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Li L, Ma H, Niu M, Chen C, Yu C, Zhang H, Jin M. Characterization of primary small intestinal lymphoma: a retrospective study based on double balloon endoscopy. BMC Gastroenterol 2024; 24:116. [PMID: 38504190 PMCID: PMC10953079 DOI: 10.1186/s12876-024-03193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/01/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The diagnosis of primary small intestinal lymphoma (PSIL) is difficult. This study aimed to evaluate the clinical, radiological and endoscopic characteristics of PSIL and provide clue for diagnosis. METHODS A total of 30 patients diagnosed with PSIL who underwent double balloon endoscopy (DBE) in the First Affiliated Hospital of Zhejiang University were retrospectively analyzed. Clinical, radiological and endoscopic data were collected. Univariate analysis was used to determine significant indicators for differentiating three main subtypes of PSIL. Cox regression analysis was performed to assess the risk factors for survival. RESULTS In this study, 10 patients were pathologically diagnosed as diffuse large B-cell lymphoma (DLBCL), 11 were indolent B-cell lymphoma (BCL) and 9 were T-cell lymphoma (TCL). Compared with DLBCL patients, the body mass index (BMI) of TCL patients was significantly lower (p = 0.004). Meanwhile, compared with patients with DLBCL, the patients with indolent BCL had lower levels of C-reactive protein, lactate dehydrogenase (LDH), fibrinogen and D-Dimer (p = 0.004, p = 0.004, p = 0.006, and p = 0.002, respectively), and lower proportion of thicker intestinal wall and aneurysmal dilation in CT scan (p = 0.003 and p = 0.020, respectively). In terms of ulcer morphology, patients with DLBCL had significantly higher proportion of deep ulcers than patients with indolent BCL (p = 0.020, respectively). Cox regression analysis showed that drink (p = 0.034), concomitant colonic ulcers (p = 0.034) and elevated LDH (p = 0.043) are risk factors for mortality in patients with PSIL. CONCLUSIONS This study provides clinical characteristics of patients with PSIL. Thicker intestinal wall and aneurismal dilation detected on CT scan and deeper ulcer on DBE examination helps to establish a diagnosis of DLBCL.
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Affiliation(s)
- Lin Li
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Huijian Ma
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Meng Niu
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chunxiao Chen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chaohui Yu
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Hong Zhang
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
| | - Meng Jin
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
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Wang F, Chen L, Liu L, Jia Y, Li W, Wang L, Zhi J, Liu W, Li W, Li Z. Deep learning model for predicting the survival of patients with primary gastrointestinal lymphoma based on the SEER database and a multicentre external validation cohort. J Cancer Res Clin Oncol 2023; 149:12177-12189. [PMID: 37428248 DOI: 10.1007/s00432-023-05123-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE Due to the rarity of primary gastrointestinal lymphoma (PGIL), the prognostic factors and optimal management of PGIL have not been clearly defined. We aimed to establish prognostic models using a deep learning algorithm for survival prediction. METHODS We collected 11,168 PGIL patients from the Surveillance, Epidemiology, and End Results (SEER) database to form the training and test cohorts. At the same time, we collected 82 PGIL patients from three medical centres to form the external validation cohort. We constructed a Cox proportional hazards (CoxPH) model, random survival forest (RSF) model, and neural multitask logistic regression (DeepSurv) model to predict PGIL patients' overall survival (OS). RESULTS The 1-, 3-, 5-, and 10-year OS rates of PGIL patients in the SEER database were 77.1%, 69.4%, 63.7%, and 50.3%, respectively. The RSF model based on all variables showed that the top three most important variables for predicting OS were age, histological type, and chemotherapy. The independent risk factors for PGIL patient prognosis included sex, age, race, primary site, Ann Arbor stage, histological type, symptom, radiotherapy, and chemotherapy, according to the Lasso regression analysis. Using these factors, we built the CoxPH and DeepSurv models. The DeepSurv model's C-index values were 0.760 in the training cohort, 0.742 in the test cohort, and 0.707 in the external validation cohort, which demonstrated that the DeepSurv model performed better compared to the RSF model (0.728) and the CoxPH model (0.724). The DeepSurv model accurately predicted 1-, 3-, 5- and 10-year OS. Both calibration curves and decision curve analysis curves demonstrated the superior performance of the DeepSurv model. We developed the DeepSurv model as an online web calculator for survival prediction, which can be accessed at http://124.222.228.112:8501/ . CONCLUSIONS This DeepSurv model with external validation is superior to previous studies in predicting short-term and long-term survival and can help us make better-individualized decisions for PGIL patients.
