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Intestinal Lymphoma


Presentation

  • There is a lack of information regarding the impact an emergency presentation has on the timing of postoperative chemotherapy and overall prognosis.[ncbi.nlm.nih.gov]
  • […] localized tumor in the distal ileum or ileocecal region; commonly presents with intussusception, abdominal tumor and pain, and Non-Burkitt's lymphoma, 13 patients, usually occurs as localized tumors in the distal ileum; commonly presents with abdominal[ncbi.nlm.nih.gov]
  • Acute intestinal obstruction was the commonest presentation. Imaging modalities revealed abnormality in all the cases but were rarely diagnostic. Most patients presented at an early stage when the disease was confined to the bowel.[ncbi.nlm.nih.gov]
  • However the Odds Ratio was significantly high for the presence of etiological risk factor (OR 7.50) and perforation as presenting symptom (OR 6.67).[ncbi.nlm.nih.gov]
  • The most common presentation was intestinal obstruction. Twelve children had Burkitt's lymphoma (BL), presenting most commonly with abdominal masses and/or intestinal obstruction.[ncbi.nlm.nih.gov]
Weight Loss
  • Abstract Of 18 patients with small-intestinal lymphoma associated with villous atrophy and crypt hyperplasia of uninvolved mucosa, most presented with acute obstruction or perforation preceded by abdominal pain and weight-loss.[ncbi.nlm.nih.gov]
  • We present a 79-year-old male patient which presented with abdominal pain in the upper parts of abdomen of four months' duration, colic timpanists, tenderness, distention, weight loss.[ncbi.nlm.nih.gov]
  • Patients were mostly young males presenting with abdominal pain, weight loss, and diarrhea and showing laboratory evidence of carbohydrate, fat, and vitamin B12 malabsorption and hypoalbuminemia.[ncbi.nlm.nih.gov]
  • It is associated with clubbing of the fingers, abdominal pain, weight loss, diarrhea, vomiting, and malabsorption, and frequently occurs in a younger age group than "Western Hemisphere" intestinal lymphoma.[ncbi.nlm.nih.gov]
  • Abdominal pain, anorexia, weight loss, diarrhea, malabsorption, and clubbing of the fingers are the most common clinical findings. The barium appearance of the small intestine and peroral jejunal biopsy specimens are abnormal in nearly all cases.[ncbi.nlm.nih.gov]
Fever
  • […] describes a case of multiple location in the small intestine of a non-Hodgkin B-cell in a 53 years old patient, who was initially diagnosed with bilateral pneumonia with pleurisy with E. coli, steeper on the right side, but the persistence of symptoms as fever[ncbi.nlm.nih.gov]
  • Symptoms of these cancers may include weight loss, abdominal pain, enlarged lymph nodes, fatigue, and fever.[beyondceliac.org]
  • Other symptoms of both types of lymphoma may include: ongoing fever without infection night sweats, fever, and chills weight loss and loss of appetite unusual itching persistent fatigue, unusual tiredness, or lack of energy pain in lymph nodes after drinking[medicalnewstoday.com]
  • The most common presenting symptoms were abdominal pain (100%), abdominal mass (50%), followed by nausea, vomiting and weight loss (25%), fever (25%) and GI bleeding (15%) as shown in the [Table 1] .[indianjcancer.com]
  • Swollen abdomen (belly) Feeling full after only a small amount of food Chest pain or pressure Shortness of breath or cough Severe or frequent infections Easy bruising or bleeding Some people with Non-Hodgkin lymphoma have what are known as B symptoms : Fever[cancer.org]
Malaise
  • […] case of multiple location in the small intestine of a non-Hodgkin B-cell in a 53 years old patient, who was initially diagnosed with bilateral pneumonia with pleurisy with E. coli, steeper on the right side, but the persistence of symptoms as fever, malaise[ncbi.nlm.nih.gov]
Pseudotumor
  • […] underwent surgery, the intraoperative foundings being: a large mesenteric tumor - 5 cm in diameter, a terminal ileal mesenteric tumor, a mesenteric tumor - 6 cm in diameter, omentum with nodular formations, a tumor - 3.3/2.5.1 cm in the abdominal wall, pseudotumoral[ncbi.nlm.nih.gov]
Splenomegaly
  • However, the presence of extensive retroperitoneal lymphadenopathy and splenomegaly favours lymphoma, whereas adjacent fat infiltration supports adenocarcinoma.[radiopaedia.org]
  • Diagnosis Examination in patients with low-grade lymphomas may demonstrate peripheral adenopathy, splenomegaly, and hepatomegaly.[emedicine.medscape.com]
  • […] ref7, ref8 : adominal pain (80-100%) diarrhea (70-100%) weight loss (90-100%) vomiting : early stage (10%) advanced stage (30%) low-grade fever (30-50%) abdominal masses early stage (20%) advanced stage (60%) clubbing of fingers (20-60%) hepatomegaly, splenomegaly[ufrgs.br]
Abdominal Pain
  • Sometimes the abdominal pain decreased expelling diarrheal dejections.[ncbi.nlm.nih.gov]
  • Abstract Of 18 patients with small-intestinal lymphoma associated with villous atrophy and crypt hyperplasia of uninvolved mucosa, most presented with acute obstruction or perforation preceded by abdominal pain and weight-loss.[ncbi.nlm.nih.gov]
  • Sudden onset of abdominal pain occurred 5 months after a successful cadaveric renal transplant. The immunousuppressants chosen were cyclosporin-A, prednisolone and azathioprine.[ncbi.nlm.nih.gov]
  • Three distinct groups were recognized: Mediterranean lymphoma, 11 patients, characterized by diffuse involvement of the proximal bowel; commonly presents with abdominal pain, diarrhea and malabsorption; Burkitt's lymphoma, 13 patients, characterized by[ncbi.nlm.nih.gov]
  • A 49-year-old woman was referred to our hospital with a history of upper abdominal pain for two weeks and was diagnosed with synchronous cancer.[ncbi.nlm.nih.gov]
Intestinal Disease
  • Seventy percent of patients with solitary lymphoma and 80% with immunoproliferative small intestinal disease were mulatto.[ncbi.nlm.nih.gov]
  • Other intestinal diseases are very important such as immunoproliferative small intestinal disease (IPSID), a prelymphomatous process, and MALT lymphomas, caused by infection of Helicobacter pylori (H. Pylori).[ncbi.nlm.nih.gov]
  • Abstract Forty-three patients with immunoproliferative small intestinal disease and primary small intestinal lymphoma were studied prospectively.[ncbi.nlm.nih.gov]
  • Mediterranean lymphoma (MTL), also known as alpha chain disease and immunoproliferative small intestinal disease (IPSID), occurs in the proximal small intestine of young adults who present with malabsorption.[ncbi.nlm.nih.gov]
  • Abstract Ten cases of primary upper small-intestinal lymphoma associated with alpha-chain protein in serum were discovered in a prospective study of the sera of patients with immunoproliferative small-intestinal disease (IPSID).[ncbi.nlm.nih.gov]
Diarrhea
  • We record the first case of HOA associated with primary intestinal lymphoma in a patient who presented with chronic diarrhea.[ncbi.nlm.nih.gov]
  • Three distinct groups were recognized: Mediterranean lymphoma, 11 patients, characterized by diffuse involvement of the proximal bowel; commonly presents with abdominal pain, diarrhea and malabsorption; Burkitt's lymphoma, 13 patients, characterized by[ncbi.nlm.nih.gov]
  • Tetracycline was necessary for the treatment of IPSID-associated diarrhea and malabsorption in spite of cytotoxic chemotherapy.[ncbi.nlm.nih.gov]
  • ., diarrhea, spasms, constipation, and oral candidiasis. The diagnosis of lymphoma was made at laparotomy in all cases. All three had complete removal of localized tumor (stage Ie or IIe), yet died within 6 months of surgery and/or chemotherapy.[ncbi.nlm.nih.gov]
  • Patients were mostly young males presenting with abdominal pain, weight loss, and diarrhea and showing laboratory evidence of carbohydrate, fat, and vitamin B12 malabsorption and hypoalbuminemia.[ncbi.nlm.nih.gov]
Abdominal Mass
  • Twelve children had Burkitt's lymphoma (BL), presenting most commonly with abdominal masses and/or intestinal obstruction. These patients responded poorly to cyclophosphamide, and the disease disseminated early and extensively.[ncbi.nlm.nih.gov]
  • RESULTS: The demographic and clinical parameters that showed significant values for differentiating CD from PIL included age of onset, symptom duration, presence of diarrhea, abdominal mass, and perianal lesions ( P 0.05).[ncbi.nlm.nih.gov]
  • The most common presenting symptoms were abdominal pain (100%), abdominal mass (50%), followed by nausea, vomiting and weight loss (25%), fever (25%) and GI bleeding (15%) as shown in the [Table 1] .[indianjcancer.com]
  • All the children had a huge abdominal mass but none of them had complete intestinal obstruction. Regarding the diagnosis, ultrasonography frequently reveals a hypoechoic thickening of the intestinal wall with dilated intestinal loops.[link.springer.com]
  • Other abdominal and pelvic organs, glandular tissue (such as the thyroid and tonsils) and the facial bones may also be involved. [ 7 ] Presentation is commonly with: Abdominal mass/swelling and ascites. Abdominal pain. Intestinal obstruction.[patient.info]
Loss of Appetite
  • An enlarged spleen might press on the stomach, which can cause a loss of appetite and feeling full after only a small meal. Lymphomas in the stomach or intestines can cause abdominal pain, nausea, or vomiting.[cancer.org]
  • Other symptoms of both types of lymphoma may include: ongoing fever without infection night sweats, fever, and chills weight loss and loss of appetite unusual itching persistent fatigue, unusual tiredness, or lack of energy pain in lymph nodes after drinking[medicalnewstoday.com]
Hepatomegaly
  • Diagnosis Examination in patients with low-grade lymphomas may demonstrate peripheral adenopathy, splenomegaly, and hepatomegaly.[emedicine.medscape.com]
  • […] ref5, ref6, ref7, ref8 : adominal pain (80-100%) diarrhea (70-100%) weight loss (90-100%) vomiting : early stage (10%) advanced stage (30%) low-grade fever (30-50%) abdominal masses early stage (20%) advanced stage (60%) clubbing of fingers (20-60%) hepatomegaly[ufrgs.br]

