Primary gastric T-cell lymphomas: Report of two cases and a review of the literature

To understand more fully the clinicopathological features of primary gastri c T-cell lymphomas (PGTL), we report two cases of PGTL and review the liter ature. The present cases were not associated with human T-cell leukemia vir us type 1 (HTLV-1) and were at clinical stage IIE. In both cases, T-cell or igin of the lymphoma cells was diagnosed immunohistochemically. The clinica l courses of these two cases were different: one followed a very aggressive clinical course and the patient died 6 months after the diagnosis, whereas the other patient survived more than 2 years without adjuvant chemotherapy . Clinicopathological features of 23 patients with PGTL are summarized with regard to their differences from primary small intestinal T-cell lymphomas (PSITL) and by association with HTLV-1. The median age at onset of PGTL wa s 58 years. The gender ratio was male-dominant (M:F = 2.3:1), About two-thi rds (10 of 17) of PGTL cases had evidence of HTLV-1 infection. The most com mon presenting symptom for PGTL was upper abdominal discomfort and/or pain (76%), whereas that in PSITL was weight loss (61%) and diarrhea (42%). Typi cal lesions for PGTL were large ulcerations at the corpus to antrum. Neopla stic cells had no typical morphological characteristics for PGTL including HTLV-l-associated cases. CD3+4+8- was the most frequently observed surface phenotype of PGTL cells, Laboratory findings at diagnosis were not informat ive. Most patients were treated by gastrectomy with or without chemotherapy . PGTL, excluding that with HTLV-1, showed better prognosis than PSITL, alt hough PGTL with HTLV-1 had a poorer prognosis.