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Lymphoproliferative Diseases of the Gastrointestinal Tract

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Immunology for Surgeons

Abstract

Lymphoproliferative disorders of the gastrointestinal tract represent a diverse group of diseases, including many types of non-Hodgkin’s lymphomas. The recognition of specific gastrointestinal lymphoproliferative disorders as discrete entities in newer non-Hodgkin’s lymphoma classification schemes has improved diagnostic accuracy and has led to advances in therapy. The surgeon still has a role to play in the staging and diagnosis of lymphoma and in the management of acute complications related to gastrointestinal lymphoma in particular. The latter conditions are frequently secondary to chronic immunosuppression in high-risk patients.

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References

  1. National Cancer Institute. Summary and description of a working formulation for clinical usage. The non-Hodgkin’s lymphoma pathologic classification project. Cancer 1982;49:2112–35.

    Article  Google Scholar 

  2. Lennert K. The Kiel Classification, in Histopathology of Non-Hodgkin’s Lymphomas [based on the updated Kiel Classification], edited by K Lennert, AC Feller: Springer, New York, 1992.

    Google Scholar 

  3. Harris NL, Jaffe ES, Stern H, et al. A Revised European-American Classification of Lymphoid Neoplasms: A Proposal from the International Lymphoma Study Group. Blood. 1994;84:1361–92.

    CAS  PubMed  Google Scholar 

  4. Jaffe ES, Harris NL, Diebold J, et al. World Health Organization Classification of Neoplastic Diseases of the Hematopoietic and Lymphoid Tissues: Report of the Clinical Advisory Committee Meeting — Airlie House, Virginia, November 1997. J Clin Oncol 1999;17:3835–49.

    PubMed  Google Scholar 

  5. Harris NL, Jaffe ES, Diebold J, et al. Lymphoma Classification-from Controversy to Consensus: the R.E.A.L. and WHO Classification of Lymphoid Neoplasms. Ann Oncol 2000;11 Suppl 1:S3–S10.

    Article  Google Scholar 

  6. AF List, Greer JP, Cousar JC, et al. non-Hodgkin’s lymphoma of the gastrointestinal tract: an analysis of clinical and pathologic features affecting outcome. J Clin Oncol 6:1125–33.

    Google Scholar 

  7. Devaney K, Jaffe ES. The surgical pathology of gastrointestinal Hodgkin’s disease. Am J Clin Pathol 1991;95:794–801.

    CAS  PubMed  Google Scholar 

  8. de Jong D, Aleman BM, Taal BG, Boot H. Controversies and consensus in the diagnosis, work-up and treatment of gastric lymphoma: an international survey. Ann Oncol 1999;10:275–80.

    Article  PubMed  Google Scholar 

  9. Pavlick AC, Gerdes H, Portlock, CS. Endoscopic ultrasound in the Evaluation of Gastric Small Lymphocytic Mucosa Associated Lymphoid Tumors. J Clin Oncol 1997;15:1761–6.

    CAS  PubMed  Google Scholar 

  10. Kessar P, Norton A, Rohatiner AZ et al. CT appearances of mucosa-associated lymphoid tissues [MALT] lymphoma. Eur Radiol 1999;9:693–6.

    Article  CAS  PubMed  Google Scholar 

  11. Zinzani PL, Magagnoli M, Chierichetti F, et al. The Role of Positron Emission Tomography [PET] in the Management of Lymphoma Patients. Ann Oncol 1999;10:1181–4.

    Article  CAS  PubMed  Google Scholar 

  12. Jerusalem G, Beguin Y, Fassotte MF, et al. Whole-Body Positron Emission Tomography using 18F-Fluorodeoxyglucose for Post-treatment Evaluation of Hodgkin’s Disease and Non-Hodgkin’s Lymphoma has Higher Diagnostic and Prognostic Value than Classical Computed Tomography Scan Imaging. Blood 1999;94:429–33.

    CAS  PubMed  Google Scholar 

  13. Hoffman M, Kletter K, Diemling M, et al. Positron emission tomography with fluorine-18-2-fluoro-2-deoxy-D-glucose [F18-FDG] does not visualize extranodal B-celllymphoma of the mucosa-associated lymphoid tissue [MALT]-type. Ann Oncol 1999;10:1185–9.

    Article  Google Scholar 

  14. Smithers DW. Summary of papers delivered at the Conference on Staging in Hodgkin’s disease. Cancer Res 1971;31:1869–70.

    CAS  PubMed  Google Scholar 

  15. Rosenberg SA. Validity of the Ann Arbor Staging Classification for the non-Hodgkin’S lymphomas. Cancer Treat Rep 1977;61:1023–7.

    CAS  PubMed  Google Scholar 

  16. Musshoff K. Clinical Staging Classification of non-Hodgkin’s lymphomas. Strahlentherapie 1977;153:218–21.

    CAS  PubMed  Google Scholar 

  17. Rohatiner A, D’Amore F, Coiffier B, et al. Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma. Ann Oncol 1994;5:397–400.

    Article  CAS  PubMed  Google Scholar 

  18. 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, clinicopathologic presentation features, and prognosis. Danish lymphoma Study Group. J Clin Oncol 1994;12:1673–84.

    CAS  Google Scholar 

  19. Zucca E, Bertoni F, Roggero E et al. The Gastric Marginal Zone B-cell Lymphoma of MALT Type. Blood 2000;96:410–19.

    CAS  PubMed  Google Scholar 

  20. Thieblemont C, Bastion Y, Berger F, et al. Mucosa-associated lymphoid tissue gastrointestinal and non-gastrointestinal lymphoma behavior: analysis of 108 patients. J Clin Oncol 1997;15:1624–30.

    CAS  PubMed  Google Scholar 

  21. Nathwani BN, Anderson JR, Armitage JO, et al. Marginal Zone B-Cell Lymphoma: A Clinical Comparison of Nodal and Mucosa-Associated Lymphoid Tissue Types. Non-Hodgkin’s Lymphoma Classification Project. J Clin Oncol 1999;17:2486–92.

    CAS  PubMed  Google Scholar 

  22. Isaacson PG. Gastric MALT lymphoma: From concept to cure. Ann Oncol 1999;10:37–645

    Article  Google Scholar 

  23. Parsonnet J, Hansen S, Rodriguez L, et al. Helicobacter pylori infection and gastric lymphomas. N Engl J Med 1994;330:1267–71.

    Article  CAS  PubMed  Google Scholar 

  24. Doglioni C, Wotherspoon AC, Moschini A, et al. High incidence of primary gastric lymphoma in northeastern Italy. Lancet 1992;339:834–5.

    Article  CAS  PubMed  Google Scholar 

  25. Hussell T, Isaacson PG, Crabtree JE, et al. The response of cells from low-grade B-cell gastric lymphomas if mucosa-associated lymphoid tissue to Helicobacter pylori. Lancet 1993;342:571–4.

    Article  CAS  PubMed  Google Scholar 

  26. Hussell T, Isaacson PG, Crabtree JE, Spencer J. Helicobacter pylori-specific tumor-infiltrating T cells provide contact dependent help for the growth for malignant B cells in low-grade gastric lymphoma of mucosa-associated lymphoid tissue. J Pathol 1996;178:122–7.

    Article  CAS  PubMed  Google Scholar 

  27. Zucca E, Bertoni F, Roggero E, et al. Molecular analysis of the progression from Helicobacter pylori-associated chronic gastritis to mucosa-associated lymphoid tissue lymphoma of the stomach. New Engl J Med 1995;338:804–10.

    Article  Google Scholar 

  28. Dierlamm J, Baens M, Wlodarska I, et al. The apoptosis inhibitor gene API2 and a novel18q gene, MLT, are recurrently rearranged in the t[11;18][q21;q21] associated with mucosa-associated lymphoid tissue lymphomas. Blood 1999;93:3601–9.

    CAS  PubMed  Google Scholar 

  29. Akagi T, Motegi M, Tamura A, et al. A novel gene, MALT1 at 18q21, is involved in t[11;18][q21;q21] found in low grade B-cell lymphoma of mucosa-associated lymphoid tissue. Oncogene 1999;18:5785–94.

    Article  CAS  PubMed  Google Scholar 

  30. Morgan JA, Yin Y, Borowsky AS, et al. Breakpoints of the t[11;18][q21;q21] in mucosa-associated lymphoid tissue [MALT] lymphoma lie within or near the previously undescribed gene MALT1 in chromosome 18. Cancer Res. 1999;59:6205–6213.

    CAS  PubMed  Google Scholar 

  31. Willis TG, Jayadel DM, Du MQ, et al. Bcl10 is involved in t[1;14][p22;q32] of MALT B ceillymphoma and mutated in multiple tumor types. Cell 1999;96:35–45.

    Article  CAS  PubMed  Google Scholar 

  32. Du MQ, Peng H, Liu H, et al. BCL10 gene mutation in lymphoma. Blood 2000;95:3885–90.

    CAS  PubMed  Google Scholar 

  33. Zhang Q, Siebert R, Yan M, et al. Inactivating mutations and overexpression of BCLIO, a caspase recruitment domain-containing gene, in MALT lymphomas with t[1;14][p22;q32]. Nat Genet 1999;22:63–8.

    Article  CAS  PubMed  Google Scholar 

  34. Isaacson PG. Gastrointestinal Lymphomas of T-and B-cell Types. Mod Path 1999;12:151–8.

    CAS  Google Scholar 

  35. Drillenberg P, van der Voort R, Koopman G, et al. Preferential expression of the mucosal homing receptor integrin alpha-4 beta-7 in gastrointestinal non-Hodgkin’s lymphomas. Am J Pathol 1997;150:919–27.

    Google Scholar 

  36. Wotherspoon AC, Doglioni C, Diss TC, et al. Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue after eradication of helicobacter pylori. Lancet 1993;342:575–7.

    Article  CAS  PubMed  Google Scholar 

  37. Steinbach G, Ford R, Glober G, et al. Antibiotic treatment of gastric lymphoma of mucosa-associated lymphoid tissue: An Uncontrolled Trial. Ann Intern Med 1999;131:88–95.

    Article  CAS  PubMed  Google Scholar 

  38. Roggero E, Zucca E, Pinotti G, et al. Eradication of helicobacter pylori in primary low grade gastric lymphoma of mucosa associated lymphoid tissue. Ann Intern Med 1995;122:767–9.

    Article  CAS  PubMed  Google Scholar 

  39. Bayerdorffer E, Neubauer A, Rudolph B, et al. Regression of primary gastric lymphoma of mucosaassociated lymphoid tissue type after eradication of Helicobacter pylori. Malt Lymphoma Study Group. Lancet 1995;345:1591–4.

    Article  CAS  PubMed  Google Scholar 

  40. Koch P, Grothaus-Pinke B, Hiddemann W, et al. Primary lymphoma of the stomach: Three-year results of a prospective multicenter study. Ann Oncol 1997;8:S85–8.

    Article  Google Scholar 

  41. Schechter NR, Portlock CS, and Yahalom J. Treatment of mucosa-associated lymphoid tissue lymphoma of the stomach with radiation alone. J Clin Oncol 1998;16:1916–21.

    CAS  PubMed  Google Scholar 

  42. Chan JK, Ng CS, Isaacson PG. Relationship between high-grade lymphoma and low-grade B-cell mucosa-associated lymphoid tissue lymphoma. Am J Pathol 1990;136:1153–64.

    CAS  PubMed Central  PubMed  Google Scholar 

  43. Du M, Peng H, Singh N, et al. The accumulation of p53 abnormalities is associated with progression of mucosa-associated lymphoid tissue lymphoma. Blood 1995;86:4587.

    CAS  PubMed  Google Scholar 

  44. Barth TFE, Dohner H, Werner CA, et al. Characteristic Pattern of Chromosomal Gains and Losses in Primary large B-cell Lymphomas of the Gastrointestinal Tract. Blood 1998;91:4321–30.

    CAS  PubMed  Google Scholar 

  45. Fisher RI, Gaynor E, Dahlberg S, et al. Comparison of a Standard Regimen CHOP with three intensive chemotherapy regimens for advanced non-Hodgkin’s lymphoma. New Engl J Med 1993;328:1002–6.

    Article  CAS  PubMed  Google Scholar 

  46. Yahalom J, Varsos G, Fuks Z, et al. Adjuvant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy after radiation in stage I low-grade and intermediate-grade non-Hodgkin’s lymphoma. Cancer 1992;71:2342–50.

    Article  Google Scholar 

  47. Miller TP, Dahlberg S, Cassady JR, et al. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate-and high-grade non-Hodgkin’s lymphoma. N Engl J Med 1998;339:21–6.

    Article  CAS  PubMed  Google Scholar 

  48. Shepard FA, Evans WK, Kutas G, et al. Chemotherapy following surgery for Stages IE and IIE Non-Hodgkin’s lymphoma of the Gastrointestinal Tract. J Clin Oncol 1988;6:253–60.

    Google Scholar 

  49. Romaguera J, Dang N, Hagemeister FB et al. Evidence for need of upper and lower endoscopies with biopsy in staging of asymptomatic patients with aggressive mantle cell lymphoma. Proc Am Soc Hemat 2000: Abst #1440.

    Google Scholar 

  50. Tsujimoto Y, Yunis J, Onorato-Showe L, et al. Molecular cloning of the chromosomal breakpoint of B-cell lymphomas and leukemias with the t(11;14) chromosome translocation. Science 1984;224:1403.

    Article  CAS  PubMed  Google Scholar 

  51. Tsujimoto Y, Jaffe E, Cossman J, et al. Clustering of breakpoints on chromosome 11 in human Bcell neoplasms with the t(11;14) chromosome translocation. Nature 1985;315:340.

    Article  CAS  PubMed  Google Scholar 

  52. Kadayifci A, Benekli M, Savas MC, et al. Multiple Lymphomatous Polyposis. J Surg Oncol 1997;64:336–40.

    Article  CAS  PubMed  Google Scholar 

  53. Breslin NP, Urbanski SJ, Shaffer EA. Mucosa-Associated lymphoid Tissue [MALT] Lymphoma manifesting as Multiple Lymphomatous polyposis of the Gastrointestinal Tract. Am J Gastr 1999;94:2540–5.

    Article  CAS  Google Scholar 

  54. Triozzi PL, Borowitz MJ, Gockerman JP. Gastrointestinal involvement and multiple lymphomatous polyposis in mantle-zone lymphoma J Clin Oncol 1986;4:866–73.

    CAS  PubMed  Google Scholar 

  55. Ruskone-Fourmestraux A, Delmer A, Lavergne A, et al. Multiple Lymphomatous polyposis of the Gastrointestinal Tract: Prospective Clinicopathologic Study of 31 Cases. Gastroenterology 1997;112:7–16.

    Article  CAS  PubMed  Google Scholar 

  56. Fine KD and Stone MJ. Alpha-heavy chain disease, Mediterranean lymphoma, and immunoproliferative small intestinal disease: A Review of Clinicopathological Features, Pathogenesis, and Differential Diagnosis. Am J Gastroenterol 1999;94:1139–52.

    CAS  PubMed  Google Scholar 

  57. Demirer T, Celebi H, Akcaglayan E, et al. Primary Low-Grade Lymphomas of the Intestine. J Clin Oncol 1999;17:3682–4.

    CAS  PubMed  Google Scholar 

  58. Akbulut J, Soykan I, Yakaryilmaz F, et al. Five year results of the treatment of 23 patients with immunoproliferative small intestinal disease: a Turkish experience. Cancer 1997;80:8–14.

    Article  CAS  PubMed  Google Scholar 

  59. Gale J, Simmonds PD, Mead GM, et al. Enteropathy-type intestinal T-cell lymphoma; clinical features and treatment of 31 patients in a single center. J Clin Oncol 2000;18:795–803.

    CAS  PubMed  Google Scholar 

  60. Wright DH. Enteropathy associated T cell lymphoma. Cancer Surv 1997;30:249–61.

    CAS  PubMed  Google Scholar 

  61. Cellier C, Delabesse E, Helmer C, et al. Refractory sprue, coeliac disease, and enteropathy-associated T-cell lymphoma. French Coeliac Disease Study Group. Lancet 2000;356:203–8.

    Article  CAS  PubMed  Google Scholar 

  62. Hecht JL and Aster JC. Molecular biology of Burkitt’s lymphoma. J Clin Oncol 2000;18:3707.

    CAS  PubMed  Google Scholar 

  63. McMaster ML, Greer JP, Greco FA, et al. Effective treatment of small-cleaved cell lymphoma with high intensity brief-duration chemotherapy. J Clin Oncol 1991;9:941–6.

    CAS  PubMed  Google Scholar 

  64. Magrath I, Adde M, Shad A, et al. Adults and children with small non-cleaved cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol 1996;14:925–36.

    CAS  PubMed  Google Scholar 

  65. Heise W, Arasteh K, Mosterz P, et al. Malignant gastrointestinal lymphomas in patients with AIDs. Digestion 1997;58:218–24.

    Article  CAS  PubMed  Google Scholar 

  66. Beck PL, Gill MJ, Sutherland LR. HIV-associated non-Hodgkin’s lymphoma of the gastrointestinal tract. Am J Gastroenterol 1996;91:2377–81.

    CAS  PubMed  Google Scholar 

  67. Hernandez JA, Navarro JT, Ribera JM, et al. Primary gastrointestinal lymphoma in patients infected with HIV: Study of 15 cases in a series of 76 patients with non-Hodgkin’s lymphoma and HIV infection. 1999 Med Clin [Barc] 1999;112:222–4.

    CAS  Google Scholar 

  68. Kumar S, Fend F, Quintanilla-Martinez L, et al. Epstein-Barr virus-positive primary gastrointestinal Hodgkin’s disease: association with inflammatory bowel disease and immunosuppression. Am J Surg Path 2000;24:66–73.

    Article  CAS  PubMed  Google Scholar 

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Authors
  1. Dorothy Pan
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  2. Carol S. Portlock
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  3. Martin S. Karpeh
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Editor information

Editors and Affiliations

  1. Kaplan Medical Center, PO Box 23273, King George PO Branch, 61231, Tel Aviv, Israel

    Andrew P. Zbar (Head of Colorectal Surgery,Senior Consultant Colorectal Surgeon) (Head of Colorectal Surgery,Senior Consultant Colorectal Surgeon)

  2. St James’s University Hospital, School of Medicine, Division of Surgery, University of Leeds, Clinical Sciences Building, Leeds, LS9 7TF, UK

    Pierre J. Guillou

  3. Department of Surgery, University of Alabama School of Medicine, Boshell Diabetes Building,1808 7th Avenue South, Birmingham, AL, 35233, USA

    Kirby I. Bland (Professor and Chairman Dept of Surgery) (Professor and Chairman Dept of Surgery)

  4. Oncology Unit 3rd Department Medicine, Athens Medical School Sotiria General Hospital, Athens, Greece

    Konstantinos N. Syrigos (Associate Professor of Medical Oncology, Head) (Associate Professor of Medical Oncology, Head)

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© 2002 Springer-Verlag London

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Pan, D., Portlock, C.S., Karpeh, M.S. (2002). Lymphoproliferative Diseases of the Gastrointestinal Tract. In: Zbar, A.P., Guillou, P.J., Bland, K.I., Syrigos, K.N. (eds) Immunology for Surgeons. Springer, London. https://doi.org/10.1007/978-1-4471-0201-4_26

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  • DOI: https://doi.org/10.1007/978-1-4471-0201-4_26

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-85233-482-6

  • Online ISBN: 978-1-4471-0201-4

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