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Primary malignant lymphoma of the breast. Lymphoma of the mucosa-associated lymphoid tissue.

Eight cases of primary non-Hodgkin's lymphoma of the breast found in the pathology files of the Institute of Oncology, Ljubljana, Yugoslavia, for a period of 25 years (from 1961 to 1985) were analyzed. During the same period 5711 cases of breast carcinoma were seen. Seven cases were diffuse lymphomas, and one case was nodular. Five cases were high-grade large cell lymphomas and three cases were of low-grade type. One case of the latter group was associated with elevated IgA in the serum and showed monoclonal reaction of plasmacytic lymphoma cells for kappa light chain and IgA. In this case amyloid deposits were seen in the breast tumor. In six cases, focal infiltration of ductal/lobular epithelium by lymphoma cells was found. This so-called lymphoepithelial lesion appears to be an important characteristic of various mucosa-associated lymphoid tissue lymphomas which have been described in different extranodal sites (e.g. gastrointestinal tract, and respiratory tract). They may show different behavior from nodal counterparts, especially in terms of their spread to other mucosal sites which may appear before or without nodal dissemination. The breast appears to be yet another location for these lymphomas.

Adult↗

A new multi-parameter flow cytometric assay for monitoring lymphoma growth and spread in a pre-clinical murine model for human lymphoma.

BACKGROUND: Mouse survival is commonly used as an indirect measure of lymphoma tumor response to anti-idiotype vaccine; however, this gives no information regarding residual lymphoma cells at primary or metastatic sites. We aimed to develop a method with which to monitor lymphoma tumor kinetics in the mouse as an independent measure of vaccine efficacy. METHODS: We developed a multi-parameter flow cytometric (MPFC) assay for 38C13 mouse lymphoma cells using sequential gating to detect aberrant antigen expression and binding by an anti-idiotype antibody (S1C5). Subsequently, we tested the utility of the MPFC assay in a 38C13 tumor modeling study in the C3H/HeN mouse. RESULTS: The MPFC assay was demonstrated in vitro to have both high specificity and sensitivity for 38C13 lymphoma cells. In tumor kinetic studies in the C3H/HeN mouse, as the tumor enlarged, the MPFC assay showed increasing prevalence of 38C13 cells at the inoculation site in addition to metastases to lymphoid organs and bone marrow. The latter findings were confirmed by both histology and immunohistochemistry. CONCLUSIONS: The MPFC assay is an independent parameter for monitoring 38C13 lymphoma kinetics and could be used to monitor tumor response to individual vaccines or other lymphoma therapy prior to clinical trials.

Animals↗

Expression of leukocyte common antigen in lymphoblastic lymphoma and small noncleaved undifferentiated non-Burkitt's lymphoma: an immunohistochemical study.

Nine cases of lymphoblastic lymphoma and eight cases of small, noncleaved undifferentiated non-Burkitt's lymphoma were studied. All cases were stained with monoclonal antibodies, directed to the leukocyte common antigen (LCA), B- and T-cell markers as well as Calla. Small noncleaved, undifferentiated non-Burkitt's lymphomas were LCA positive and expressed one or more B-cell markers. Three cases of lymphoblastic lymphoma were LCA positive and showed reactivity with antibodies OKT4, OKT6 and OKT8. The six remaining cases of lymphoblastic lymphoma were LCA negative, except for only one case that was weakly LCA positive using more sensitive detection methods. Two of the LCA negative cases expressed Calla, and four cases did not show any reactivity with the monoclonal antibodies used. In all LCA negative cases, small residual non-neoplastic nodules representing remnants of lymphoid follicles, could be detected. Since five out of nine cases of lymphoblastic lymphoma were LCA negative, lack of staining for LCA does not preclude the diagnosis of lymphoma.

Adolescent↗

Human peripheral gamma delta T cells are stimulated by Daudi Burkitt's lymphoma and not by any other Burkitt's lymphoma tested.

