Anatomic distribution and histologic subtypes of primary gastrointestinal lymphomas: A retrospective analysis of 152 cases

Background: Gastrointestinal (GI) lymphomas are a heterogeneous group of neoplasms. Studies have demonstrated a wide variation in the sites of involvement and histologic subtypes, which are independent prognostic factors. Hence, it is important to study the frequency and distribution pattern of GI lymphoma in a particular region. Aim: The aim of this study was to study all cases of primary GI lymphomas presented to our center for 5 years with reference to the pattern of distribution and histologic subtypes and compare our data with the literature. Materials and Methods: In this retrospective study, all cases of primary GI lymphomas over a period of 5 years from 2010 to 2014 were analyzed. Results: There were 152 cases of primary GI lymphomas. Age ranged from 3 years to 83 years. There were 133 adult patients and 19 pediatric patients. Most common site of involvement was small intestine followed by stomach, large intestine, and esophagus. Most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), followed by Burkitt lymphoma, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma, follicular lymphoma, mantle cell lymphoma, B-cell lymphoma unclassifiable with features intermediate between DLBCL and Burkitt lymphoma, and plasmablastic lymphoma. There were five cases of T-cell non-Hodgkin lymphoma which included adult T-cell leukemia/lymphoma, anaplastic large-cell lymphoma, enteropathy-associated T-cell lymphoma, and T-lymphoblastic lymphoma. One case of Hodgkin lymphoma with predominant involvement of the large intestine and without any peripheral node involvement was also encountered. Conclusion: In our series, the most common site of involvement was the small intestine. This is in contrast to majority of studies where the most common site is the stomach. Similar to the other studies, DLBCL was the most common histologic subtype. Compared to other studies, there were more number of Burkitt lymphoma and lesser number of MALT lymphoma in our series.