Prognosis of Primary Intestinal non-Hodgkin′s Lymphoma Perforation_West China Medical Journal

Authors：

GOU Hongfeng ¹ ,  CHEN Xinchuan ²

1. Center of Medical Oncology, 2. Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041,P.R.China;

Corresponding?author：

CHEN Xinchuan, Email: joan.gou@gmail.com

Keywords：

腸腫瘤; 淋巴瘤; 穿孔; 預后

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【摘要】　目的　對原發性腸道非霍奇金淋巴瘤穿孔患者的臨床及病理特征、診治、預后進行探討。　方法　回顧性分析1999年1月-2008年12月診治的17例原發性腸道非霍奇金淋巴瘤穿孔患者的臨床資料。　結果　 B細胞型9例，T細胞型8例。17例原發腸道非霍奇金淋巴瘤穿孔患者的穿孔部位:大腸7例，小腸7例，回盲部3例。所有患者均行手術治療。除2例穿孔前行化療的患者以外，其余患者術前均未明確診斷。有14例獲得隨訪結果，6例術后3個月內死亡，術后接受化療者7例，1、2、3年生存率分別為41.2%、 23.6%、11.7%，僅1例生存期超過5年。　結論　原發性腸道非霍奇金淋巴瘤穿孔術前診斷困難，預后極差。
【Abstract】　Objective　 To analyze the clinical features, diagnosis, therapy and prognosis of primary intestinal non-hodgkin′s lymphoma perforation.　Methods　 The clinical data of 17 patients with the primary intestinal non-Hodgkin′s lymphoma perforation from January 1999 to December 2008 were retrospectively analyzed.　Results　 Nine patients had intestinal B-cell lymphoma, and eight had intestinal T-cell lymphoma. The sites of perforation were as follows: colon and rectum in 7 (41.2%), ileum and jejunum in 7 (41.2%), and ileocecal junction in 3 (17.6%). All patients had undergone the operations. The disease was not diagnosed before the operation in all of the patients except for the Two patients had a history of systemic chemotherapy before perforation. A total of 14 patients were followed up, in whom six died within three months after the operation; the survival rate 1, 2, and 3 years after the operation was 41.2%, 23.6%, and 11.7%, respectively in seven patients who had undergone the systemic chemotherapy before the operation; one patients lived more than 5 years.　Conclusion　 The diagnosis of primary colonic malignant lymphoma perforation is difficult; the prognosis is miserable.

Citation： GOU Hongfeng,CHEN Xinchuan. Prognosis of Primary Intestinal non-Hodgkin′s Lymphoma Perforation. West China Medical Journal, 2010, 25(11): 1960-1963. doi: Copy

1.	d′Amore F, Brincker H, Gronbaek K, et al. Non-Hodgkin′s lymphoma of the gastrointestinal tract: a population-based analysis of incidence, geographic distribution, clinicopathogic presentation features, and prognosis. Danish lymphoma Study Group[J]. J Clin Oncol 1994, 12(8): 1673-1684.
2.	Otter R, Bieger R, Kluin PM, et al. Primary gastrointestinal non-Hodgkin′s lymphoma in a population-based registry[J]. Br J Cancer, 1989, 60(5): 745-755.
3.	Domizio P, Owen R, Shepherd N, et al. Primary lymphoma of the small intestine: a clinicopathological study of 119 cases[J]. AM J Surg Pathol, 1993, 17(5): 429-442.
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6.	Yin L, Chen CQ, Peng CH, et al. Primary small-bowel non-Hodgkin′s lymphoma: a study of clinical features, pathology, management and prognosis[J]. J Int Med Res, 2007, 35(3): 406-415.
7.	Peter K, Francisco del Valle, Wolfgang E, et al. Primary gastrointestinal non-Hodgkin′s lymphoma: Ⅰ. anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German multicenter study GIT NHL 01/92[J]. J Clin Oncol, 2001, 19(18): 3861-3873.
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9.	Jamhbuklar MI, Joshi MA, Balsarkar D, et al. Perforation of jejunal on-Hodgkin′s lymphoma[J]. India J Gastroneterol, 2004, 23(3): 110-111.
10.	Kim HS, Lee DK, Bail SK, et al. Primary CD56+T/NK cell lymphoma of the colon[J]. J Gastroenterol, 2002, 37(11): 939-946.
11.	Ara C, Coban S, Kayaalp C, et al. Spontaneous intestinal perforation due to non-Hodgkin′s lymphoma: evaluation of eight cases[J]. Dig Dis Sci, 2007, 52(8): 1752-1756.
12.	Musshoff K, Schmidt-follmer H. Prognosis of non-Hodgkin′s lymphoma with special emphasis on the staging classification[J]. Z Krebsforsch Klin Onkol Cancer Res Clin Oncol, 1975, 83(4): 323-340.
13.	Daum S, Ullrich R, Heise W, et al. Intestinal non-Hodgkin′s lymphoma: a multicenter prospective clinical study from the German Study Group on lntestinal non-Hodgkin′s lymphoma[J]. J Clin Oncol, 2003, 21(14): 2740-2746.
14.	Ibrahim EM, Ezzat AA, EI-Weshi AN, et al. Primary intestinal diffuse large B-cell non-Hodgkin′s lymphoma: clinical features, management, and prognosis of 66 patients[J]. Ann Oncol, 2001, 12(1): 53-58.
15.	Aydin I, Baskent A, Celik G, et al. A case of primary intestinal lymphoma associtated with intestinal perforation[J]. Ulus Travma Derg, 2001, 7(1): 74-76.
16.	Yokota T, Yamada Y, Murakami Y, et al. Abdominal crisis caused by perforation of ileal lymphoma[J]. Am J Emerg Med, 2002, 20(2): 136-137.
17.	Hata S, Pietsch J, Shanka S. Intestinal complications in children undergoing chemotherapy for mediastinal non-Hodgkin′s lymphoma[J]. Pediatr Hematol Oncol, 2004, 21(8): 707-710.
18.	Meyers PA, Potter VP, Wollner N, et al. Bowel perforation during initial treatment for childhood non-Hodgkin′s lymphoma[J]. Cancer, 1985, 56(2): 259-261.
19.	Nakamura S, Matsumoto T, Takeshita M, et al. A clinicopathologic study of primary small intestine lymphoma: prognostic significance of mucosa-associated lymphoid tissue-derived lymphoma[J]. Cancer, 2000, 88(2): 286-294.
20.	Amer MH, el-Akkad S. Gastrointestinal lymphoma in adults: clinical features and management of 300 cases[J]. Gastroenterology, 1994, 106(4): 846-858.

