Primary esophageal non-Hodgkin's lymphoma.

A 77-year-old woman with primary esophageal non-Hodgkin's lymphoma in clinical stage IEA (Ann Arbor Classification) developed pain and difficulty in swallowing. An upper gastrointestinal examination revealed a submucosal tumor from the upper to the middle portion of the esophagus. Histopathological examination at endoscopic biopsy with endoscopic partial incision showed non-Hodgkin's lymphoma (diffuse type--large cell). Immunohistological examination of tumor cells disclosed LCA (+), CD3(DAKO) (+), MT1 (+), UCHL1 (+), MB1 (+), MxPanB (-) and EMA (-) reactivity and showed T cell lymphoma. The clinical stage was determined to be IEA after further work-up. Improvement of swallowing difficulty and esophageal findings on upper gastrointestinal series were noted after modified CHOP therapy and radiotherapy (total 50 Gy).     

Primary gastric non-Hodgkin's lymphoma: a clinicopathological study of 41 patients

Pathological findings in 41 patients (male/female ratio: 1.3/1) with primary localized gastric non-Hodgkin's lymphoma (NHL) were retrospectively studied and correlated with survival. The median observation period after diagnosis was 32 (0–189) months. Nineteen patients were low-grade NHL, all but one B-cell lymphomas of the mucosa-associated lymphoid tissue (MALT) type. Twenty-two patients had primary (n-7) or secondary (n=15) high-grade lymphomas; Musshoff stage IE was found in 29 and II E in 12 cases. The median age at diagnosis was 61 years (range, 26–88 years), and proliferation, measured by the number of mitosis and Ki-67 antigen positivity (MIB-1), was high or moderately high in 24 cases and low in 17 cases. Follicular lymphatic hyperplasia could be found in 25 of 34 evaluable cases, more often in low-grade than in high-grade NHL. Most of the patients were treated by resective surgery and additional ratio- or chemotherapy. Thirteen patients (31%) died (median survival: 10 months), 5 of them within 3 months after surgery owing to postoperative complications. Survival was superior, though not statistically significant, in low-grade lymphomas. Our retrospective anlysis of heterogeneously treated gastric lymphomas reveals that gastric lymphomas, especially of the low-grade MALT type, often remain a localized disease with a good long-term prognosis. Our study confirms previous reports indicating that lymphomas of the MALT type represent a specific clinicopathological entity.     

Primary esophageal T-cell non-Hodgkin's lymphoma.

Primary non-Hodgkin's lymphoma of the esophagus is a rare disease. We report a 52-year-old man who had a polypoid mass in the esophagus at endoscopy. Histology was suggestive of non-Hodgkin's lymphoma; immunohistochemistry was positive for CD3, CD45 RO, LCA. He was treated with 6 cycles of CHOP and is disease-free 14 months later.     

Primary non-Hodgkin's lymphoma in the esophagus

Lymphoma is a malignant neoplasm classically involving the lymph and reticuloendothelial tissues. According to the World Health Organization classification (2000) for non-Hodgkin's lymphoma (NHL), there are over 20 different subtypes, each with its own characteristics and behavior. Gastrointestinal lymphoma is a less common type of NHL, usually affecting the stomach, colon and small intestines. The esophagus, however, is rarely involved. Here the investigators report a case of primary NHL of the esophagus so that this may be of help to physicians in future encounters.     

Primary non-Hodgkin's lymphoma of bone

We describe a patient with hip pain who had a painful solitary pelvic bone lesion with a lytic, permeative appearance and minimal periosteal reaction, despite a relatively large soft tissue mass. Histologic examination and thorough evaluation revealed this solitary tumor to be a primary non-Hodgkin's lymphoma of the bone.     

