Gastrointestinal lymphoma: prevention and treatment of early lesions.
Gastrointestinal lymphomas comprise a group of distinct clinicopathological entities. Differences in lifestyle and environmental factors between countries could account for the variety in the distribution of the main subtypes: low-grade B-cell lymphomas of the mucosa-associated lymphoid tissue type, alpha-chain disease and enteropathy (coeliac disease)-associated T-cell lymphoma (EATL). The possibility of preventing these lymphomas implies a knowledge of their natural history together with an identification of potential predisposing factors. The development of the lymphoid hyperplasia and subsequently low-grade lymphoma with the possibility of high-grade transformation is a multifactorial process involving both antigenic and host-related factors. The pathogenic role of Helicobacter pylori and gluten has been demonstrated in gastric lymphoma and enteropathy-associated T-cell lymphoma respectively, while environmental factors, especially non-specific bacterial ones, may play a major role in the pathogenesis of alpha-chain disease. The most difficult task in preventing these lymphomas is the recognition of early lesions likely to regress after the removal of the exogenous stimulus.
Ruskoné-Fourmestraux
A
A
Service de Gastroentérologie, Hôtel Dieu, 1, Place Parvis Notre Dame, Paris, cedex 04, 75181, France.
Rambaud
J C
JC
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000379:methods; D011230:Precancerous Conditions / Q000175:diagnosis*; D011379:Prognosis; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome