Malignant lymphoma of the gastrointestinal tract and mesentery. A clinico-pathologic study of the significance of histologic classification. NHL Study Group of the Comprehensive Cancer Center West.
A series of 92 malignant lymphomas of the gastrointestinal tract and mesentery obtained from a population-based registry was studied to assess whether the newly defined concept of mucosa-associated lymphoma has clinical relevance. The cases were grouped according to localization; gastric, intestinal, and mesenteric lymphoma. All cases were reviewed histologically, graded according to the Working Formulation, and reclassified according to the Kiel classification, which was modified to include the categories low- and high-grade mucosa-associated lymphoma. Clinical data, as well as staging and follow-up data, were related to both the original diagnosis and the diagnosis after reclassification. The results showed that the distribution of the types of lymphoma is related to site: centroblastic lymphoma was predominant in the stomach, lymphoblastic in the bowel, and follicular centroblastic-centrocytic in the mesentery. Gastrointestinal lymphoma was disseminated in approximately 50% of the patients at presentation. Survival analysis revealed that classification according to the original Kiel classification and grading according to the Working Formulation provided important prognostic information, whereas introduction of mucosa-associated lymphoma as an entity did not. It was concluded that modification of current classifications to include a separate category for mucosa-associated lymphoma is not useful.
Department of Pathology, University Hospital Leiden, The Netherlands.
J H
JH
van Krieken
R
R
Otter
J
J
Hermans
K
K
van Groningen
P J
PJ
Spaander
M M
MM
van de Sandt
J F
JF
Keuning
P M
PM
Kluin
D005770:Gastrointestinal Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008223:Lymphoma / Q000145:classification / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology*