Malignant intestinal non-Hodgkin's lymphoma from the surgical point of view.
BACKGROUND
Primary intestinal non-Hodgkin's lymphoma (I-NHL) is much less frequent than gastric lymphoma and has hardly been studied in prospective trails. To the surgeon, patients frequently present with abdominal emergencies.


METHODS
A consecutive series of patients subjected to surgery because of I-NHL between 1998 and 1999 was evaluated retrospectively for characteristic clinical, radiographic and intraoperative findings. Patients with gastric lymphoma were not considered.


RESULTS
10 patients, 8 males and 2 females, with I-NHL were subjected to first-line surgery because of painful abdominal tumor, intestinal hemorrhage, obstruction or perforation. I-NHL was located most often in the small bowel (n = 7). It was rare in the colon (n = 2) and the duodenum (n = 1). Median postoperative follow-up was 28 months. Perioperative mortality was 10% (n = 1). Probability of survival 3 years after surgery was 60%.


CONCLUSIONS
Patients with I-NHL frequently present with complications of tumor growth, requiring urgent surgical treatment. Irrespective of surgical complications we advocate surgery in cases of resectable disease as first-line treatment. Adjuvant treatment is indicated with respect to resection status and histopathological staging.
Department of Surgery, University Hospital Mannheim, University of Heidelberg, Germany. stephan.samel@chir.ma.uni-heidelberg.de
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Samel
J
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Wagner
R
R
Hofheinz
J
J
Sturm
S
S
Post
D000328:Adult; D000368:Aged; D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007414:Intestinal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007422:Intestines / Q000473:pathology / Q000601:surgery; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate