Copyright ©2011 Baishideng Publishing Group Co.
World J Gastroenterol. Feb 14, 2011; 17(6): 697-707
Published online Feb 14, 2011. doi: 10.3748/wjg.v17.i6.697
Table 1 Expression of common markers and translocations in histological subtypes of gastrointestinal lymphomas
TypeCD5CD10CD19CD20CD22CD23CD43CD79aCD3CD7CD4CD8CD30CD15CD45ROAdditional features
Diffuse large B-cell lymphoma-(+)-(+)+++--+-----(+)--(+)Bcl-6+(-), Bcl-2+(-), t (14;18), t (3;14), t (8;14)
MALT lymphoma--+++--(+)+-------(+)t (11;18), t (14;18), t (1;14), t (3;14)
Follicular lymphoma-+(-)+++-(+)-+-----(+)--Bcl-2+, Bcl-6+, t (14;18)
Burkitt lymphoma-++++-(+)++-------C-myc, t (8;14)
Mantle cell lymphoma+-+++-++-------Cyclin D1+, t (11;14)
Peripheral T-cell lymphoma-unspecified+(-)-(+)----+(-)-+(-)-(+)+(-)-(+)-(+)-(+)-(+)-
Extranodal NK/T cell lymphoma-(+)-----+--(+)+(-)-(+)--(+)-(+)-EBV+, gains of 2q, 15q, 17q, 22q, losses of 6q, 8p, 11q, 12q, 13q
EATL------+/--++-(+)+(-)+(-)-+(-)TIA1+, gains of 1q, 5q, 7q, 9q, losses of 8p, 9p, 13q
Hodgkin disease+(-)---(+)----(+)+(-)-(+)--+(-)+(-)-(+)Variable
Table 2 Characteristic features of gastrointestinal lymphomas
RegionAge (yr)GIL (%)SexPredilection siteEtiological/risk factorsPresenting symptomsCommon pathological subtypesRadiographic features
Oropharyngeal> 50-M > FTonsil, nasopharynx1, base of tongueEBVDysphagia, dyspnea, painless mass, ulcer, oral/hearing pain, B symptoms rareDLBCL, EMZL/MALT, PTCL, FL, MCL, ENKL, HDLobular mass, ulcers
EsophagusVariable< 1-Mid and lower thirdEBV, HIVDysphagia, odynophagia, weight loss, epigastric/chest pain, pneumonia, bleeding rare, B symptoms rareDLBCL, MALT lymphoma, HD, MCL, T-cell lymphomaStricture, ulcerated mass, submucosal nodules, varicoid-like, achalasia-like, aneurysmal, fistula formation
Stomach> 5060-75M > FAntrumH. pylori (MALT lymphoma), HTLV-1, HBV (DLBCL), EBV, HCVEpigastric pain, dysphagia, nausea, vomiting, weight loss, abdominal mass, gastrointestinal bleeding, obstruction, perforation, B symptoms rareDLBCL, MALT, PTCLUlcers, polypoid mass, thickened fold, mucosal nodularity, linitis plastica-like
Small intestineVariable20-30Usually, M > FIleum, jejunum, duodenum, multiple sitesCeliac disease (EATL), C. jejuni (IPSID), EBV, HIV/AIDSAbdominal pain, nausea, vomiting, weight loss, GI bleeding, obstructive symptoms, intussusceptions, perforation, diarrhea (in IPSID), B symptoms rareDLBLCL, MALT, EATL, MCL, Burkitt lymphoma, FL, IPSID, PTCL, ENKLPolypoid mass, multiple nodules, infiltrative form, ulcer, excavation, fistulization, extraluminal mass, mucosal thickening, strictures
Colon/rectum50-706-12M > FCaecum, ascending colon, rectumCeliac disease (EATL), EBV, H. pylori (MALT lymphoma)Abdominal pain, weight loss, abdominal mass, lower GI bleeding, obstruction, perforationDLBCL, MALT, EATL, MCL, PTCL, Burkitt lymphomaPolypoid mass, ulcers, mucosal nodularity, cavitary mass, mucosal thickening, strictures, aneurysmal
Table 3 Paris staging system for primary gastrointestinal lymphomas
StageGastrointestinal lymphomas
TXLymphoma extent not specified
T0No evidence of lymphoma
T1Lymphoma confined to the mucosa/submucosa
T1mLymphoma confined to mucosa
T1smLymphoma confined to submucosa
T2Lymphoma infiltrates muscularis propria or subserosa
T3Lymphoma penetrates serosa (visceral peritoneum) without invasion of adjacent structures
T4Lymphoma invades adjacent structures or organs
NXInvolvement of lymph nodes not assessed
N0No evidence of lymph node involvement
N1Involvement of regional lymph nodes
N2Involvement of intra-abdominal lymph nodes beyond the regional area
N3Spread to extra-abdominal lymph nodes
MXDissemination of lymphoma not assessed
M0No evidence of extranodal dissemination
M1Non-continuous involvement of separate site in gastrointestinal tract (e.g. stomach and rectum)
M2Non-continuous involvement of other tissues (e.g. peritoneum, pleura) or organs (e.g. tonsils, parotid gland, ocular, adnexa, lung, liver, spleen, kidney, breast, etc.)
BXInvolvement of bone marrow not assessed
B0No evidence of bone marrow involvement
B1Lymphomatous infiltration of bone marrow
TNMClinical staging: status of tumor, node, metastasis, bone marrow
pTNMBHistopathological staging: status of tumor, node metastasis, bone marrow
pNThe histological examination will ordinarily include six or more lymph nodes
Table 4 International prognostic index
Adverse risk factors
Age > 60 yr
≥ 2 extranodal sites
Ann arbor stage III-IV
Performance status ≥ 2 (ECOG)
High lactate dehydrogenase
Low (n = 0-1)
Low-intermediate (n = 2)
High-intermediate (n = 3)
High (n = 4-5)