A HISTOMORPHOLOGICAL STUDY OF GASTRO-INTESTINAL LYMPHOMAS - AN ANALYSIS OF 47 CASES

BACKGROUND AND OBJECTIVES - The Gastro-intestinal tract forms the commonest site of extra nodal lymphoma and is the second most common extra nodal lymphoma in AIDS patients. This study analyses the clinical and pathological findings of 47 patients diagnosed with gastrointestinal lymphomas, in our hospital, a tertiary care centre in South India. MATERIALS AND METHODS - The clinical and histopathological materials of 47 patients diagnosed with gastrointestinal lymphomas from January 2008 to July 2012 were considered for study. The pathologic findings including immunohistochemical profile were analyzed. RESULTS - Of 47 cases, all were primary lymphomas with 57.45 percent occurring in males and 42.55 percent in females. Male female ratio is 1.35 is to 1. The mean age was 40.15 yrs. The most common site of involvement was stomach (18 cases) followed by small intestine (12 cases) and large intestine (10 cases).The commonest gross presentation was nodular lesion. Using Working classification for clinical usage, the grading of lymphomas was done and included 7 low grade, 31 intermediate grade and 9 high grade lymphomas. B cell lymphomas constituted 94.3 percent cases (33 cases) while T cell lymphomas constituted 5.7 percent cases (2 cases), after exclusion of 12 cases in which IHC markers were not done. Histologically, all were diffuse lymphomas with features of MALT lymphomas seen in 5 cases, Diffuse Large B Cell Lymphomas (DLBCL) in 9 cases and Immunoproliferative small intestinal disease (IPSID) in 3 cases. As a comprehensive Immunohistochemical panel was not available, further typing of l ymp ho mas including rar er t yp es was n ot possible.CONCLUSION - The study highlights the increasing incidence of lymphomas with various types of gross presentation. The results parallel those of Western literature with B cell lymphomas especially DLBCL being the commonest. Cases of Immunoproliferative small intestinal disease which are reported in certain geographically restricted locations are also seen in our study. A definitive diagnosis rests on combined histologic, immunohistochemical and molecular studies.