Endoscopic and clinical analysis of primary T‐cell lymphoma of the gastrointestinal tract according to pathological subtype. Issue 5 (May 2014)

• Record Type: Journal Article
• Authors: Kim, Do Hoon; Lee, Danbi; Kim, Jeong Won; Huh, Jooryung; Park, Seong Ho; Ha, Hyun Kwon; Suh, Cheolwon; Yoon, Soon Man; Kim, Kyung‐Jo; Choi, Kee Don; Ye, Byong Duk; Byeon, Jeong‐Sik; Song, Ho June; Jung, Hwoon Yong; Yang, Suk‐Kyun; Kim, Jin‐Ho; Myung, Seung‐Jae
• Is Part Of: Journal of gastroenterology and hepatology. Volume 29:Issue 5(2014:May)
• Page Start: 934
• Page End: 943
• Publication Date: 2014-05
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.12471
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh12471-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>Little is known about the clinicopathological characteristics of primary gastrointestinal T‐cell lymphomas (PGITL). This study evaluated the clinical and endoscopic features of the pathological subtypes of PGITL.</p> </sec> <sec id="jgh12471-sec-0002" sec-type="section"> <title>Methods</title> <p>Forty‐two lesions in 36 patients with PGITL were assessed, including 15 enteropathy‐associated T‐cell lymphomas (EATL), 13 peripheral T‐cell lymphomas (PTCL), 10 NK/T‐cell lymphomas (NK/TL), and four anaplastic large cell lymphomas (ALCL).</p> </sec> <sec id="jgh12471-sec-0003" sec-type="section"> <title>Results</title> <p>PTCL occurred more frequently in the stomach and duodenum and NK/TL more frequently in the small and large intestines (<italic>P</italic> = 0.009). The endoscopic features of the four subtypes were similar (<italic>P</italic> = 0.124). Fifteen of 41 lesions (36.6%) were Epstein–Barr virus (EBV) positive, with NK/TL more likely to be EBV positive than the other types (<italic>P</italic> < 0.001). First endoscopy and first computed tomography (CT) scan indicated that 65.4% and 51.4% of the lesions, respectively, were malignant, and that 43.2% and 42.3%, respectively, were GI lymphomas. The two modalities together correctly diagnosed about half of the lesions before biopsy. Intestinal perforation was associated with small bowel location (<italic>P</italic> < 0.001) and infiltrative type (<italic>P</italic> = 0.009), and was more common in NK/TL than in the other subtypes (<italic>P</italic> = 0.015). Multivariate analysis showed that higher international prognosis index (<italic>P</italic> = 0.008) and the presence of complications (<italic>P</italic> = 0.006) were associated with poor prognosis. Survival was poorer in patients with small bowel lesions than with lesions at other locations (<italic>P</italic> = 0.048).</p> </sec> <sec id="jgh12471-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The four main pathological types of PGITL differed in clinical characteristics. As PGITL was often not diagnosed by initial endoscopic or radiological examination, a high index of suspicion is necessary to ensure its early diagnosis.</p> </sec> </abstract>