Published online Jan 7, 2014. doi: 10.3748/wjg.v20.i1.296
Revised: November 2, 2013
Accepted: November 18, 2013
Published online: January 7, 2014
AIM: To investigate the clinical features, diagnosis, treatment and prognosis of intestinal T-cell lymphomas (ITCL) by retrospective analysis.
METHODS: Sixty-eight patients who were diagnosed with ITCL in case reports in the Chinese literature were compiled and reviewed. Age, gender, CD56 expression, surgical management, multifocal nature, perforation and cyclophosphamide chemotherapy were analyzed as the prognostic factors. The Kaplan-Meier method was adopted for the univariate analysis and the cumulative survival curve analysis.
RESULTS: The male-to-female ratio was 1.52 to 1. The median age was 41.7 years. Twenty-seven patients had symptoms of abdominal pain or diarrhea. Thirty-six of 60 patients with temperature records had high fevers at the onset of the illness. Twenty-six of 34 patients who underwent fiberoptic colonoscopy were misdiagnosed with Crohn’s disease, intestinal tuberculosis or cancer. Sixty-one patients underwent surgery. Twelve of 61 surgical patients required a second operation for anastomotic leakage or secondary perforation. The sites of lesion involvement were the jejunum (8.82%), ileum (29.41%), ileum and colon (4.41%), colon (55.88%) and appendix (1.47%). The median cumulative survival rate was 3 mo (3.00 ± 0.48).
CONCLUSION: Efforts should be made to correctly diagnose ITCL and select the proper operative approach that may reduce serious complications and create opportunities for further treatment.
Core tip: Intestinal T-cell lymphoma (ITCL) is a rare non-Hodgkin lymphoma of T-cell origin. ITCL is difficult to diagnose because its unique characteristics are clinically rare. The disease characteristics differ between the Western world and Asia. Most of these patients are misdiagnosed and suffer serious complications due to improper operative approaches. The prognosis of ITCL is poor. Large studies on this cancer remain scarce. We performed a statistical analysis of 68 cases collected from the Chinese literature to enhance our understanding of the histological definition, epidemiology, etiology, clinical features, surgical treatment and prognosis of ITCL.