Experience of the diagnosis and treatment of primary small intestine lymphoma / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To report the experiences of the diagnosis and treatment of primary lymphoma of the small intestine (PSIL).</p><p><b>METHODS</b>The clinical data of 15 patients with PSIL treated from January 2003 to July 2007 was investigated retrospectively. Of the 15 cases, 9 patients were male and 6 were female, the average age was 51.6 years (range, 18 - 73 years). Data of gender, age, clinical manifestation, laboratory examination, imageology examination, diagnosis and treatment of the patients was reviewed.</p><p><b>RESULTS</b>The most common clinical manifestations were as follow abdominal pain, abdominal lump, bowel obstruction, gastrointestinal hemorrhage and athrepsy. Serum tumor markers were checked normal. All the 15 cases were found with tumor by spiral CT, and 12 cases were diagnosed as PSIL. Eleven cases were given Ba-meal examinations, and positive results was found in 4 cases, and only 1 case was considered to be PSIL. All the 15 patients received operation. All the patients were diagnosed as non-Hodgkin lymphoma (NHL) by postoperative pathology (8 patients as diffuse large B-cell lymphoma, 5 as mucosa associated lymphoid tissue type B cell lymphoma and 2 as enteropathy-type intestinal T cell lymphoma). No perioperative death occurred. Ten patients received adjuvant chemotherapy with the regimen of CHOP (cyclophosphamide + epirubicin + vincristine + prednisone) after the operation. Fourteen cases were followed-up for a mean time of 30 months (range, 6 - 52 months). The 1- and 3-years survival rate was 85.7% and 57.1%, respectively.</p><p><b>CONCLUSIONS</b>PSIL has no specific clinical manifestations, the diagnostic rate with barium study is low, spiral CT scan is a promising diagnostic method for PSIL. Operation combined with chemotherapy is important for PSIL.</p>