Workup

  • Although a variety of laboratory and imaging studies are used in the evaluation and staging of suspected NHL (see Workup ), a well-processed hematoxylin and eosin (H&E)–stained section of an excised lymph node is the mainstay of pathologic diagnosis.[emedicine.medscape.com]
Anergy
  • […] acquired immune deficiency syndrome as demonstrated by demography, sexual history, cachexia, opportunistic infections by Cytomegalovirus, Pneumocystis carinii, atypical Mycobacterium, Candida, and/or evidence of immune deficiency, such as skin test anergy[ncbi.nlm.nih.gov]
Candida
  • All three had acquired immune deficiency syndrome as demonstrated by demography, sexual history, cachexia, opportunistic infections by Cytomegalovirus, Pneumocystis carinii, atypical Mycobacterium, Candida, and/or evidence of immune deficiency, such as[ncbi.nlm.nih.gov]

Treatment

  • Treatments were surgery plus chemotherapy (n 6), surgery alone (n 3), chemotherapy alone (n 2), chemotherapy and radiation (n 1), surgery and radiation (n 1); two patients died before treatment.[ncbi.nlm.nih.gov]
  • In localized diseases (stage 1 and 2), the primary surgical treatment had the most favorable influence on failure-free survival (P 0.05). The resection of localized intestinal lymphoma may be appropriate as the primary treatment.[ncbi.nlm.nih.gov]
  • It is proposed that in order to develop evidence-based treatment protocols, there should be an intestinal NHL registry.[ncbi.nlm.nih.gov]
  • We retrospectively analyzed the clinicopathological features of 19 patients with PSIL, who had been diagnosed by double-balloon endoscopy (DBE) and had not received surgical treatment.[ncbi.nlm.nih.gov]
  • Data from this study suggest that following initial surgery the chemotherapy is the treatment of choice for these patients.[ncbi.nlm.nih.gov]