Daudi Burkitt's lymphoma cells have molecules on their surface which can stimulate proliferation of human gamma delta T cells, while Raji, another Burkitt's lymphoma, cannot stimulate human gamma delta T cells. Human peripheral gamma delta T cells, coexpressing the V gamma 9/V delta 2 chains of the T cell receptor, lyse Daudi cells but not Raji cells. Here, we have screened four other Burkitt's lymphoma cell lines (HH514, DG75, Ramos, and Wilson), as well as cells derived from a fresh Burkitt's lymphoma, to see if any of them can be recognized by human gamma delta T cells. Leukemia-derived lines MOLT-4, CEM, and K562 have also been included in these studies. Among the Burkitt's lymphomas tested, only Daudi, DG75, and HH514 could be lysed by V gamma 9/V delta 2+ T cell clones derived from the peripheral blood of healthy donors. These T cell clones were also able to lyse the NK sensitive leukemia lines K562 and MOLT-4. When bulk cultures of peripheral blood mononuclear cells from healthy donors were cultured with different Burkitt's lymphoma or leukemia cell lines, only Daudi stimulated the outgrowth of gamma delta T cells. Similarly, only Daudi cells could stimulate proliferation of gamma delta T cell clones, and the response was enhanced significantly in the presence of interleukin-2. These data and our prior observations showing the use of the V gamma 9/V delta 2 TCR type by Daudi-reactive human gamma delta T cells indicate that Daudi cells are not representative of other Burkitt's lymphoma cell lines.

Burkitt Lymphoma↗

Primary hepatic marginal zone B-cell lymphoma with mantle cell lymphoma phenotype.

We report a rare case of primary hepatic lymphoma, Stage II disease, in a 48-year-old male who had a solitary hepatic tumour measuring 4 x 4.5 x 3 cm. The tumour showed a nodular growth pattern and lymphoepithelial lesions with bile ducts. Some neoplastic nodules had a non-neoplastic atrophic germinal centre and/or a thin mantle cell layer. Morphologically, the neoplastic cells were centrocyte-like cells or intermediate lymphocytes. They expressed L26(CD20)+/LN-1(CDw75)+/-/LN-2(CD74)+/cyclin D1- and had a monotypic immunoglobulin of cytoplasmic IgM (kappa) on paraffin sections. The neoplastic cells or neoplastic nodules expressed surface IgM+/surface IgD+/-/Leu-1(CD5)+/DRC-1+/alkaline phosphatase+/B1(CD20)+/B4(CD19)- on fresh frozen sections. We therefore diagnosed this case as primary hepatic marginal zone B-cell lymphoma with mantle cell lymphoma phenotype. We confirm that it is difficult to differentiate extranodal marginal zone B-cell lymphoma (low grade B-cell lymphoma of mucosa-associated lymphoid tissue type; MALT lymphoma) and mantle cell lymphoma.

Biopsy, Needle↗

Development of stroma in malignant lymphomas of the brain compared with epidural lymphomas. An immunohistochemical study.

The relation of lymphoma cells to gliomesenchymal stroma within nervous tissue was studied by peroxidase-antiperoxidase immunostaining of formalin-fixed and paraffin-embedded surgical specimens for fibronectin (FN), factor VIII-related antigen and glial fibrillary acidic protein in 17 malignant non-Hodgkin lymphomas of the brain. For comparison, 9 non-Hodgkin lymphomas, 6 Hodgkin lymphomas, and 19 plasmacytomas of the spinal or cranial epidural spaces were studied with the same methods. Lymphoma cells were consistently negative for all markers. All lymphomas of the brain showed conspicuous concentric perivascular circles of immunoreactivity for FN in parts infiltrating brain tissue. Such structures are considered to derive from splitting of basal laminae of preexisting brain vessels; they were not seen in tumors of the epidural space. Cells with conspicuous FN content were found in brain as well as in epidural lymphomas. A monohistiocytic origin of those cells was confirmed by presence of monohistiocytic markers lysozyme and alpha-1-anti-chymotrypsin. Thus, additional immunostaining for FN seems to be useful for detecting monohistiocytes/macrophages in brain tumors.

