Lymphoma Flashcards
4 criteria for primary GI lymphoma
no peripheral or mediastinal LNs
normal WBC/diff
primary tumor in GI tract
No liver/spleen mets
most common locations for GI lymphoma
Stomach (75%)
Small bowel 9%
rectal 2%
most common location in SB for GI lymphoma
ileum (has more lymphatic tissue)
predisposing conditions for GI lymphoma
Autoimmune/Immunodeficiency
Crohn’s
Prior radiation
Endemic Middle Eastern Condition predisposing to GI lymphoma
immunoproliferative small intestinal disease (IPSID)
What is happening to incidence of GI lymphoma in the US?
increasing secondary to autoimmune disease (AIDS) and immunosuppresive drugs.
GI Lymphomas arise from:
lymphoid aggregates in the submucosa
Presentation of GI lymphoma
Similar to any other SB tumor
- pain
- bleeding
- intussusception
- typically bulky (>5cm) often on sarcoma differential
Classification systems for GI lymphoma
REAL/WHO (Revised Euro/American)
Most common GI lymphoma subtypes
mucosa associated lymphoid tissue (MALT 40%)
Diffuse Large B cell (40%)
Endoscopic staging of MALT lymphoma
Requires systematic blind biopsies
Genetic test that predicts sensitivity of MALT lymphoma to H pylori eradication?
(FISH) or polymerase chain reaction (PCR) testing for t(11;18)
Lugano staging of GI lymphoma
Stage I - tumor is confined to the gastrointestinal tract.
Stage II - The tumor extends into the abdomen. :
• Stage II1: mesenteric nodes
• Stage II2: distant abdominal nodes
• Stage IIE: locally invasive tumor (thru serosa_
Stage III - There is no stage III disease in this system.
Stage IV - There is disseminated extranodal or supra-diaphragmatic nodal involvement.
Genetic test that predicts poor sensitivity of MALT lymphoma to H pylori eradication?
(FISH) or polymerase chain reaction (PCR) testing for t(11;18)
First line treatment for MALT lymphoma
H pylori eradication alone, followed by radiologic and endoscopic surveillance.