Primary non-Hodgkin's lymphoma of the liver

We review the literature on primary hepatic lymphoma (PHL). PHL is a rare malignancy, and constitutes about 0.016% of all cases of non-Hodgkin's lymphoma. It has been reported to occur with increased frequency in patients with chronic hepatitis C infection. Most patients with PHL present with abdominal pain, constitutional symptoms and have hepatomegaly on examination. Imaging studies reveal solitary, or less often, multiple masses in the liver. The predominant histology is B-cell lymphoma, most commonly diffuse large cell type. Most patients are treated with chemotherapy, with some physicians employing a multimodality approach incorporating surgery and radiotherapy with chemotherapy. The prognosis is variable, with good response to early aggressive combination chemotherapy.     

Primary non-Hodgkin's lymphoma of the esophagus

Squamous cell carcinoma and adenocarcinoma constitute the majority of malignancies of the esophagus. Although lymphoma may involve any part of the gastrointestinal tract either primarily or secondarily, esophageal involvement is rare. We describe two cases of primary esophageal non-Hodgkin's lymphoma and review the literature, with particular attention to roentgenographic studies, esophagoscopic findings, and endoscopic biopsy results.     

Primary gastric non-Hodgkin's lymphoma in Finland, 1972-1977. Clinical presentation and results of treatment

During the period 1972-1977, 66 patients were treated for primary gastric non-Hodgkin's lymphoma in various hospitals in Finland. Most frequently, the disease occurred in middle-aged or old patients and had a male predominance. Clinical symptoms were non-specific. An abdominal mass was felt in 21% of the patients. Roentgenologic findings were mostly non-specific but suggested a malignant tumour. A definitive diagnosis was difficult to confirm by endoscopic examination. Forty-four patients had surgical resection, 30 patients curative resection, and 14 palliative resection, and 16 patients had only explorative laparotomy. Eighty-five per cent of the patients who had curative resection survived 5 years, compared with 15% of those who underwent palliative resection. Curative resection gave the best survival of 5 years. The stage of the disease was a very important prognostic factor: the 5-year survival was 85% for patients with stage-I disease but only 3% for those with stage-IV disease.     

Primary non-Hodgkin's lymphoma of the brain. A review

We have reported 14 primary non-Hodgkin's lymphomas of the brain seen in Calgary and Edmonton, Alberta, between 1975 and 1983. Eleven patients had histiocytic lymphoma while the remaining 3 were lymphocytic. The clinical presentations were extremely variable, with increased intracranial pressure (60%) and focal neurological deficits (60%) being most common. The most frequent appearance on computed tomographic scan was a hyperdense lesion of the cerebrum (44%); four cases had multifocal lesions. All patients had subtotal resection of the tumor. Two patients had surgery only and their mean survival was 3.5 months. Ten patients received whole brain irradiation, with 2 patients receiving a boost to the primary tumor site as well. The mean survival was 24.7 months. Two patients received chemotherapy in addition to radiotherapy and their mean survival was 20.0 months. Three of the 14 patients have had an inordinately long disease-free survival of 64, 75, and 80 months from the time of diagnosis.     

Primary non-Hodgkin's lymphoma of the kidney

A 53-year-old woman was admitted to the hospital because of end-stage renal failure of unknown etiology. She had to begin hemodialysis a few days later. An open biopsy showed non-Hodgkin's lymphoma of the kidney. The patient died after the first cycle of chemotherapy and necroscopy confirmed that the lymphomatous involvement of the kidney was primary. From the current literature we are not aware of other cases of primary non-Hodgkin's lymphoma of the kidney.     

