Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2017; 23(35): 6491-6499
Published online Sep 21, 2017. doi: 10.3748/wjg.v23.i35.6491
Gastrosplenic fistula occurring in lymphoma patients: Systematic review with a new case of extranodal NK/T-cell lymphoma
Dong Hyeok Kang, Jimi Huh, Jong Hwa Lee, Yoong Ki Jeong, Hee Jeong Cha
Dong Hyeok Kang, Jimi Huh, Jong Hwa Lee, Yoong Ki Jeong, Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 682-714, South Korea
Hee Jeong Cha, Department of Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 682-714, South Korea
Author contributions: Kang DH and Huh J performed the literature selection, data extraction, and initial drafting of the manuscript; Lee JH and Jeong YK conceptualized and designed the review and performed critical revision/editing of the manuscript; Cha HJ provided pathology data and performed critical revision/editing of the manuscript; all authors reviewed and approved the final manuscript as submitted.
Conflict-of-interest statement: No authors have conflict-of-interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jimi Huh, MD, Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, 682-714, Ulsan 682-714, South Korea. jimihuh@mail.ulsan.ac.kr
Telephone: +82-52-2508913 Fax: +82-52-2301155
Received: April 6, 2017
Peer-review started: May 4, 2017
First decision: June 7, 2017
Revised: June 20, 2017
Accepted: July 24, 2017
Article in press: July 24, 2017
Published online: September 21, 2017
Processing time: 142 Days and 15.8 Hours
Abstract
AIM

To provide the overall spectrum of gastrosplenic fistula (GSF) occurring in lymphomas through a systematic review including a patient at our hospital.

METHODS

A comprehensive literature search was performed in the MEDLINE database to identify studies of GSF occurring in lymphomas. A computerized search of our institutional database was also performed. In all cases, we analyzed the clinicopathologic/radiologic features, treatment and outcome of GSF occurring in lymphomas.

RESULTS

A literature search identified 25 relevant studies with 26 patients. Our institutional data search added 1 patient. Systematic review of the total 27 cases revealed that GSF occurred mainly in diffuse, large B-cell lymphoma (n = 23), but also in diffuse, histiocytic lymphoma (n = 1), Hodgkin’s lymphoma (n = 2), and NK/T-cell lymphoma (n = 1, our patient). The common clinical presentations are constitutional symptoms (n = 20) and abdominal pain (n = 17), although acute gastrointestinal bleeding (n = 6) and infection symptoms due to splenic abscess (n = 3) are also noted. In all patients, computed tomography scanning was very helpful for diagnosing GSF and for evaluating the lymphoma extent. GSF could occur either post-chemotherapy (n = 10) or spontaneously (n = 17). Surgical resection has been the most common treatment. Once patients have recovered from the acute illness status after undergoing surgery, their long-term outcome has been favorable.

CONCLUSION

This systematic review provides an overview of GSF occurring in lymphomas, and will be helpful in making physicians aware of this rare disease entity.

Keywords: Gastrosplenic fistula; Lymphoma; NK/T-cell lymphoma; Systematic review

Core tip: Gastrosplenic fistula (GSF) is a very rare complication occurring in lymphomas. Due to its rarity, GSF had not been well-investigated. Therefore, we intend to provide an overall spectrum of GSF occurring in lymphomas through a systematic review. GSF occurred mainly in diffuse, large B-cell lymphoma, but also in various kinds of lymphoma. Common clinical presentations are constitutional symptoms and abdominal pain. Occasionally, acute gastrointestinal bleeding and splenic abscess have occurred. Computed tomography was helpful for diagnosing GSF and for evaluating the lymphoma extent. GSF could occur either post-chemotherapy or spontaneously. Surgical resection has been the most common treatment.