Prognosis

  • There is a lack of information regarding the impact an emergency presentation has on the timing of postoperative chemotherapy and overall prognosis.[ncbi.nlm.nih.gov]
  • INTERPRETATION AND CONCLUSIONS: Intestinal lymphomas differ significantly from their gastric counterpart, not only in pathology, but also with regard to clinical features, management and prognosis.[ncbi.nlm.nih.gov]
  • Although the histological type did not correlate with survival, stage did and tumours extending beyond the local lymph nodes were associated with a significantly worse prognosis.[ncbi.nlm.nih.gov]
  • BACKGROUND: The non-Hodgkin's lymphoma is the AIDS symbol of tumor, with high incidence and poor prognosis.[ncbi.nlm.nih.gov]
  • Treatment by a variety of modalities is far from satisfactory, and the prognosis is much poorer than that observed in patients with the "Western" form of intestinal lymphoma.[ncbi.nlm.nih.gov]

Etiology

  • The etiology and pathogenesis of this disease are unknown, but several hypotheses are discussed.[ncbi.nlm.nih.gov]
  • However the Odds Ratio was significantly high for the presence of etiological risk factor (OR 7.50) and perforation as presenting symptom (OR 6.67).[ncbi.nlm.nih.gov]
  • We propose the term "NK-cell enteropathy" for this syndrome of as yet unknown etiology.[ncbi.nlm.nih.gov]
  • IPSID is an ideal model for the study of the etiology and pathogenesis of lymphoma in man.[ncbi.nlm.nih.gov]
  • Larger and further studies must be carried out on etiology, pathogenesis and management.[ncbi.nlm.nih.gov]

Epidemiology

  • Epidemiology The disease affects mainly the adult, with male predominance, and it is frequently associated with gluten-sensitive entheropathy. Pathology The disease consists of ulcerated lesions involving the small intestine. Perforation may occur.[atlasgeneticsoncology.org]
  • Over the past decade, Jonas Ludvigsson, MD, PhD, a pediatrician and professor of clinical epidemiology at the Karolinska Institutet in Stockholm, established a large population-based database using biopsy results from 28 pathology departments in Sweden[newsroom.cumc.columbia.edu]
  • Descriptive epidemiology of gastrointestinal non-Hodgkin's lymphoma in a population-based registry. Br J Cancer 1999;79:1929-34. 12. Shukla K, Patel T, Shukla J, Palanki S. Primary gastrointestinal lymphoma - A clinicopathologic study.[indianjcancer.com]
  • […] as a tumor composed of large lymphoid cells, often with an inflammatory background ( WHO, 2008 ) Terminology Also called intestinal T cell lymphoma (with or without enteropathy), but many other T cell lymphomas can present with intestinal involvement Epidemiology[pathologyoutlines.com]
  • Epidemiology [ 4 ] It most commonly affects children but can occur in adults. Burkitt's and 'Burkitt-like' lymphomas account for fewer than 10% of adult diffuse lymphomas but account for the majority of childhood B-cell lymphomas.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology [ edit ] The majority of gastric lymphomas are non-Hodgkin's lymphoma of B-cell origin. These tumors may range from well-differentiated, superficial involvements ( MALT ) to high-grade, large-cell lymphomas.[en.wikipedia.org]
  • For discussion of individual subtypes of NHL, see the following: Pathophysiology NHLs are tumors originating from lymphoid tissues, mainly of lymph nodes.[emedicine.medscape.com]

Prevention

  • Chemotherapy drugs are injected directly into the spinal fluid to prevent the cancer from spreading to the central nervous system. This method of injection is referred to as “intrathecal.”[healthline.com]
  • UCLA's Jonsson Comprehensive Cancer Center has more than 240 researchers and clinicians engaged in disease research, prevention, detection, control, treatment and education.[newsroom.ucla.edu]
  • Treatment Malignant lymphoma of the small bowel is treated with surgical resection, usually followed by chemotherapy to prevent perforation Radiation therapy may also be used Small Bowel Lymphoma-Aneurysmal Dilatation.[learningradiology.com]
  • To prevent that, you need to be on a gluten -free diet. Once gluten is out of the picture, your small intestine will start to heal. But because celiac disease is so hard to diagnose, people can have it for years.[webmd.com]
  • Whether resection of localized disease before initiation of chemotherapy prevents delayed complications of hemorrhage and perforation is not clear.[academic.oup.com]

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