Primary gastric lymphoma

AIM: The purpose of this review is to describe the variousaspects of primary gastric lymphoma and the treatmentoptions currently available. METHODS: After a systematic search of Pubmed, Medscape and MDconsult, we reviewed and retrieved literature regarding gastric lymphoma. RESULTS: Primary gastric lymphoma is rare however, the incidence of this malignancy is increasing. Chronic gastritis secondary to Helicobacterpylori(H pylon) infection has been considered a major predisposing factor for MALT lymphoma.Immune histochemical marker studies and molecular biology utilizing polymerase chain reaction have facilitated appropriate diagnosis and abolished the need for diagnostic surgical resection. Advances in imaging techniques including Magnetic Resonance Imaging (MRI) and Endoscopic UItrasonography (EUS) have helped evaluation of tumor extension and invasion.The clinical course and prognosis of this disease is dependent on histopathological sub-type and stage at the time of diagnosis. Controversy remains regarding the best treatment for early stages of this disease. Chemotherapy, surgery and combination have been studied and shared almost comparable results with survival rate of 70-90%. However, chemotherapy possesses the advantage of preserving gastric anatomy.Radiotherapy alone has been tried and showed good results.Stage ⅢE, IVE disease treatment is solely by chemotherapy and surgical resection has been a remote consideration. CONCLUSION: We conclude that methods of diagnosis and staging of the primary gastric lymphoma have dramatically improved. The modalities of treatment are many and probably chemotherapy is superior because of high success rate,preservation of stomach and tolerable complications.     

Primary gastric lymphoma

The records of 50 patients with localized primary gastric lymphoma were reviewed and clinical and prognostic factors characterized. Pathologic material was reclassified according to Rappaport's, Lukes-Collins, and Lennert's Kiel classifications. Factors with the greatest prognostic significance included initial stage as determined by surgery and pathology, absolute tumor size, degree of penetration through the stomach wall, and histologic grade of the lymphoma.After surgical resection for cure, the overall 5-year disease-free survival was 47%. For stage I disease, this was 78% vs 29% for stage II (P=0.006). Patients with lymphomas less than 5 cm in diameter had 58% 5-year disease-free survival vs 32% for those with tumors greater than 10 cm (P=0.06). Full-thickness penetration decreased 5-year survival from 75% to 38% (P=0.06). Patients with histologically low-grade lymphomas had a better prognosis than those with high-grade lymphomas. The most significant correlation of histology to survival was seen with the Kiel classification with a 5-year survival of 39% for centroblastic polymorphous lymphoma vs 66% for LP immunocytoma.When lymphoma recurred it developed outside the abdomen in a majority of patients. The addition of abdominal radiation therapy to surgical resection made no significant impact on survival for either stage I or II disease.     

Primary non-Hodgkin's lymphoma of the adrenals. A case report

Bilateral primary non-Hodgkin's lymphoma (NHL) of the adrenals is uncommon. Less than 70 cases have been described in the literature. The symptoms of disease are variable and depend on the tumor size and the presence of adrenal insufficiency .We report a case of large diffuse B-cell adrenal lymphoma discovered in a 40-year-old woman presenting bilateral lumbar pain. Hormonal exploration demonstrated adrenal insufficiency. Imaging explorations showed a large and bilateral adrenal mass. Percutaneous CT-guided biopsy of the adrenal and search for extension revealed primary bilateral adrenal lymphoma. After glucocorticoid substitution, treatment was based on a CHOP regimen chemotherapy; outcome was unfavourable after the second cure; the patient died from septic shock. The diagnosis of primary adrenal non-Hodgkin lymphoma should be investigated in patients with a rapidly growing bilateral adrenal mass associated with adrenal insufficiency.     

Primary non-Hodgkin's lymphoma of the thyroid gland

It is reported on a patient with low-malignant primary non-Hodgkin lymphoma of the thyroid gland with hitherto 7-year absence of recidivity after exclusive operative therapy. The course is critically discussed in the light of the literature. Conclusions relate to the diagnostic and therapeutic regimen within clinical treatment, cytology, antibody diagnostics, operation and combined therapy in lymphomas of the thyroid gland and Hashimoto's thyroiditis.     

Primary non-Hodgkin's T-Cell lymphoma of the esophagus

We report a case of primary esophageal non-Hodgkin's T-cell lymphoma in a young white female. At admission, endoscopy revealed large, irregularly shaped, esophageal ulcerations with super imposed candidiasis. Endoscopic ultrasonography to assess submucosal alterations and periesophageal involvement revealed a diffuse hypoechogenic thickening (up to 5 mm) of the esophageal wall, a pattern consistent with lymphomatous infiltration. Definitive diagnosis was made with the aid of histology and immunohistochemistry.