1. 　d′Amore F, Brincker H, Gronbaek K, et al. Non-Hodgkin′s lymphoma of the gastrointestinal tract: a population-based analysis of incidence, geographic distribution, clinicopathogic presentation features, and prognosis. Danish lymphoma Study Group[J]. J Clin Oncol 1994, 12(8): 1673-1684.
2. 　Otter R, Bieger R, Kluin PM, et al. Primary gastrointestinal non-Hodgkin′s lymphoma in a population-based registry[J]. Br J Cancer, 1989, 60(5): 745-755.
3. 　Domizio P, Owen R, Shepherd N, et al. Primary lymphoma of the small intestine: a clinicopathological study of 119 cases[J]. AM J Surg Pathol, 1993, 17(5): 429-442.
4. 　Amromin GD, Solomon RD. Necrotizing enteropaty: a complication of treated leukemia or lymphoma patients[J]. JAMA, 1962, 182(1): 23-29.
5. 　Daum S, Ullrich R, Heise W, et al. Intestinal non-Hodgkin′s lymphoma: a multicenter prospective clinical study from the german study group on intestinal non-Hodgkin′s lymphoma[J]. J ClinOncol, 2003, 21(14): 2740-2746.
6. 　Yin L, Chen CQ, Peng CH, et al. Primary small-bowel non-Hodgkin′s lymphoma: a study of clinical features, pathology, management and prognosis[J]. J Int Med Res, 2007, 35(3): 406-415.
7. 　Peter K, Francisco del Valle, Wolfgang E, et al. Primary gastrointestinal non-Hodgkin′s lymphoma: Ⅰ. anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German multicenter study GIT NHL 01/92[J]. J Clin Oncol, 2001, 19(18): 3861-3873.
8. 　Freeman HJ. Free perforation due to intestinal lymphoma in biopsy-defined or suspected celiac disease[J]. J Clin Gastroenterol, 2003, 37(4): 299-302.
9. 　Jamhbuklar MI, Joshi MA, Balsarkar D, et al. Perforation of jejunal on-Hodgkin′s lymphoma[J]. India J Gastroneterol, 2004, 23(3): 110-111.
10. 　Kim HS, Lee DK, Bail SK, et al. Primary CD56+T/NK cell lymphoma of the colon[J]. J Gastroenterol, 2002, 37(11): 939-946.
11. 　Ara C, Coban S, Kayaalp C, et al. Spontaneous intestinal perforation due to non-Hodgkin′s lymphoma: evaluation of eight cases[J]. Dig Dis Sci, 2007, 52(8): 1752-1756.
12. 　Musshoff K, Schmidt-follmer H. Prognosis of non-Hodgkin′s lymphoma with special emphasis on the staging classification[J]. Z Krebsforsch Klin Onkol Cancer Res Clin Oncol, 1975, 83(4): 323-340.
13. 　Daum S, Ullrich R, Heise W, et al. Intestinal non-Hodgkin′s lymphoma: a multicenter prospective clinical study from the German Study Group on lntestinal non-Hodgkin′s lymphoma[J]. J Clin Oncol, 2003, 21(14): 2740-2746.
14. 　Ibrahim EM, Ezzat AA, EI-Weshi AN, et al. Primary intestinal diffuse large B-cell non-Hodgkin′s lymphoma: clinical features, management, and prognosis of 66 patients[J]. Ann Oncol, 2001, 12(1): 53-58.
15. 　Aydin I, Baskent A, Celik G, et al. A case of primary intestinal lymphoma associtated with intestinal perforation[J]. Ulus Travma Derg, 2001, 7(1): 74-76.
16. 　Yokota T, Yamada Y, Murakami Y, et al. Abdominal crisis caused by perforation of ileal lymphoma[J]. Am J Emerg Med, 2002, 20(2): 136-137.
17. 　Hata S, Pietsch J, Shanka S. Intestinal complications in children undergoing chemotherapy for mediastinal non-Hodgkin′s lymphoma[J]. Pediatr Hematol Oncol, 2004, 21(8): 707-710.
18. 　Meyers PA, Potter VP, Wollner N, et al. Bowel perforation during initial treatment for childhood non-Hodgkin′s lymphoma[J]. Cancer, 1985, 56(2): 259-261.
19. 　Nakamura S, Matsumoto T, Takeshita M, et al. A clinicopathologic study of primary small intestine lymphoma: prognostic significance of mucosa-associated lymphoid tissue-derived lymphoma[J]. Cancer, 2000, 88(2): 286-294.
20. 　Amer MH, el-Akkad S. Gastrointestinal lymphoma in adults: clinical features and management of 300 cases[J]. Gastroenterology, 1994, 106(4): 846-858.

West China Medical Journal

Prognosis of Primary Intestinal non-Hodgkin′s Lymphoma Perforation

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