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A Journal on Surgery

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Minerva Chirurgica 2001 October;56(5):451-60

language: Italian

Primary lymphoma of the gastrointestinal tract: diagnosis and treatment

De Falco M., Gentile A., Parmeggiani D., Giudicianni C., Calabria M., Parmeggiani U.


Background. A retrospective analysis of 12 years' experience (1987-1999), concerning gastro-intestinal lymphomas (LNH-GI) has been performed, to offer a contribution for the identification of the diagnostic and prognostic criteria.
Methods. During this period, 11 cases (9 male and 2 female) have been treated: 8 with gastric localization and 3 with intestinal localization, with age ranging between 12 and 78 years. Most of the analyzed cases (5 cases out of 8 with gastric localization and all the cases with intestinal localization) underwent surgical treatment without a sure understanding of the nature of lymphoma. Clinical observation showed forms in an advanced state of local development.
Results. However, the low specifity of available diagnostic tools and the therapeutic delay are factors that seems do not influence the prognosis, as well as the stage of the disease determined with traditional classification methods. The aspect that seems to be crucial for the prognosis of the disease is the histotype (5 low grade cases free of desease from 36 months to 10 years, vs 4 high grade cases died between 46 days and 40 months after the surgical treatment).
Conclusions. Some interesting considerations arise from the analysis of the diagnostic procedure and from the method of treatment: the specifity and precocity of the diagnosis could be improved by a large use of endoscopic ultrasonography that allow to obtain deep biopsy; the identification of histotype before surgical treatment can address and modulate the therapeutic strategy eliminating the over treatment for L.G. forms.

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