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Affiliation(s)
- Feifan Wang
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, 89 Donggang Road, Shijiazhuang, 050000, China
| | - Lu Chen
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing, 100191, China
| | - Lihong Liu
- Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Yitao Jia
- Department of Oncology, Hebei General Hospital, Shijiazhuang, 050051, China
| | - Wei Li
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, 89 Donggang Road, Shijiazhuang, 050000, China
| | - Lianjing Wang
- Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Jie Zhi
- Department of Oncology, Hebei General Hospital, Shijiazhuang, 050051, China
| | - Wei Liu
- Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Weijing Li
- Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Zhongxin Li
- Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, 89 Donggang Road, Shijiazhuang, 050000, China.
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Cristian M, Așchie M, Deacu M, Boșoteanu M, Bălțătescu GI, Stoica AG, Nicolau AA, Poinăreanu I, Orășanu CI. Comparison of Ki67 Proliferation Index in Gastrointestinal Non-Hodgkin Large B-Cell Lymphomas: The Conventional Method of Evaluation or AI Evaluation? Diagnostics (Basel) 2023; 13:2775. [PMID: 37685312 PMCID: PMC10486605 DOI: 10.3390/diagnostics13172775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/14/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
The most common NHL subtype in SEEU is DLBCL (39%), and it manifests with a variety of cellular morphologies and a high proliferation index. Also, the GI tract is the most common site of extranodal NHLs, and most NHLs involving the GI tract are of B-cell lineage, of which diffuse large B-cell lymphoma is the most common subtype, irrespective of location. The last few years have seen digital pathology as a vital technology that has a positive impact on diagnostics, but studies on the use of DP for lymphoma identification, however, are still restricted to only determining whether a tumor is present or absent. Using the example of cases of malignant NHL, we aim to investigate the diagnostic utility of DP using QuPath software in evaluating the proliferation index and the prognostic significance and to show that improved visualization and analysis contribute to the convergence of these complementary diagnostic modalities for lymphomas. The average proliferation index (Ki67) was 58.33% with values between 10% and 85%. After the stratification of the cases, an increased proliferation index was observed in the majority of cases (53.33%), and this aspect was associated with the advanced age of the patients (p = 0.045). Visual assessment provides lower Ki67 values than automated digital image analysis. However, the agreement coefficient between the conventional method and the AI method indicates an excellent level of reliability (ICC1-0.970, ICC2-0.990). The multivariate analysis revealed that in the cases where the proliferation index Ki67 is high (˃70%), the IPI score represents an important risk factor predicting mortality (HR = 10.597, p = 0.033).
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Affiliation(s)
- Miruna Cristian
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania (C.I.O.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, “Ovidius” University of Constanta, 900591 Constanta, Romania
- Department of Clinical Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Institute of Doctoral Studies, School of Medicine, ”Ovidius” University, 900573 Constanta, Romania
| | - Mariana Așchie
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, “Ovidius” University of Constanta, 900591 Constanta, Romania
- Department of Clinical Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Academy of Medical Sciences, 030171 Bucharest, Romania
| | - Mariana Deacu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania (C.I.O.)
- Department of Clinical Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Mădălina Boșoteanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania (C.I.O.)
