Small intestine lymphomas

Czech version

Authors: P. Sopirjaková ¹; D. Belada ²; M. Kopáčová ¹; S. Rejchrt ¹; J. Bureš ¹; I. Tachecí ¹
Authors‘ workplace: II. interní gastroenterologická klinika, LF UK a FN Hradec Králové ¹; IV. interní hematologická klinika, LF UK a FN Hradec Králové ²
Published in: Gastroent Hepatol 2013; 67(5): 377-380
Category: Gastrointestinal Oncology: Review Article

Overview

Primary malignant tumours of the small intestine are rare; they only represent around 2% of all malignant tumours in the gastrointestinal system. Small intestine lymphomas represent less than one fifth of them. They create a quite heterogeneous group of mainly B-cell type non-Hodgkin`s lymphomas. Their more difficult diagnostics ensues from their localisation with a need to use specialised endoscopy, imaging and immunohistochemical methods. Determination of the diagnosis is usually delayed due to the non-specific symptoms of the disease. Quite frequently we can experience complications. A spontaneous perforation of the small intestine requiring an urgent surgical solution occurs in 9% of patients. Capsule endoscopy and balloon enteroscopy, which have so far been the gold standard of the diagnostics of small intestine diseases, have an irreplaceable role in the diagnostics. Co-operation of a gastroenterologist, a pathologist and a hemato-oncologist is necessary as regards early diagnostics and therapy for these diseases as well as for further follow-up care of patients with a small intestine lymphoma.

Key words:
lymphoma – double-balloon enteroscopy – capsule endoscopy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
30. 8. 2013

Accepted:
2. 10. 2013

Sources

1. Domizio P, Owen RA, Stepherd NA et al. Primary lymphoma of the small intestine. A clinicopathological study of 119 cases. Am J Surg Pathol 1993; 17(5): 429–442.

2. Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma. World J Gastroenterol 2011; 17(6): 697–707.

3. Wang GB, Xu GL, Luo GY et al. Primary intestinal non-Hodgkin’s lymphoma in China. World J Gastroenterol 2011; 17(41): 4625–4631.

4. Freedman AS. Clinical presentation and diagnosis of primary gastrointestinal lymphomas [online]. Wellesley: UpToDate 2013: 21.2.

5. Freedman AS. Management of gastrointestinal lymphomas [online]. Wellesley: UpToDate 2013: 21.2.

6. Dawson IM, Cornes JS, Morson BC. Primary malignant lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis. Br J Surg 1961; 49: 80–89.

7. Lewin KJ, Ranchod M, Dorfman RF. Lymphomas of the gastrointestinal tract: a study of 117 cases presenting with gastrointestinal disease. Cancer 1978; 42(2): 693–707.

8. Aledavood A, Nasiri MR, Memar B et al. Primary gastrointestinal lymphoma. J Res Med Sci 2012; 17(5): 487–490.

9. Tomíška M, Vášová I, Adam Z et al. Primární lymfomy zažívacího traktu: I. klasifikace, patogeneze a diagnostika. Klin Onkol 2002; 15: 47–57.

10. Vaidya R, Habermann TM, Donohue JH et al. Bowel perforation in intestinal lymphoma: incidence and clinical features. Ann Oncol 2013; 24(9): 2439–2443.

11. Koch P, del Valle F, Berdel WE et al. Primary gastrointestinal non-Hodkin´s lymphoma: I. Anatomic and histologic distribution, clinical features and survival data of 371 patients registered in the German Multicenter Study GIT NHL 01/92. J Clin Oncol 2001; 19(18): 3861–3873.

12. Bureš J, Rejchrt S et al. Vyšetření tenkého střeva a enteroskopický atlas. Praha: Grada Publishing 2001.

13. Cyrany J, Pintér M, Tycová V et al. Trimodality imaging of colonic lymphoma. Endoscopy 2009; 41 (Suppl 2): E1–E2.

14. Kopácová M, Rejchrt S, Tycová V et al. Tumorous neo-vascularization: a newly recognized endoscopic feature of intestinal non-Hodgkin lymphoma. Endoscopy 2007; 39 (Suppl 1): E95.

15. Sopirjaková P, Podhola M, Kopácová M et al. Case 1-2011: small intestinal diffuse large B-cell lymphoma in a 58-year-old patient with coeliac disease. Acta Medica (Hradec Kralove) 2011; 54(1): 25–28.

16. Tachecí I et al. Kapslová endoskopie. Hradec Králové: Nucleus 2008.

17. Foss HD, Stein H. Pathology of intestinal lymphomas. Recent Results Cancer Res 2000; 156: 33–41.

18. Grajo JR, Kayton ML, Steffensen TS et al. Presentation of ileal Burkitt lymphoma in children. J Radiol Case Rep 2012; 6(8): 27–38.

19. Smedby KE, Akerman M, Hildebrand H et al. Malignant lymphomas in coeliac disease: evidence of increased risks for lymphoma types other than enteropathy-type T cell lymphoma. Gut 2005; 54(1): 54–59.

20. Viljamaa M, Kaukinen K, Pukkala E et al. Malignancies and mortality in patients with coeliac disease and dermatitis herpetiformis: 30-year population-based study. Dig Liver Dis 2006; 38(6): 374–380.

21. Anderson LA, McMillan SA, Watson RG et al. Malignancy and mortality in a population-based cohort of patients with coeliac disease or „gluten sensitivity“. World J Gastroenterol 2007; 13(1): 146–151.

22. Verbeek WH, Van De Water JM, Al-Toma A et al. Incidence of enteropathy – associated T-cell lymphoma: a nation-wide study of a population-based registry in The Netherlands. Scand J Gastroenterol 2008; 43(11): 1322–1328.

23. Mulder CJ, Wahab PJ, Moshaver B et al. Refractory coeliac disease: a window between coeliac disease and enteropathy associated T cell lymphoma. Scand J Gastroenterol Suppl 2000; 232: 32–37.

24. Nijeboer P, van Wanrooij RL, Tack GJ et al. Update on the diagnosis and management of refractory coeliac disease. Gastroenterol Res Pract 2013; 2013: 518483.

25. Howdle PD, Jalal PK, Holmes GK et al. Primary small-bowel malignancy in the UK and its association with coeliac disease. QJM 2003; 96(5): 345–353.

26. Malamut G, Afchain P, Verkarre V et al. Presentation and long-term follow-up of refractory celiac disease: comparison of type I with type II. Gastroenterology 2009; 136(1): 81–90.

27. Schuppan D, Junker Y, Barisani D. Celiac disease: from pathogenesis to novel therapies. Gastroenterology 2009; 137(6): 1912–1933.