Review
Copyright ©The Author(s) 2015.
World J Gastrointest Endosc. Aug 10, 2015; 7(10): 928-949
Published online Aug 10, 2015. doi: 10.4253/wjge.v7.i10.928
Table 1 Endoscopic features of rare gastrointestinal lymphomas according to two classification systems
Ref.Wang et al[18]Myung et al [17]
No. of patients1332
Endoscopic patternMucosal - ulcerative30.7%Fungating39%
Mucosal - erosive15.3%Ulcerative6%
Polypoid23%Infiltrative14%
Massive31%Ulcerofungating31%
Ulceroinfiltrative11%
Table 2 Table listing gastro-intestinal lymphoma with main gastro-intestinal organ involvement, typical presenting characteristics, typical immunophenotype and genotype and prognosis
Lymphoma histotypePresenting characteristicsMain GI involvementMain endoscopic patternTypical immunophenotypeTypical genotypePrognosis
T and NK lymphomasEATLCeliac patients with abdominal pain and small intestine obstruction/perforationDuodenum and jejunumMultiple erosions and ulcersCD3+, CD4-, CD8+/-, CD7+, CD5-, CD2+, TIA+, GrBPer+, CD30-/+, CD25-/+, CD56-/+, CD16-, CD57-, BCL6-, CD10-, EBV-, EMA-/+TRB and TRG clonally rearranged +9q31.3 -16q12.1 +1q32.2-q41 +5q34-q35.2 +8q24 (MYC)Poor
PTCLPoor performance statusStomach and duodenumUlcerativeCD3+, CD4+, CD8-, CD7+, CD5+, CD2+, TIA-, GrBPer-, CD30-/+, CD25-, CD56-, CD16-, CD57-, BCL6-, CD10-, EBV-, EMA-1TCR clonally rearranged +7q/+8q/+17q/+22q/-4q -5q/-6q/-9p/-10q/-12q/-13q54% survival at five year Poor in case of high IPI score and stage III-IV disease
Extranodal NK/T-cell lymphomaGastrointestinal bleeding and B symptomsSmall intestineMultiple erosions and ulcerscyCD3+, CD4-, CD8-/+, CD7-, CD5-, CD2+, TIA+, GrBPer+, CD30-, CD25-, CD56+, CD16-, CD57-, BCL6-, CD10-, EBV+, EMA-TCR in germinal configuration No specific cytogenetic studies on this specific subtypePoor especially if perforation occurs
Adult T-cell leukemia/lymphomaAbdominal pain, diarrhea, general fatigue, weight lossNo site preferencesUlcersCD3+, CD4+, CD8-, CD7-, CD5+, CD2+, TIA-, GrBPer-, CD30-/+, CD25++, CD56-, CD16-, CD57-, BCL6-, CD10-, EBV-, EMA-TCR clonally rearranged Monoclonal integration of HTLV-1Poor2 Good3
Indolent lympho-prolipherative diseases of GI tractT-LPDDyspepsia and mild diarrheaSmall intestine and colonUnremarkable/friable or erythematous mucosaCD3+, CD4-, CD8+, CD7+/-, CD5+/-, CD2+, TIA+/-, GrBPer-/+, CD30-, CD56-, EBV-TCR-γ monoclonalIndolent course
NK-cell enteropathyVague symptoms (dyspepsia)Stomach and small intestineLesions exhibit superficial ulceration, flat elevations with central depression and are associated with edema and local hemorrhagecCD3+, CD4-, CD8-, CD7+, CD5-, TIA+, GrBPer+, CD56+, EBV-TRC polyclonal or oligoclonalIndolent course
Mantle cell lymphomaVague symptoms (dyspepsia)ColonMultiple polyposis, seldom with ulcerationsCD19+, CD20+, CD5+, CD10-, CD43+, sIg+, BCL6-, IRF4/MUM1-, Cyclin D1+BCR rearranged t(11;14)(q13;q32)Negative impact on prognosis
Follicular lymphomaVague symptoms (dyspepsia)Second part of duodenumWhitish polypsCD19+, CD20+, CD5-, CD10+, CD43-, sIg+, BCL6+, IRF4/MUM1-/+, Cyclin D1-, α4β7+BCR rearranged t( 14:18)(q32:q2 1)Good
Extramedullary plasmacytomaAlarm symptoms and obstructionStomachInfiltrating massPlasmacells expressing CD79a+, CD38+, CD19-, CD138+, CD56+, usually CD20-BCR rearranged t(11;14)(q32;q13)Poor
PTLDAlarm symptomsColonRubbery erythematous or ulceratedSimilar to DLBCL and Burkitt’s lymphoma CD19+, CD20+, CD5-/+, CD10-/+, CD43-/+, sIg+/-, BCL6-/+, IRF4/MUM1-/+, Cyclin D1-Monoclonal BCRPoor median survival 6 mo
Plasmablastic lymphomaAlarm symptomsStomachLarge masses and exophitic processesCD79a+, CD138+, CD38+, IRF4/MUM1, CD45-, CD20, PAX5-, CD56-Clonal IgH chain gene rearranqementPoor
Hodgkin’s lymphomaObstructionColonProtruding massCD30+, CD15+, CD45-, CD20-, CD79a-, PAX5+, Ig-, OCT2-, BOB1-, CD3-, CD2-, CD5-, ALK-Clonal immunoglobulin gene rearrangeme ntsPrognostic impact not known
Table 3 Prevalence of gastrointestinal lymphomas among transplant recipients according to transplanted organ
TransplantPrevalence
Bone marrow0.50%
Liver1%-2%
Kidney0.7%-4%
Heart2%-10%
Small bowelup to 30%
Table 4 Reports of gastrointestinal plasmablastic lymphoma from 1998
ManuscriptYearlocalizationEndoscopic appearanceHIV
Pruneri et al[230]1998StomachLarge polypoid mass-
Colomo et al[231]2004Anal regionMass+
Dong et al[232]2005GI tractNot reported+
Small IntestineNot reported+
Tavora et al[228]2006Anal regionNot reported+
Anal regionExophytic mass+
Taddesse-Heath et al[233]2010Small intestine/colon (2 cases)Not reported+
Brahmania et al[234]2011Ano-rectal junctionHypervascular cauliflower-like mass-
Mihaljevic et al[235]2012StomachNot reported-
Hashimoto et al[236]2012StomachNot reported-
Chapman-Fredricks et al[229]2012StomachNot reported+
Luria et al[237]2014Anal regionMass+
SigmaMass-
Small bowelNot reported-
IleumNot reported-