- Department of Clinical Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Gabriela Izabela Bălțătescu
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, “Ovidius” University of Constanta, 900591 Constanta, Romania
- Department of Clinical Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Andreea Georgiana Stoica
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania (C.I.O.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, “Ovidius” University of Constanta, 900591 Constanta, Romania
- Department of Hematology, ”Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Anca Antonela Nicolau
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, “Ovidius” University of Constanta, 900591 Constanta, Romania
- Department of Clinical Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Ionuț Poinăreanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania (C.I.O.)
- Department of Pathology, Săcele Municipal Hospital, 505600 Brașov, Romania
| | - Cristian Ionuț Orășanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania (C.I.O.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, “Ovidius” University of Constanta, 900591 Constanta, Romania
- Department of Clinical Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Institute of Doctoral Studies, School of Medicine, ”Ovidius” University, 900573 Constanta, Romania
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Tran QT, Nguyen Duy T, Nguyen-Tran BS, Nguyen-Thanh T, Ngo QT, Tran Thi NP, Le V, Dang-Cong T. Endoscopic and Histopathological Characteristics of Gastrointestinal Lymphoma: A Multicentric Study. Diagnostics (Basel) 2023; 13:2767. [PMID: 37685305 PMCID: PMC10486743 DOI: 10.3390/diagnostics13172767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Background: Extranodal non-Hodgkin lymphoma (NHL) is more prevalent in the gastrointestinal (GI) tract than in other sites. This study aimed to determine the endoscopic characteristics of primary gastrointestinal non-Hodgkin lymphomas. Methods: We investigated 140 patients from three tertiary referral hospitals with primary malignant lymphoma of the gastrointestinal tract. Characteristics of the lesions were evaluated and analyzed using image-enhanced endoscopy, endoscopic ultrasound, and histopathology. Results: The median age was 60.5 (range: 11-99), and 59 (42.1%) were female. The most frequent complaint was abdominal pain (74.3%), followed by bloody feces (10%) and diarrhea (2.9%). B symptoms were observed in 15 (10.7%) patients. GI obstruction was the most common complication (10.0%), followed by hemorrhage (7.9%) and perforation (1.5%). Regarding endoscopic findings, the identified sites were the following: the stomach (61.4%), colon (10%), small intestine (10%), ileocecum (8.6%), rectum (6.4%), and duodenum (3.6%). Diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma are most prevalent in the stomach. Helicobacter pylori was identified in 46 cases (39.0%), with MALT lymphoma being the most infected subtype. Nearly all gastrointestinal non-Hodgkin lymphomas manifested as superficial type (25-59.6%) and ulcer type (15.6-50%) under endoscopy. We found that fungating type and protruding with ulcer type were more frequent types of aggressive lymphomas (diffuse large B-cell lymphoma, mantle cell lymphoma, and T-cell lymphoma) compared to the indolent types (MALT lymphoma, follicular lymphoma, duodenal-type follicular lymphoma, and small lymphocytic lymphoma) (p < 0.05). Conclusions: This study showed that most subtypes of gastrointestinal non-Hodgkin lymphomas exhibited same endoscopic features (superficial type and ulcer type). Aggressive gastrointestinal non-Hodgkin lymphomas (diffuse large B-cell lymphoma, mantle cell lymphoma, and T-cell lymphoma) were highly suspected when fungating lesions and protruding with ulcer lesions were encountered under endoscopy. Endoscopists should be aware of the connection between enhanced endoscopic characteristics and histological varieties of gastrointestinal lymphoma to improve diagnosis.