Antigens↗

Differential expression of cyclin D1 in mantle cell lymphoma and other non-Hodgkin's lymphomas.

Mantle-cell lymphomas are associated with a characteristic chromosomal translocation, t(11;14)(q13;q32). This translocation involves rearrangement of the bcl-1 proto-oncogene from chromosome 11 to the immunoglobulin heavy chain gene on chromosome 14, resulting in an overexpression of cyclin D1 mRNA (also known as bcl-1 and PRAD1). In the current study performed on paraffin-embedded tissue, cyclin D1 mRNA could be detected in 23 of 24 mantle-cell lymphomas by reverse transcription polymerase chain reaction (RT-PCR) whereas only 9 of 24 demonstrated a t(11;14) by PCR. However, we also found that cyclin D1 mRNA could be detected in the majority (11 of 17, 65%) of non-mantle-cell lymphomas and in a minority of atypical lymphoid hyperplasias (3 of 7, 43%). Cyclin D1 mRNA expression was not observed in floridly reactive lymph nodes (0 of 9) or in unstimulated lymph nodes (0 of 20), suggesting that it is a sensitive adjunct marker for malignant lymphoproliferative processes, but not specific for mantle-cell lymphoma. A semiquantitative RT-PCR assay was developed that compared the ratio of cyclin D1 to the constitutively expressed gene beta2-microglobulin. Using this assay on a limited number of our specimens, cyclin D1 overexpression in mantle-cell lymphoma could be reliably distinguished from its expression in other non-Hodgkin's lymphomas. This assay for cyclin D1 expression, designed for formalin-fixed, paraffin-embedded tissue, was a very sensitive and specific marker for mantle-cell lymphoma.

Adult↗

Localized aggressive non-Hodgkin's lymphoma of the nasal cavity: a survey by the Japan Lymphoma Radiation Therapy Group.

PURPOSE: To clarify the role of radiotherapy and chemotherapy in the treatment of patients with localized aggressive non-Hodgkin's lymphomas (NHL) originating in the nasal cavity. METHODS AND MATERIALS: The survey, administered at 25 Japanese institutes in 1998, enabled us to collect the clinical data for 787 patients with localized aggressive NHL who were treated between 1988 and 1992. RESULTS: There were 42 patients (5%) with nasal lymphomas. Twelve of these patients received radiotherapy alone, and 30 were treated with a combination of radiotherapy and chemotherapy. The median radiation dose was 47 Gy (22-66). Twelve patients were reviewed histopathologically according to REAL (Revised European-American Classification of Lymphoid neoplasms) classification. T-cell or natural killer (NK) cell lymphomas were detected in 9 patients (75%), and diffuse large B-cell lymphomas in 3 (25%). The 5-year overall and disease-free survival (DFS) rates of all patients were 57% and 59%, respectively. The 5-year DFS rate for the 30 patients treated with the combined therapy was 64% and that for the 12 patients treated with radiotherapy alone was 46% (p = 0.021). For the 34 patients with stage-modified International Prognostic Index (m-IPI) 0-1, the 5-year DFS rates of those treated with the combined therapy and radiotherapy alone were 68% and 45%, respectively (p = 0.020), but there was no difference in DFS rate among the two groups of patients with m-IPI 2-3. The 5-year local control rates of the patients who received >46 Gy (n = 22) and < or =46 Gy (n = 20) were 95% and 76% (p = 0.087), respectively. There was no significant difference among the 5-year DFS rates (62% vs. 67%) and local control rates (87% vs. 100%) of the patients with T-cell or NK-cell lymphoma and diffuse large B-cell lymphoma. CONCLUSIONS: Patients with nasal lymphomas (m-IPI 0-1) should be treated with combined therapy. For the patients with high risk (m-IPI 2-3), the effectiveness of combined therapy was not clarified because of the small number of the patients. A high radiation dose >46 Gy may need to be used to achieve good local control.

