Gastrointestinal lymphoma: prevention and treatment of early lesions

• Published in: Baillière's best practice & research. Clinical gastroenterology 2001-04, Vol.15 (2), p.337-354
• Main Authors: Ruskoné-Fourmestraux, Agnès, Rambaud, Jean Claude
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Combined Modality Therapy; enteropathy-associated T-lymphoid disease; epidemiology; Female; gastric; Gastrointestinal Neoplasms - complications; Gastrointestinal Neoplasms - diagnosis; Gastrointestinal Neoplasms - mortality; Gastrointestinal Neoplasms - prevention & control; Helicobacter pylori; Humans; immunoproliferative small intestinal disease; infectious disease; intestinal; lymphoma; Lymphoma, B-Cell, Marginal Zone - complications; Lymphoma, B-Cell, Marginal Zone - diagnosis; Lymphoma, B-Cell, Marginal Zone - mortality; Lymphoma, B-Cell, Marginal Zone - prevention & control; Lymphoma, Non-Hodgkin - complications; Lymphoma, Non-Hodgkin - diagnosis; Lymphoma, Non-Hodgkin - mortality; Lymphoma, Non-Hodgkin - prevention & control; Male; MALT; Mass Screening - methods; oncogenesis; Precancerous Conditions - diagnosis; prevention; Prognosis; Severity of Illness Index; Survival Rate; treatment; Treatment Outcome
• ISSN: 1521-6918; 1532-1916
• DOI: 10.1053/bega.2000.0177

Gastrointestinal lymphomas comprise a group of distinct clinicopathological entities. Differences in lifestyle and environmental factors between countries could account for the variety in the distribution of the main subtypes: low-grade B-cell lymphomas of the mucosa-associated lymphoid tissue type, alpha-chain disease and enteropathy (coeliac disease)-associated T-cell lymphoma (EATL). The possibility of preventing these lymphomas implies a knowledge of their natural history together with an identification of potential predisposing factors. The development of the lymphoid hyperplasia and subsequently low-grade lymphoma with the possibility of high-grade transformation is a multifactorial process involving both antigenic and host-related factors. The pathogenic role of Helicobacter pylori and gluten has been demonstrated in gastric lymphoma and enteropathy-associated T-cell lymphoma respectively, while environmental factors, especially non-specific bacterial ones, may play a major role in the pathogenesis of alpha-chain disease. The most difficult task in preventing these lymphomas is the recognition of early lesions likely to regress after the removal of the exogenous stimulus.