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Affiliation(s)
- Quang Trung Tran
- Department of Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany;
- Gastroenterology-Endoscopy Center, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam
| | - Thinh Nguyen Duy
- Faculty of Medicine and Pharmacy, Tay Nguyen University, 567 Le Duan Street, Buon Ma Thuot 63000, Vietnam;
- Department of Histology, Embryology, Pathology and Forensic, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue 49000, Vietnam; (B.S.N.-T.); (Q.T.N.); (N.P.T.T.); (V.L.)
| | - Bao Song Nguyen-Tran
- Department of Histology, Embryology, Pathology and Forensic, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue 49000, Vietnam; (B.S.N.-T.); (Q.T.N.); (N.P.T.T.); (V.L.)
| | - Tung Nguyen-Thanh
- Faculty of Basic Science, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue 49000, Vietnam;
| | - Quy Tran Ngo
- Department of Histology, Embryology, Pathology and Forensic, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue 49000, Vietnam; (B.S.N.-T.); (Q.T.N.); (N.P.T.T.); (V.L.)
| | - Nam Phuong Tran Thi
- Department of Histology, Embryology, Pathology and Forensic, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue 49000, Vietnam; (B.S.N.-T.); (Q.T.N.); (N.P.T.T.); (V.L.)
| | - Vi Le
- Department of Histology, Embryology, Pathology and Forensic, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue 49000, Vietnam; (B.S.N.-T.); (Q.T.N.); (N.P.T.T.); (V.L.)
- Department of Pathology, Khanh Hoa Oncology Hospital, 229 Nguyen Khuyen Street, Nha Trang 57000, Vietnam
| | - Thuan Dang-Cong
- Department of Histology, Embryology, Pathology and Forensic, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue 49000, Vietnam; (B.S.N.-T.); (Q.T.N.); (N.P.T.T.); (V.L.)
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Upadhyay A, Shekhar S, Pandey V, Prakash A, Saha K. Synchronous Adenocarcinoma Stomach With Marginal Zone Lymphoma: A Sporadic Occurrence and Review of Literature. Cureus 2023; 15:e41631. [PMID: 37565106 PMCID: PMC10410680 DOI: 10.7759/cureus.41631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Synchronous adenocarcinoma of the stomach with lymphoma is extremely rare. We report a case of a 65-year-old male patient with synchronous adenocarcinoma of the stomach with nodal marginal zone lymphoma. Initial endoscopic biopsy suggested invasive moderately differentiated adenocarcinoma and a locoregional disease, per contrast-enhanced computed tomography (CECT) scans. The patient was started on neo-adjuvant chemotherapy with the 5FU, leucovorin, oxaliplatin, docetaxel (FLOT) regime and, after response evaluation, underwent radical gastrectomy. Histopathology and immunohistochemistry suggested synchronous adenocarcinoma of the stomach with marginal zone lymphoma in perigastric lymph nodes. This case is probably the first such synchronous malignancy case reported from India. The prognosis of multiple primary malignancies is usually poor because no standard guidelines are available regarding optimum treatment and sequencing of available treatment modalities. The frequency of synchronous primary cancers has been increasing in recent years, probably due to better diagnostic modalities, and second primary in patients with cancer should be considered as one of the differential diagnoses.
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Affiliation(s)
| | - Shashank Shekhar
- Medical Oncology, Meherbai Tata Memorial Hospital, Jamshedpur, IND
| | - Vanita Pandey
- Pathology, Meherbai Tata Memorial Hospital, Jamshedpur, IND
| | | | - Kaushik Saha
- Specialist, Pathology, Tata Main Hospital, Jamshedpur, IND
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Liu X, Chen H. Anal lymphoma: a tumor with insufficient attention. Discov Oncol 2023; 14:88. [PMID: 37273008 DOI: 10.1007/s12672-023-00706-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/29/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Anal lymphomas are extremely rare. There are no relevant descriptions in professional books, and there are only a few case reports in the literature. Here, we report a new case and review the literature to summarize the clinical and pathological features of anal lymphoma. METHODS We described a case of anal lymphoma confirmed by pathological diagnosis, then searched the PubMed database, and finally selected 12 reported cases to be included in the study. We described the clinical and pathological characteristics of the patients. RESULTS Thirteen patients with anal lymphoma were confirmed. Seven men and six women with a median age of 50. There were four cases of HIV- and EBV-infected patients. The size of the tumor was 1-13 cm, all of which were diagnosed as B-cell lymphoma, and 61.5% were diffuse large B-cell lymphomas. Among the 13 patients, eight received chemotherapy or immunochemotherapy, two received radiotherapy, one received chemotherapy combined with radiotherapy, one received surgery, and one gave up treatment. Three patients died, and only 2 of 10 surviving patients had complete remission. CONCLUSION Anal lymphoma is extremely rare. Patients with persistent abscess complicated with HIV or EBV infection should undergo pathological biopsy to exclude anal lymphoma.
