A clinicopathologic study of primary small intestine lymphoma - Prognosticsignificance of mucosa-associated lymphoid tissue-derived lymphoma

BACKGROUND. It remains unclear whether the presence of mucosa-associated ly mphoid tissue (MALT) lymphoma has prognostic implications for patients with primary small intestine lymphoma. METHODS. The clinicopathologic features of 80 patients with primary small i ntestine lymphoma were examined retrospectively in relation to the presence of MALT lymphoma. Survival was compared univariately and multivariately am ong the groups divided by clinicopathologic findings. RESULTS. Twenty-one cases (26%) were diagnosed as low grade E-cell lymphoma (15 marginal zone B-cell lymphoma of MALT type, 2 mantle cell lymphoma, an d 4 follicle center lymphoma), 46 cases (58%) were diagnosed as high grade B-cell lymphoma (19 secondary large cell lymphoma with a low grade MALT com ponent, 17 diffuse large cell lymphoma without MALT features, 7 Burkitt lym phoma, and 3 lymphoblastic lymphoma), and 13 cases (16%) were diagnosed as T-cell lymphoma. a significantly better survival was noted for patients wit hout colorectal and/or gastric involvement, diffuse infiltration under manr oscopy, high grade histology, and perforation. Those patients with MALT typ e tumors, less advanced stage of disease, B-cell phenotype, benign lymphoid ; follicular hyperplasia, and radical tumor resectability appeared to have a better survival rate. Based on Cox multivariate analysis, early stage dis ease-and MALT-derived tumors were determined to he independent prognostic f actors (P < 0.05). CONCLUSIONS. The presence of MALT-derived lymphoma appears to have a favora ble prognosis among patients with primary small intestinal lymphoma, (C) 20 00 American Cancer Society.