Korean J Gastroenterol.
2002 Jul;40(1):32-40.
Clinical Features and Prognostic Factors of Primary Intestinal Lymphoma According to the Cell Lineage
- Affiliations
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- 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. jooskim@snu.ac.kr
- 2Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Abstract
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BACKGROUND/AIMS: The majority of primary intestinal lymphoma is derived from the B-cell lineage of non-Hodgkins lymphoma. Although primary intestinal T-cell lymphoma rarely occurs, it shows aggressive clinical course and high mortality rate. The aim of this study was to analyze clinical features and prognostic factors of primary intestinal lymphoma according to the cell lineage.
METHODS
All 58 patients with primary intestinal lymphoma were enrolled from January 1990 to March 2000. The clinical characteristics, endoscopic findings, and survival rates were analyzed retrospectively. Then, prognostic factors affecting survival rates were investigated through univariate and multivariate analysis.
RESULTS
Of 58 patients, 43 were B-cell lymphoma and 15 were T-cell lymphoma. The most common clinical symptom was abdominal pain. While fever, perforation, and hemorrhage developed significantly in T-cell lymphoma, intussusception developed only in B-cell lymphoma. The most common endoscopic finding was a single polypoid mass in B-cell lymphoma and multiple ulcers in T-cell lymphoma. The five-year survival rate of B-cell lineage (48%) were significantly higher than that of T-cell lineage (13%). In univariate analysis, performance status, fever, curative resection, and complete remission were statistically significant in both cell lineages. Multivariate analysis revealed that fever was the most significant prognostic factor.
CONCLUSIONS
Intestinal T-cell lymphoma should be suspected in patients with multiple intestinal ulcers accompanied with fever and bleeding. Early treatment is recommended for the primary intestinal lymphoma with fever because of its poor prognosis.
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