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Affiliation(s)
- Xibo Liu
- Department of Pathology, Shaoxing People's Hospital, No. 568, Zhongxing North Road, Shaoxing, 312000, Zhejiang Province, China
| | - Hongliang Chen
- Department of Anorectal Surgery, Shaoxing People's Hospital, No. 568, Zhongxing North Road, Shaoxing, 312000, Zhejiang Province, China.
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Huang T, Wang T, Fang X, Su P, Huang X, Fu H, Liu T. Evaluation of the clinical characteristics and prognostic factors of gastrointestinal non-Hodgkin lymphoma based on anatomical sites and histological subtype. Scand J Gastroenterol 2023:1-6. [PMID: 36740826 DOI: 10.1080/00365521.2023.2173987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aimed to analyze the clinical characteristics and prognostic factors of patients with non-Hodgkin lymphoma (NHL) in the gastrointestinal tract. METHODS This study investigated patients (n = 456) with gastrointestinal tract NHL who had been initially treated in our hospital between January 2018 and December 2021. We compared clinical characteristics and prognostic factors according to the anatomic site of involvement and histologic subtypes. RESULTS Gastrointestinal tract involvement was more common in B-cell than T-cell lymphomas (91.7% versus 8.3%). The intestine (n = 237) involvement was more common than the stomach (n = 219). Patients with T-cell lymphoma were more likely to present with advanced disease and B symptoms than B-cell lymphoma. Subgroup survival analysis was conducted for 358 patients whose follow-up time was more than 2 years, we found that T-cell immunophenotype and elevated serum lactate dehydrogenase (LDH) were independent prognostic factors for survival. Patients with advanced disease were identified as risk factors for relapsed or refractory gastrointestinal tract NHL. CONCLUSIONS In our subgroup survival analysis, we found that the survival outcomes demonstrated no significant differences between the stomach and intestinal tract NHL. Serum LDH levels and histologic subtypes were independent prognostic factors for the survival of gastrointestinal tract NHL. Advanced diseases were considered risk factors for relapsed or refractory gastrointestinal tract NHL.
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Affiliation(s)
- Tingxuan Huang
- Department of Gastroenterology, Fujian Medical University Union Hospital, Fujian Medical University Cancer Center, Fujian Medical University, Fuzhou, China
| | - Taiqin Wang
- Department of Otolaryngology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xuefen Fang
- Department of Gastroenterology, Fujian Medical University Union Hospital, Fujian Medical University Cancer Center, Fujian Medical University, Fuzhou, China
| | - Ping Su
- Department of Propaganda, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaoyun Huang
- Department of Gastroenterology, Fujian Medical University Union Hospital, Fujian Medical University Cancer Center, Fujian Medical University, Fuzhou, China
| | - Haiying Fu
- Department of Hematology, The Third Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, The Third People's Hospital of Fujian Province, Fuzhou, China
| | - Tingbo Liu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Haematology, Fujian Medical Centre of Haematology, Fujian Provincial Key Laboratory on Haematology, Fuzhou, China
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8
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Mao S, Diao C, Cao L. Primary small intestinal extranodal NK/T cell lymphoma, nasal type with kidney involvement: a rare case report and literature review. Diagn Pathol 2022; 17:75. [PMID: 36199094 PMCID: PMC9533626 DOI: 10.1186/s13000-022-01254-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/22/2022] [Accepted: 09/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Extranodal NK/T cell lymphoma, nasal type (EN-NK/T-NT) is a rare and aggressive type of non-Hodgkin’s lymphoma. EN-NK/T-NT seldom occurs in the gastrointestinal tract, and renal involvement is relatively rare. Case presentation Here we report a case of primary small intestinal EN-NK/T-NT