Adolescent↗

B-cell lymphoma accompanying monoclonal macroglobulinemia with features suggesting marginal zone B-cell lymphoma.

Waldenstroem's macroglobulinemia is usually closely related to a histopathologic subtype called lymphoplasmacytoid lymphoma in the Revised European-American Lymphoma (REAL) classification. Here, we report a case of B-cell lymphoma accompanied by monoclonal macroglobulinemia and pathologically compatible with marginal zone B-cell lymphoma (MZBCL) rather than lymphoplasmacytoid lymphoma. The patient was a 74-year-old man with lymphomatous lesions that were recognized as submandibular lymphadenopathy, subcutaneous tumor and bilateral orbital masses, but with no bone marrow involvement. The atypical lymphoid cells that occupied the lymph node were varied such as small cells harboring irregular nuclei, monocytoid B-cells, large cells with vesicular nuclei, and plasma cells. The tumor cells expressed CD19, CD20, IgM and kappa on their cell surfaces and cytoplasmic IgM, but not CD5 or CD10. These findings suggest that the clinical and histopathologic findings of this case are compatible with those of MZBCL rather than lymphoplasmacytoid lymphoma. Serum IgM was elevated up to 4080 mg/dl and M-proteinemia of IgM-kappa type was confirmed by immunoelectrophoresis. Hyperviscosity syndrome caused by monoclonal IgM was not apparent. Immunohistochemical study confirmed that monoclonal IgM-kappa was produced and secreted from the tumor cells of MZBCL. This case suggests a close relationship between MZBCL and lymphoplasmacytoid lymphoma, from the perspective of the cellular origin during B-cell differentiation.

Aged↗

Epidemiology of the non-Hodgkin's lymphomas: distributions of the major subtypes differ by geographic locations. Non-Hodgkin's Lymphoma Classification Project.

BACKGROUND: There has been no previous systematic study of the distribution of the major subtypes of non-Hodgkin's lymphoma (NHL) across geographic regions, although there have been isolated reports of such differences. DESIGN: As part of a clinical evaluation of the International Lymphoma Study Group (ILSG) classification of NHL, we classified 1378 NHLs from eight different geographic sites (Omaha, NE, USA; Vancouver, BC, Canada; Capetown, South Africa; London, England; Würzburg/Göttingen, Germany; Lyon, France; Locarno/Bellinzona, Switzerland; and Hong Kong) using the ILSG classification. RESULTS: Substantial differences were found in the distribution of the major subtypes of NHL across geographic regions (P < 0.0001). A greater percentage of follicular lymphoma was seen in North America, London and Capetown (31% versus 14% at other sites). Peripheral T-cell lymphoma was more common in London, Capetown and Hong Kong (9%) than elsewhere (3%). In Locarno/Bellinzona, higher percentages of mediastinal large B-cell lymphoma (9% versus 2% elsewhere) and mantle cell lymphoma (14% versus 6% elsewhere) were seen. Angiocentric nasal T-/NK-cell lymphoma was only seen in Hong Kong (8%) and Lyon (2%). CONCLUSIONS: Our study provides evidence that the distribution of NHL subtypes differs by geographic region. These findings suggest that geographical differences in etiologic or host factors may be responsible for the observed differences in the distribution of cases across NHL subtypes.

Canada↗

Autologous PBPCT in a patient with lymphoma and Sjögren's syndrome: complete remission of lymphoma without control of the autoimmune disease.

A patient with primary Sjögren's syndrome developed massive gland enlargement and was diagnosed a MALT-type lymphoma stage IIA. After initial radiotherapy the patient relapsed with high grade immunoblastic lymphoma. Chemotherapy led to remission of the lymphoma and improvement of the autoimmune disease. A peripheral blood stem cell harvest was performed. However, subsequent to standard chemotherapy the patient experienced an exacerbation of arthralgia and vasculitis while his lymphoma remained in partial remission. With additional chemotherapy and steroid treatment complete remission of the lymphoma and autoimmune disease was achieved and high-dose chemotherapy followed by PBPCT with an unmanipulated graft was performed. Engraftment was prompt with no signs of active autoimmune disease after the transplantation. Two months later, signs of autoimmune disease slowly recurred. Steroid treatment improved this, but the patient remained steroid-dependent and later died from therapy-resistant Pneumocystis carinii pneumonia while the lymphoma remained in complete remission. In this patient with systemic Sjögren's disease, PBPCT completely controlled the aggressive lymphoma but was not permanently effective for the autoimmune disease.

Adult↗

Clinical characteristics and pathological classification of non-Hodgkin's lymphoma in Kuwait. Results of a collaborative study with the International Lymphoma Study Group (ILSG).

Kuwait was chosen by the International Lymphoma Study Group (ILSG) as one of the sites attending in the project on "Clinical characteristics and pathological classification of non Hodgkin's lymphoma (NHL) in the developing countries". The Kuwait study involved 206 cases of NHL, diagnosed, staged and treated in the Kuwait Cancer Control Center (KCCC). All cases were reviewed and reclassified independently by the pathologists of KCCC and the International Lymphoma Study Group (ISLG) using the latest World Health Organization (WHO) classification of neoplastic disease of the hematopoietic and lymphoid tissues. Immunophenotyping as to B- or T-cell was documented in all cases. Three main pathological entities (diffuse large B-cell lymphoma, follicular lymphoma, peripheral T-cell lymphoma) were identified and studied thoroughly. The intense cooperation between experts of the ISLG and pathologists of the KCCC proved that the WHO classification was fully reproducible in Kuwait. The high incidence of extranodal lymphomas (53%) observed in the KCCC may not be due to special ethnic or environmental conditions in Kuwait but rather be due to a selection of patients coming to our center.

Adolescent↗

Hepatosplenic alphabeta T-cell lymphomas: a report of 14 cases and comparison with hepatosplenic gammadelta T-cell lymphomas.

Hepatosplenic gammadelta T-cell lymphoma is a distinct entity, characterized by occurrence in young adult males with hepatosplenomegaly, B-symptoms, peripheral blood cytopenias, and no lymphadenopathy; lymphomatous infiltrates in the splenic red pulp, hepatic sinusoids, and bone marrow sinuses; T-cell receptor (TCR) gammadelta chains and a cytotoxic T-cell phenotype; isochromosome 7q; and an aggressive clinical course. In comparison, this study describes the clinicopathologic features of 14 hepatosplenic T-cell lymphomas expressing TCR alphabeta chains. They occurred in 11 women and 3 men with a median age of 36 years. Clinical presentation was similar to that described previously for hepatosplenic gammadelta T-cell lymphomas, except for the female preponderance and age distribution (5 patients younger than 13 years of age and 5 patients older than 50 years of age). Disease distribution was primarily in the splenic red pulp and hepatic sinusoids, although liver infiltrates were largely periportal in four cases. Bone marrow involvement, observed in eight patients, was usually interstitial and/or within the sinuses. Lymph nodes were involved in five patients, although lymphadenopathy was demonstrable in only two. Ten cases were composed of intermediate-size tumor cells with round/oval nuclei, slightly dispersed chromatin, inconspicuous nucleoli, and scant to moderate amounts of cytoplasm. Four lymphomas contained primarily large cells with irregular nuclei, dispersed chromatin, discernible nucleoli, and moderate to abundant cytoplasm. Tumor cells in all 14 lymphomas were cytotoxic alphabeta T-cells; 13 co-expressed natural killer cell-associated antigens and showed T-cell clonality. Three lymphomas were associated with Epstein-Barr virus. Two of four cases had an isochromosome 7q. Eleven patients are dead, eight within a year of diagnosis, and two patients have maintained complete remissions after combination chemotherapy. These data show that hepatosplenic T-cell lymphomas include an alphabeta-subtype. This group, along with the previously recognized gammadelta group, should be recognized as phenotypically heterogeneous subtypes of the same disease entity.

Adult↗

A common clonal origin of nodal marginal zone B-cell lymphoma and plasma cell myeloma demonstrating different immunophenotypes: a case report of composite lymphoma.

We demonstrated an 83-year-old male case of composite lymphoma. Before 18 years, he was diagnosed with nodal marginal zone B-cell lymphoma in the cervical lymph node. Peripheral blood showed anemia and IgA (kappa)-type monoclonal gammopathy (IgA; 3,625 mg/dL). Bone marrow aspiration biopsy exhibited plasma cell myeloma, in which atypical plasma cells were positive for cytoplasmic IgA (kappa) and atypical lymphoid cells intermingled were positive for CD20. In contrast, cervical lymph node biopsy revealed nodal marginal zone B-cell lymphoma, in which lymphoma cells were positive for cytoplasmic IgG (lambda). Southern blotting analysis of the IgH gene showed same clonal rearrangement band in both lymph node and bone marrow samples and additional band in the bone marrow. Sequence analyses of the IgH gene showed an identical sequence of CDR3 in both samples. Thus, we demonstrated a common clonal origin of composite lymphoma comprising nodal marginal zone B-cell lymphoma and plasma cell myeloma. Nodal marginal zone B-cell lymphoma recurred in cervical lymph node and involved into the bone marrow, differentiating into plasma cell myeloma in which Ig isotype switched and monoclonal gammopathy developed. Sequence analysis of the IgH gene was a powerful tool for determination of clonal origin.

Aged↗

A translocation involving a specific breakpoint (q35) on chromosome 5 is characteristic of anaplastic large cell lymphoma ('Ki-1 lymphoma').

Two cases of non-Hodgkin's lymphoma are reported in which a chromosomal translocation was observed involving the same site (q35) on the long arm of chromosome 5. The other breakpoint involved in the translocation was chromosome 2 (p23) in one case and chromosome 3 (q12) in the other. Both cases were large cell lymphomas expressing CD30 antigen ('Ki-1 lymphoma'). One was clearly of T lymphoid origin, the other probably B cell derived. One other case of a Ki-1 lymphoma with 2;5 translocation (involving the same breakpoint on chromosome 5) has been reported previously, and it is suggested that this cytogenetic abnormality may be specifically associated with Ki-1 lymphoma. The literature contains a further eight cases of lymphoid neoplasms with a translocation involving a breakpoint at q35 on chromosome 5. They have all been described as cases of 'malignant histiocytosis', but the present findings make it likely that these cases were in reality also examples of Ki-1 lymphoma. The breakpoint at the q35 region on chromosome 5 is close to the position of the fms proto-oncogene, suggesting that an abnormality affecting this gene might possibly play a causal role in 'Ki-1 lymphoma'. However, DNA restriction fragment analysis of the present cases showed no evidence that the breakpoint on chromosome 5 involves the fms gene or its immediate vicinity.

Adolescent↗

Comparison of different lymphoma cell purging modalities: An experimental study with K422 lymphoma cells.

