  2. Ковынев И.Б., Поспелова Т.И., Агеева Т.А., Лосева М.И. Частота и структура неходжкинских злокачественных лимфом в Новосибирске, НСО и городах Сибирского федерального округа. Бюллетень СО РАМН. 2006;4(122):175–81.
    [Kovynev IB, Pospelova TI, Ageeva TA, Loseva MI. Incidence and structure of non-Hodgkin’s malignant lymphomas in Novosibirsk, Novosibirsk Oblast, and cities of Siberian Federal Okrug. Byulleten’ SO RAMN. 2006;4(122):175–81. (In Russ)]
  3. Поддубная И.В. Первичные лимфомы желудочно-кишечного тракта. В кн.: Клиническая онкогематология. Под ред. М.А. Волковой. М.: Медицина, 2007. С. 734–70.
    [Poddubnaya IV. Primary lymphomas of the gastrointestinal tract. In: Volkova MA, ed. Klinicheskaya onkogematologiya. (Clinical oncohematology.) Moscow: Meditsina Publ.; 2007. pp. 734–70. (In Russ)]
  4. Mihaljevic B. Primary Extranodal Lymphomas of Gastrointestinal Localization: A Single Institution 5-yr Experience. Med. Oncol. 2006;23(2):225–7. doi: 10.1385/mo:23:2:225.
  5. Bilsel Y, Balik E, Yamaner S, Bugra D. Clinical and therapeutic considerations of rectal lymphoma: A case report and literature review. World J Gastroenterol. 2005;11(3):460–1. doi: 10.3748/wjg.v11.i3.460.
  6. Feller AJ. Histopathology of nodal and extra nodal non-Hodgkin’s lymphomas. 3rd edition. Berlin: Springer-Verlag; 2004. doi: 10.1007/978-3-642-18653-0.
  7. Ferreri AJ. Summary statement on primary central nervous system lymphomas from the Eighth International Conference on Malignant Lymphoma, Lugano, Switzerland, June 12–15, 2002. J Clin Oncol. 2003;21(12):2407–14. doi: 10.1200/jco.2003.01.135.
  8. Rosas ME, Frisnacho VO, Yabar BA. Malignant duodenal neoplasia: clinical-pathologic profile. Rev Gastroenterol Peru. 2003;23(2):99–106.
  9. Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphomas. World J Gastroenterol. 2011;17(6):697–707. doi: 10.3748/wjg.v17.i6.697.
  10. Balfe P, O’Brian S, Daly P, et al. Management of gastric lymphoma. Surgeon. 2008;6(5):262–5. doi: 10.1016/s1479-666x(08)80048-0.
  11. Contreary K, Nance FC, Becker WF. Primary lymphoma of gastrointestinal tract. Ann Surg. 1980;191(5):593–8. doi: 10.1097/00000658-198005000-00011.
  12. Dar AM. Isolated primary esophageal lymphoma – a rare case report. Indian J Thorac Cardiovasc Surg. 2011;27(1):53–5. doi: 10.1007/s12055-010-0069-x.
  13. Al-Saleem T. Immunoproliferative small intestinal disease (IPSID): a model for mature B-cell neoplasms. Blood. 2005;105(6):2274–80. doi: 0.1182/blood-2004-07-2755.
  14. Cavalli F, Isaacson PG, Gascoyne RD, Zucca E. MALT Lymphomas. Hematology Am Soc Hematol Educ Program. 2001:241–58.
  15. Azarm T. Primary Gastrointestinal lymphoma, Clinicopathologic Study of 49 Small Intestinal Lymphoma Cases and the Treatment Option of Choice. Intern J Hematol Oncol Stem Cell Res. 2009;3(4):21–3.
  16. Bairey O, Shpilberg O. Non-Hodgkin’s Lymphomas of the Colon. Israel Med Assoc J. 2006;8(12):832–5.
  17. Berthold D, Ghielmini M. Treatment of malignant lymphomas. Swiss Med Wkly. 2004;134(33–34):472–80.
  18. Dughayli MS, Baidoun F, Lupovitch A. Synchronous perforation of Non-Hodgkin’s Lymphoma of the small intestine and colon: a case report. J Med Case Rep. 2011;5:57. doi: 10.1186/1752-1947-5-57.
  19. Cappell MS. Acute Nonvariceal Upper Gastrointestinal Bleeding: Endoscopic Diagnosis and Therapy. Med Clin. 2008;92(3):511–50. doi: 10.1016/j.mcna.2008.01.001.
  20. Неред С.Н., Стилиди И.С., Поддубная И.В., Шаленков В.А. Хирургическое лечение осложненных форм первичных неходжкинских лимфом желудка. Вестник РОНЦ им. Н.Н. Блохина. 2011;1:66–74.
    [Nered SN, Stilidi IS, Poddubnaya IV, Shalenkov VA. Surgical treatment of complicated forms of gastric non-Hodgkin’s lymphomas. Vestnik RONTs im. N.N. Blokhina. 2011;1:66–74. (In Russ)]
  21. Pennazio M. Small-intestinal pathology on capsule endoscopy: spectrum of vascular lesions. Endoscopy. 2005;37(9):864–9. doi: 10.1055/s-2005-870212.
  22. Khan SH, Ahmaf M, Wani NA, Khardi MY. Primary Ileocaecal Lymphoma: Clinico-Pathological Features and Results of Treatment. JK Science. 2000;2(2):232.
  23. Shum JB, Croome K. Upper gastrointestinal and intra-abdominal hemorrhage secondary to diffuse large B-cell gastric lymphoma. Can J Surg. 2008;51(3):E56–7.
  24. Урядов С.Е., Шапкин Ю.Г., Капралов С.В. Эндоскопический гемостаз при толстокишечных кровотечениях. Саратовский научно-медицинский журнал. 2010;6(3):719–22.
    [Uryadov SE, Shapkin YuG, Kapralov SV. Endoscopic hemostasis in bleeding from large intestine. Saratovskii nauchno-meditsinskii zhurnal. 2010;6(3):719–22. (In Russ)]
  25. Толпинский А.П., Токарев Б.В., Бахлаев И.Е. Осложнения рака желудка: методические указания к практическим занятиям по онкологии. Петрозаводск: ПетрГУ, 1995. C. 25.
    [Tolpinskii AP, Tokarev BV, Bakhlaev IE. Oslozhneniya raka zheludka: metodicheskie ukazaniya k prakticheskim zanyatiyam po onkologii. (Complications of gastric cancer: guidelines for practical training in oncology.) Petrozavodsk: PetrGU Publ.; 1995. pр. 25. (In Russ)]
  26. Vadala G, Salice M, L’Anfusa G, et al. Complication of ileal lymphoma. Minerva Chir. 1995;50(11):963–6.
  27. Varghese C, Jose CC, Subhashii J, et al. Primary Small Intestinal Lymphoma. Oncology. 1992;49(5):340–2. doi: 10.1159/000227069.