[Procedures for staging primary gastrointestinal lymphoma].
The non-Hodgkin's lymphomas (NHL) are usually generalized diseases and can involve almost any organ or tissue. Nevertheless also primary extranodal disease is frequent in NHL and some localizations are accomplished by a worse prognosis (brain, testicle) other, in particular primary gastrointestinal involvement, can be cured in a high percentage of cases with surgery, chemotherapy and radiotherapy. The gastrointestinal localization's symptomatology is not characteristic: abdominal pain is frequent and other symptoms can be present in other gastrointestinal diseases. Endoscopy, radiology and surgery are the most important diagnostic procedures. The first gives important information about the disease and it permits pre-operative diagnosis. The second is useful to detect both nodal extension (CT scan and MRI imaging) and intrinsic stomach or bowel involvement (contrast radiology of the gastrointestinal tract). The third is an important diagnostic and therapeutic moment. Some Authors recently don't agree with this invasive procedures routinely because of its potential morbidity and mortality. The determination of the extent of disease in patients with NHL is very important and serves multiple purposes: information regarding the imminence of potential complications, indication of prognosis and treatment planning. The most used staging system is the Ann Arbor scheme, originally designed for HG disease. This scheme is inadequate in particular for primary gastrointestinal NHL. Others, like Blackledge or Mushoff schemes show more correlation between tumor burden, nodal and extranodal involvement. An exact diagnosis, precise staging and a correct treatment bring to a potential curability.
Ospedale S. Carlo Borromeo, Milano.
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Tedeschi
D005770:Gastrointestinal Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008223:Lymphoma / Q000473:pathology* / Q000601:surgery; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging
Procedure dello staging nel linfoma gastrointestinale primario.