Blood-derived autografts from patients with non-Hodgkin's lymphoma (NHL) are frequently contaminated with clonogenic lymphoma cells. In order to obtain a more efficient lymphoma cell depletion from the transplants we compared the efficiency of different purging techniques: B-cell-directed depletion, CD34+ selection by immunomagnetic beads (IMB selection) or by immunoadsorption with a biotin-avidin column (BAC selection). Furthermore, two combination approaches were investigated: IMB selection after B-cell depletion as well as BAC selection after B-cell depletion. To assess purging efficiency, fluorescence-tagged (PKH26) K422 follicular NHL cells were admixed to the respective samples of leukapheresis products. BAC selection following B-cell depletion compared to BAC selection alone showed no significant differences in CD34+ purity (77 +/- 12. 5% vs. 70.7 +/- 5.4%) (mean +/- SE) or CD34+ recovery (35.3 +/- 8.5% vs. 32.8 +/- 10.4%), but a significantly (p < 0.005) higher lymphoma cell purging efficiency (log 4.32 +/- 0.15 vs. log 2.92 +/- 0.19). IMB selection following B-cell depletion and IMB selection alone resulted in a CD34+ purity of 40.8 +/- 8.7% and 64.7 +/- 7.9%, a CD34+ recovery of 47.2 +/- 8.3% and 26.5 +/- 6.5% and a lymphoma cell purging efficiency of log 3.68 +/- 0.16 and log 3.48 +/- 0.21, respectively. Lymphoma cell purging efficiency after either CD34 selection method alone as well as after either double purging method was significantly higher (p < 0.0005 and p < 0.00005, respectively) compared to B-cell depletion alone (log 1.44 +/- 0.23). Our results argue for the combination of different purging modalities to achieve a maximal lymphoma cell depletion.

Antigens, CD34↗

Localised extranodal non-Hodgkin's lymphoma of the gastrointestinal tract: Sheffield Lymphoma Group experience (1989-1998).

Extranodal non-Hodgkin's lymphoma (NHL) of the gastrointestinal tract accounts for about one third of all extranodal NHL. We retrospectively reviewed the clinical and histopathologic records of 71 patients with stage IE and IIE primary gastrointestinal NHL referred to the Sheffield Lymphoma Group (SLG) from 1989 to 1998. Cross-referencing with the Hospital Histopathology Department database revealed that only two-thirds of all cases were seen by the Group. The most common primary site was the stomach (45 patients, 63% of all cases), followed by the small intestine (16, 23%) and large intestine (9, 13%). The median age of patients was 62 years; the majority of patients presented with stage I (61%) and/or grade (65%) NHL. Mucosa-associated lymphoid tissue (MALT) lymphomas were the largest histologic subtype seen (57%), with 87% of these arising from the stomach; next most frequent was the diffuse large B-cell subtype (21% of all cases) most frequently arising from the intestine (60%). For treatment of gastric MALT lymphoma, a combined approach (surgery followed by chemotherapy, antihelicobacter therapy followed by chemotherapy) was favoured (22 cases). Five-year and 10-year overall survivals were 52% and 45% respectively. Knowledge of the Revised European American Lymphoma classification and the Helicobacter pylori/MALT association has influenced treatment approaches over the 10-year study period. For small intestinal lymphoma, surgery (with or without chemotherapy) gave 5- and 10-year survivals of 60%. Overall survival of patients with primary gastrointestinal lymphoma managed by the SLG is similar to that reported from other large series.

Adult↗

[NK-cell lymphomas and NK-like T-cell lymphomas].

Two types of NK(natural killer)-cell lymphomas have been described. One is "nasal and nasal-type NK-cell lymphoma", and the other is "blastic NK-cell lymphoma". Nasal and nasal-type NK-cell lymphoma is characterized by an extranodal presentation, angiocentric and angiodestructive proliferation, LGL(large granular lymphocyte) morphology, CD2+CD3-CD16-/+CD56+CD57- phenotype, and an aggressive clinical course. Blastic NK-cell lymphoma, a recently described rare disease, is characterized by a frequent manifestation into the skin, lymphoblastic morphology, CD2-/+CD3-CD4+/-CD16-CD56+CD57- phenotype, and a poor prognosis. Recently described "NK-like T-cell lymphomas" are defined as lymphomas of NK-like T-cell(MHC-unrestricted CTL) origin, and are characterized by an extranodal manifestation, LGL morphology, CD3+CD4-CD8+CD16+/-CD56+CD57- phenotype, and an aggressive clinical course.

Antigens, CD↗