Clinical diagnosis and treatment of primary small intestinal lymphoma
Background: To report experiences in the diagnosis and treatment of primary lymphoma of the small intestine (PSIL).
Methods: The clinical data of 15 patients with PSIL treated from January 2015 to July 2019 at Guangzhou First People’s Hospital were investigated retrospectively. Among the 15 patients, 9 were male, and 6 were female, with ages ranging from 18 to 73 years, with a median age of 51.6 years. Data relating to gender, age, clinical manifestation, laboratory examination, imaging, diagnosis, and treatment of the patients were reviewed.
Results: The most common clinical manifestations were abdominal pain, abdominal lump, bowel obstruction, gastrointestinal hemorrhage, and athrepsy. Serum tumor markers were checked and found to be normal. In all 15 cases, tumors were found by spiral computed tomography (CT), and 12 cases were diagnosed as PSIL. Eleven cases were given barium meal examinations, and positive results were found in 4 cases, with only 1 case considered to be PSIL. All 15 patients underwent surgery. All patients were diagnosed as having non-Hodgkin lymphoma by postoperative pathology (8 patients with diffuse large B-cell lymphoma, 5 with mucosa associated lymphoid tissue type B-cell lymphoma and 2 with enteropathy-type intestinal T-cell lymphoma). There were no cases of perioperative deaths. Ten patients received adjuvant chemotherapy with the CHOP (cyclophosphamide, epirubicin, vincristine, and prednisone) regimen after the operation. Fourteen cases were followed up for a mean duration of 30 months (range of 6-52 months). The 1- and 3-year survival rates were 85.7% and 57.1%, respectively.
Conclusion: PSIL has no specific clinical manifestations. The diagnostic rate with barium study is low, whereas spiral CT is a promising diagnostic method for PSIL. Surgery combined with chemotherapy is important for the treatment of PSIL.
Keywords: Lymphoma, non-Hodgkin, primary small intestine lymphoma (PSIL), diagnosis, therapy