with kidney involvement. We present the case of a 71-year-old female who was admitted to our hospital for coronary heart disease with a fever of unknown origin. Laboratory examination showed renal impairment and PET/CT showed a locally thickened wall of the small intestine, abnormally increased FDG metabolism in the right lower abdomen, and multiple slightly high-density masses with abnormal increased FDG metabolism in the right kidney. The gross specimen showed a grayish-white lump located in the ileum approximately 15 cm away from the ileocecum, and two grayish-white lumps located in the upper and lower poles of the right kidney, respectively. The pathological diagnosis was EN-NK/T-NT. The patient died approximately 10 months after the operation. Conclusion EN-NK/T-NT is a rare type of non-Hodgkin’s lymphoma and may develop insidiously, with fever as the only clinical manifestation. The disease was found to be difficult to diagnose in the early stage, resulting in a highly aggressive clinical course and short survival time.
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Affiliation(s)
- Shuyan Mao
- Department of Pathology, Shanghai Pudong New Area People's Hospital, No.490, Chuanhuan South Road, Chuansha town, 200120, Shanghai, China
| | - Changying Diao
- Department of Pathology, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, China.
| | - Lei Cao
- Department of Pathology, Shanghai Pudong New Area People's Hospital, No.490, Chuanhuan South Road, Chuansha town, 200120, Shanghai, China
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9
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Clinical Management and Operative Decision-Making in a Patient With a History of Follicular Lymphoma. Dermatol Surg 2022; 48:890-892. [DOI: 10.1097/dss.0000000000003504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Colo-enteric fistula associated with diffuse large B cell lymphoma that resulted in gastrointestinal bleeding: A case report and literature review. Int J Surg Case Rep 2022; 91:106798. [PMID: 35131626 PMCID: PMC8829056 DOI: 10.1016/j.ijscr.2022.106798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/21/2022] [Accepted: 01/21/2022] [Indexed: 11/23/2022] Open
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11
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Alvarez-Lesmes J, Chapman JR, Poveda JC. Pitfalls in gastrointestinal tract haematopoietic lesions. Pathology 2021; 54:177-183. [PMID: 34801278 DOI: 10.1016/j.pathol.2021.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 08/23/2021] [Indexed: 02/07/2023]
Abstract
Specimens from the gastrointestinal (GI) tract are among the most commonly encountered in routine pathology practice worldwide. It is well known that the luminal GI tract is home to various areas rich in mucosa-associated lymphoid tissue (MALT), whether native or acquired. The latter may be particularly problematic due to its well-known predisposing factors such as Helicobacter pylori infection and autoimmune conditions. Nevertheless, native GI structures are often the subject of query, particularly in conditions that may mimic lymphoproliferative conditions, including infectious and inflammatory diseases. Herein, we describe and share common clinicopathological findings in our daily practice that are challenging to distinguish from subtle low-grade neoplastic lymphoproliferative disorders.
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Affiliation(s)
- Jessica Alvarez-Lesmes
- Department of Pathology, Division of Hematopathology, Division of Gastrointestinal Pathology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, and Jackson Memorial Hospital, Miami, FL, USA
| | - Jennifer R Chapman
- Department of Pathology, Division of Hematopathology, Division of Gastrointestinal Pathology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, and Jackson Memorial Hospital, Miami, FL, USA
| | - Julio C Poveda
- Department of Pathology, Division of Hematopathology, Division of Gastrointestinal Pathology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, and Jackson Memorial Hospital, Miami, FL, USA.
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