Primary Gastrointestinal Non-Hodgkin Lymphoma Diagnosed after Emergency Surgery

Aim: The present retrospective study aims to evaluate the data of 15 patients who required immediate surgical intervention because of obstruction and/or perforation due to primary gastrointestinal Non-Hodgkin lymphoma.

Methods: Patients who underwent surgical intervention due to gastrointestinal system bleeding, radiological evidence of perforation or intestinal obstruction and subsequently diagnosed with gastrointestinal lymphoma at Department of General Surgery, Kocatepe University during August 2007 to September 2016 were examined retrospectively. Their medical records, clinical histories, symptoms, pathological reports, and treatment modalities were analysed.

Results: There were 15 patients with primary gastrointestinal system lymphomas (male: 8, female: 7) with their mean age of 69.7 years (40-90). Tumors were determined in stomach for 7 (46.7%) patients (Kardia: 3, Antrum: 3, Corpus: 1), in jejunum for one (6.6%), in ileum for 4 (26.7%), in right colon for 2 (13.3%), and in multiple organ involvement for one patient (6.6%). Clinical manifestations were nausea and/or vomiting in 7 patients (46.6%); loss of appetite in 8 patients (53.3%); abdominal pain in 11 patients (73.3%); and weight loss in 10 patients (66.6%). The most common pathological subtype was diffuse large B-cell lymphoma (86.6%). All 15 patients underwent surgical treatment and received postoperative chemotherapy. The mean follow-up period of the patients was 68 months (24-108 months). Only one patient (6.6%) died in the postoperative period.

Conclusion: Initial presentation of primary gastrointestinal tract Non-Hodgkin lymphoma may be an obstruction, bleeding, or perforation. Clinicians and surgeons should keep this in mind while assessing the patients with mechanic bowel obstruction.