Primary gastric lymphoma: A report of 16 pediatric cases treated at a single institute and review of the literature.

Nilgün Kurucu, Canan Akyüz, Bilgehan Yalçın, İnci Y Bajin, Ali Varan, Diclehan Orhan, İbrahim Karnak, Burça Aydın, Tezer Kutluk
Author Information
  1. Nilgün Kurucu: Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
  2. Canan Akyüz: Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
  3. Bilgehan Yalçın: Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
  4. İnci Y Bajin: Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
  5. Ali Varan: Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
  6. Diclehan Orhan: Department of Pediatric Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
  7. İbrahim Karnak: Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
  8. Burça Aydın: Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
  9. Tezer Kutluk: Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Abstract

Gastrointestinal tract is the most common extranodal site for childhood non-Hodgkin lymphomas (NHLs). However, primary gastric lymphoma (PGL) is very rare. We report our experience with PGL. Between 1972 and 2019, patients with PGL among 1696 NHL cases were evaluated retrospectively. Patient characteristics, treatments, and survival rates were recorded. We also reviewed the cases reported in literature. There were 16 PGL (11 males, five females) cases with a median age of 10 years. Most frequent complaints, similarly to the literature, were pain and vomiting. Hematemesis/melena and anemia were present in 20% of patients. Most common tumor location was antrum. Histopathological subtypes were Burkitt and non-Burkitt B-cell lymphoma in 43.75% and marginal zone lymphoma (MZL) in 6.25% of cases while mucosa-associated lymphoid tissue (MALT) and low-grade lymphomas constitute 15.3% of cases reported in the literature. In our series, Helicobacter pylori (H. pylori) was analyzed in only the case with MZL and found to be positive. However, H. pylori positivity was reported in 75% of the cases in the literature. H. pylori eradication, chemotherapy, and radiotherapy were applied in one, 14, and five patients. Subtotal gastrectomy with gastroduodenostomy/jejunostomy was performed in three patients. Gastrojejunostomy was done without tumor resection in two patients. Nine patients lived without disease for a median of 59 (12-252) months. Five-year EFS and OS were 69.6% and 64.3%, respectively. PGL constitutes 0.94% of our NHL cases. Interestingly, most of the cases in the literature were from Turkey. While adult PGL is mostly MALT lymphoma, most pediatric cases had high-grade histopathology. Although surgery and radiotherapy were applied earlier, chemotherapy alone is sufficient.

Keywords

MeSH Term

Adolescent
Child
Child, Preschool
Female
Gastrectomy
Gastric Bypass
Helicobacter Infections
Helicobacter pylori
Humans
Lymphoma, B-Cell, Marginal Zone
Lymphoma, Non-Hodgkin
Male
Retrospective Studies
Stomach Neoplasms
Survival Rate
Turkey

Word Cloud

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